Download [EXCLUSIVE] Her Mother's Daughter Season 1
One of my patients is 91 years of age, resides in a nursing home and is bedridden and noncommunicative. She has been more or less unresponsive for the past two years. The physicians who previously cared for her did not think intubation or hospitalization for acute problems were appropriate for this patient. The general consensus has supported palliative care. The daughter, who has power of attorney, has resisted the physicians' opinions. She has changed physicians every few months because she disagrees with the medical community about her mother's code status and hospital transfers. The daughter is in her 50s and spends four to six hours daily at her mother's bedside. Some nurses have said that they think the daughter is angry with her mother for a past hurt and that keeping her alive may be her way of punishing her mother.
Download Her Mother's Daughter Season 1
If the daughter's primary goal of treatment is to maximize the length of her mother's existence, a helpful step is to explore how prolongation of the mother's life has meaning for the daughter. What does her mother's continued existence as a living human being, albeit an unresponsive one, mean for the daughter? While the mother may not be responding verbally, she may be responding to the daughter physically, perhaps squeezing her hand or smiling in response to verbal stimulation. What does the daughter gain from the time she spends with her mother? Is the mother the daughter's only living relative? Any one or a combination of these factors may be preventing the daughter's emotional acceptance of palliation.
The daughter's ambivalence about her mother's death, the long hours spent at the mother's bedside and the staff 's second-guessing of the daughter's motives are cause for concern. It appears that there may be unresolved mother-daughter relationship issues that form a significant impediment to the daughter's acceptance of a palliation regimen. Failure to explore the daughter's psychosocial issues could foil even the best-executed contract of care.