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crap day. Advised in-law to put husband on hospice care ($0), not medical treatment ($5.7k/day)

Grammarhero

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my cousin-in-law’s husband has been in the ER the last eighteen (18) days to medically treat stage 4, bone marrow cancer. The medical bills the last eighteen (18) days total $102,600, but their co-pay is only $1,400.

However, the doctor indicated that they have done all they medically could, so the insurance won’t certify or cover further medical treatments, which moving forward would cost the middle-class family $5,700 per day. The doctors say continuing medical treatments have less than a 1 percent chance of survival for the next two weeks, at $79,800 total.

The insurance will cover hospice care 100 percent, but not any more medical treatment. My cousin-in-law asked me for my advice. I was thinking about their two kids and her ability to provide a roof and food for their kids. So I advise putting the husband on hospice care, with insurance covered at 100 percent.

The husband’s brothers and sisters are upset and want my middle-class cousin-in-Law to pay $79,800 for a less than one percent chance of survival. WTF? Lots of freaking family drama.

Honestly, anybody in TUG deal with a crap situation like this? *sigh*


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RX8

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Tough situation. My mother-in-law just went on hospice two weeks ago so I understand somewhat.

I think one should consider the comfort of the patient. Continuing with treatment, probably uncomfortable or even painful treatments, is not something I would want to endure in my final days knowing the payoff odds.
 

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If the odds were better then that’d be different
You have the doctor. The one that probably would be handling the issue saying not good
So why are siblings thinking they have better info?

If the family has the funds. The odds can burn through that pretty quickly and that will most likely have a financial impact on the family
 

Grammarhero

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If the odds were better then that’d be different
You have the doctor. The one that probably would be handling the issue saying not good
So why are siblings thinking they have better info?

If the family has the funds. The odds can burn through that pretty quickly and that will most likely have a financial impact on the family

I think the siblings are emotionally irrational right now. Grief does weird things for people.


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Passepartout

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Yep. I was my mom's family 'of record' post stroke for a few years of rehab and assisted living until a further stroke put her in a near- coma, requiring feeding tubes and O2 and such. I asked her what to do. At great effort, she had the nursing home staff get her into a chair beside her bed. I asked if she wanted treatment, or to go 'see dad' (my father had died 40 years ago) She raised one hand and waved, 'Bye, Bye'. We honored her wishes, of course arranging for comfort care until nature took it's course. My brother hasn't spoken to me since for over 20 years. He thought no expense should have been spared to keep her alive.

Jim
 

CalGalTraveler

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What a difficult decision! My prayers are with you and your family.

Ask the husbands' brothers and sisters who are so passionate about spending the future livelihood of their nieces and nephews at risk to pay for this. Put up or shut up.

However if having them pay for the next 2 weeks puts insurance coverage of hospice care at risk, then don't do it.
 
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Fredflintstone

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I’m very sorry to hear about this.

From experience, given the stage of cancer, the only real option is pain management. Hospices are excellent at addressing pain management so frankly a hospice is the best option.

Sadly, bone cancer is one of the most painful cancers to have so pain management is simply a humane approach to handling it.

My prayers go out to your family.


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Grammarhero

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What a difficult decision! My prayers are with your family.

Ask the husbands brothers and sisters who are so passionate about spending the future livelihood of their nieces and nephews at risk to pay for this. Put up or shut up.

However if their paying for the next 2 weeks puts insurance coverage of hospice care at risk, then don't do it.

The husbands’ brothers and sisters won’t put that money up, or shut up. They think they are right, wise, and that we should just listen to them. Part of conflict might be cultural. As Asian-Americans, we are taught to respect our elders.

I just want what’s best for the two kids, including having a roof over their heads and food on the table.


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Jan M.

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Based on my own family experience and what I saw when I worked in a hospital years ago the doctors are telling her that he has two weeks or less left no matter what. This is a very difficult time for her and having to deal with his siblings on top of everything else she is going through makes it even worse. It isn't unusual for some family members to not be able to accept the reality of the situation and the inevitable. That puts added stress on her but she should not give in to them pressuring her. Given the circumstances you've laid out it would be extremely irresponsible of her to spend that money when she has children to consider and the doctors are doing everything but coming right out and saying don't waste your money. The best thing for her husband, her and their children is to put him in hospice care under palliative care to minimize his pain and suffering. Hospices are a blessing to both the patient and their families at times like this. Hopefully she and the children will be able to visit him as much as they can while he is still able to communicate with them. She might also consider seeing what counseling is available to both her and the children to help them get through this time and prepare them for his passing. My heart goes out to her.

It would help if her husband would decline further treatment. He does have that option as long as he is still competent to make that choice. And if he isn't that pretty much says it all.
 
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PcflEZFlng

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Be at peace knowing you are making the right recommendation in accordance with the doctor's advice. If certain family members are upset about it and holding it against you, yet are unwilling to help financially, then that's on them. Unfortunately, there is little or nothing you can do except move on with regard to them.

Jim - that also applies to your brother (though by now you probably already know that).
 

DaveNV

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The realist in me says you made the right call. It's sad, certainly, but is the only viable choice. If the other family members are really so insistent on a different course of treatment, let THEM pay for it. That should make them respond differently.

Dave
 

moonstone

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Yep. I was my mom's family 'of record' post stroke for a few years of rehab and assisted living until a further stroke put her in a near- coma, requiring feeding tubes and O2 and such. I asked her what to do. At great effort, she had the nursing home staff get her into a chair beside her bed. I asked if she wanted treatment, or to go 'see dad' (my father had died 40 years ago) She raised one hand and waved, 'Bye, Bye'. We honored her wishes, of course arranging for comfort care until nature took it's course. My brother hasn't spoken to me since for over 20 years. He thought no expense should have been spared to keep her alive.

Jim

I worked in a nursing home for many years and often spoke to family members who were in the same type of situation as you were Jim. I always told them the decision (if there was no DNR) was theirs to make, but they needed to think if they were making the decision for themselves or their loved one. If they wanted to use all possible means to keep their loved one alive were they doing it for their piece of mind and to have their loved one around longer, or to help the loved one. What kind of quality of life would the person have hooked up to all sorts of tubes? Are they living or existing? It does sound harsh but people need to think of the person on the receiving end of treatment. I urged both of my parents and in-laws to make a living will (their wishes for end of life stages) many years ago while they were all still of sound mind. They all chose to sign DNR orders to take effect in the event that they had a catastrophic illness or injury and have comfort measures only. I am glad all of us siblings do not have to make that decision for them that could be objected to, or cause hard feelings for a family member. I am glad you honoured your mothers wishes.

On a variation of that, my brother is extremely upset at my dad for having my mom admitted to a long term care facility 6 years ago when her dementia got too much for my dad (& I) to handle. My brother thought I should have just moved in with our parents and cared for her at home since I was trained in that field. He hasn't spoken to me and barely to my dad in that time and has never, to our knowledge, gone to visit Mom. My mom always said she never wanted to end up in a nursing home like my grandma (her mom) did. I knew full well what was involved with her care and how many years it could last. As much as I love my Mom and wanted to honour her wishes, I believe she is having a better life in the long term care home than what Dad & I could give her at home. I didn't want to leave my DH and move in with my dad for many years and there is no way he could have managed her on his own even with the 4-6 hrs a day of home help they would have qualified for.

Not wanting to get political but I am so grateful for our Canadian healthcare system. My dad is paying less than $1,800 Cndn /month for a top notch long term care facility for Mom. His cost is also tax deductible as a medical expense for mom. A fellow firefighter in DH's hall is fighting stage 4 cancer that is in his bones, lymphatic system and now brain and so far he is out of pocket a few dollars a month for a portion of one the drugs not covered by our provincial drug plan, his firefighters insce or his (day job)employers benefits.

To the OP, I think you gave your cousin the best advise. As others have said if the Dr's say there doesn't seem to be any hope, why drag out his suffering and put the family in any more financial distress than they already are.


~Diane
 

bizaro86

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Yep. I was my mom's family 'of record' post stroke for a few years of rehab and assisted living until a further stroke put her in a near- coma, requiring feeding tubes and O2 and such. I asked her what to do. At great effort, she had the nursing home staff get her into a chair beside her bed. I asked if she wanted treatment, or to go 'see dad' (my father had died 40 years ago) She raised one hand and waved, 'Bye, Bye'. We honored her wishes, of course arranging for comfort care until nature took it's course. My brother hasn't spoken to me since for over 20 years. He thought no expense should have been spared to keep her alive.

Jim

I almost always click the "like" button to thank people for a post, but that didn't seem appropriate here. Nonetheless, thank you for sharing this story. I appreciate it.
 

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my cousin-in-law’s husband has been in the ER the last eighteen (18) days to medically treat stage 4, bone marrow cancer. The medical bills the last eighteen (18) days total $102,600, but their co-pay is only $1,400.

However, the doctor indicated that they have done all they medically could, so the insurance won’t certify or cover further medical treatments, which moving forward would cost the middle-class family $5,700 per day. The doctors say continuing medical treatments have less than a 1 percent chance of survival for the next two weeks, at $79,800 total.

The insurance will cover hospice care 100 percent, but not any more medical treatment. My cousin-in-law asked me for my advice. I was thinking about their two kids and her ability to provide a roof and food for their kids. So I advise putting the husband on hospice care, with insurance covered at 100 percent.

The husband’s brothers and sisters are upset and want my middle-class cousin-in-Law to pay $79,800 for a less than one percent chance of survival. WTF? Lots of freaking family drama.

Honestly, anybody in TUG deal with a crap situation like this? *sigh*


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This same sort of situation happened to me with my father and hospice would be covered at a 100% and I told the family that I could not afford the cost and if each person that was so vehemently mad at me that I would let the hospital know that they were each going to pay 30% of the bill and to meet me at the finance department and surprise not body showed and not another word was said to me.. when people have to put money where their mouth is, its amazing how they shut up...sorry I'm still bitter abut it years later...
 

Chrisky

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my cousin-in-law’s husband has been in the ER the last eighteen (18) days to medically treat stage 4, bone marrow cancer. The medical bills the last eighteen (18) days total $102,600, but their co-pay is only $1,400.

However, the doctor indicated that they have done all they medically could, so the insurance won’t certify or cover further medical treatments, which moving forward would cost the middle-class family $5,700 per day. The doctors say continuing medical treatments have less than a 1 percent chance of survival for the next two weeks, at $79,800 total.

The insurance will cover hospice care 100 percent, but not any more medical treatment. My cousin-in-law asked me for my advice. I was thinking about their two kids and her ability to provide a roof and food for their kids. So I advise putting the husband on hospice care, with insurance covered at 100 percent.

The husband’s brothers and sisters are upset and want my middle-class cousin-in-Law to pay $79,800 for a less than one percent chance of survival. WTF? Lots of freaking family drama.

Honestly, anybody in TUG deal with a crap situation like this? *sigh*


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Hello. You don’t mention in your post, or if I missed it I apologize. But what does her husband want? Or is he capable of making that decision?
I would definitely reiterate to your cousin-in-law and to his family, if they want to continue medical treatments they should pay for it. She should tell them she is taking the doctors’ advise and putting him into a hospice. If they do not speak to her again, they are not much of a family and are only thinking of themselves and really not considering their sibling! It is really none of their business, as far as I am concerned. This is a decision that has to be made by your cousin-in-law and her husband, and no one else.
What a terrible situation she is in, and then having to deal with her husband’s family.
 

pittle

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We had to make a similar decision with my mother. We chose the Hospice route and they were remarkable. I knew the prognosis was not good, and that her money was running out. We were not looking for an inheritance, but did not want the four of us to go into debt for no more guaranteed time. Mom was not able to make the decisions at that time, but years before had said she was ready to go join Daddy - so that did make it easier for us kids.
 
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bogey21

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My kids and ex-wife know what I want. No extraordinary care; no extraordinary expense; and keep me pain free. They know this both verbally and in writing. I doubt they will fight about it but who knows...

George
 
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Grammarhero

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Hello. You don’t mention in your post, or if I missed it I apologize. But what does her husband want? Or is he capable of making that decision?
I would definitely reiterate to your cousin-in-law and to his family, if they want to continue medical treatments they should pay for it. She should tell them she is taking the doctors’ advise and putting him into a hospice. If they do not speak to her again, they are not much of a family and are only thinking of themselves and really not considering their sibling! It is really none of their business, as far as I am concerned. This is a decision that has to be made by your cousin-in-law and her husband, and no one else.
What a terrible situation she is in, and then having to deal with her husband’s family.

When he was still lucid last week, he signed a health care power of attorney. As long as insurance covered his medical treatments, he wanted medical treatments to prolong his life. If insurance didn’t cover, he didn’t want to burden his family. Even near death, His kids were on mind, and he wanted to ensure that his family had a roof over their head and food on the table.

The brother and sister don’t believe he was lucid and question the health care POA.


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We are so sorry for what you are going through with your cousin-in-law's husband and the family members. We will keep your cousin and her husband in our thoughts and prayers.

Unfortunately Family Members do not always respond well to these situations. When my niece had to make the decision yesterday concerning her Father (my brother Mike) and turn off the machines she had the full support of the family. Mike had made it very clear for years what the decision should be. It was still a tough call to make.
 

Grammarhero

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Thanks for all your advice. I feel a lot better. Felt like crap earlier today, but it can only get better tomorrow. It sucked having to deal with a loved one’s upcoming death and arguing about it.


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dsmrp

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Thanks for all your advice. I feel a lot better. Felt like crap earlier today, but it can only get better tomorrow. It sucked having to deal with a loved one’s upcoming death and arguing about it.

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So sorry for your cousin, her kids and you.
Hopefully your cousin's BIL & SIL, will come round and emotionally accept their sibling's condition, and see that your cousin & you made the right call. And all can say their goodbyes while they still can.
 

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I almost always click the "like" button to thank people for a post, but that didn't seem appropriate here. Nonetheless, thank you for sharing this story. I appreciate it.

There needs to be more buttons

I’m on several biker forums. They have buttons for
Informative. Funny. Like. Agree. Etc
Sometime we may agree but like doesn’t fit the bill
 

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I’m soo sorry. Years ago we were in a similar situation regarding our FIL. Palliative Care was discussed and siblings refused. Instead he lived in pain an additional 2 months. Unfortunately I have a feeling that a similar situation will happen w/ my MIL.
 

rapmarks

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Many years ago, my husband’s cousin was suffering from advanced cancer. My husband’s step brother, who was unrelated to the cousin, was most insistent that she try an experimental treatment in a Houston, which the cousin couldn’t afford. The step brother was so insistent that we all chipped in to cover the treatment. They went to Houston, and within 24 hours she was in a coma, they got her home and she died that weekend with her family around her. I was overcome with grief and guilt that we had killed her. Her family assured me it was her last hope, but I never felt right about it.
 
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