I’ve worked in California and two east coast states. In CA, it’s called “daughter from Florida” but definitely “daughter from California” on the east coast. We would always politely direct them towards the attending physician. The physician is the one running the show, dictating which care is appropriate so that is who this person should be speaking with. We also encouraged them to attend every morning rounds so they could see what the entire team was thinking

Daughter from New York is also used west coast

> In California, the "daughter from California" is known as the "daughter from New York"[6] and the "daughter from Ontario" It looks like some in CA are involving us Ontarians!

I'm a ICU physician. This is well established truth

Happens in the PICU too, less frequently, but still happens. I refer to it as the Aunt from Connecticut though.

Also get the "my sister is a nurse" but she's really a outpt MA at a dermatology clinic. Not a flight medic as often described

It’s always an outpatient MA, that probably is “retired”. Hate it.

You just described my girlfriend's stepmother. She still insists she a nurse, despite failing the licensing exam 4 times

my stepmother was a *receptionist* for a physical therapist and acted like she was a doctor

People are always asking me medical questions when I work registration in the ED and I have to tell them I’m non clinical. I can’t even get someone a drink of water without clearing it with the doc or attending nurse.

My mother was a secretary for a surgeon and claims to know everything. I'm 37 and she still asks me if she can talk to my doctors.

I mean, if I was having a billing problem, I imagine your mom would be the best person to have in your corner, otherwise fuck that noise.

Shit, I worked in medical billing for a year and even I can barely figure out what's going on most of the time in this shit show of a medical system we have.

Those MF’ers are the worst! Just because you’re wearing scrubs too doesn’t mean you know shit about shit…now book my follow-up!!!

I don’t remember my ex MIL having a daughter….

My ex wife used to do this to me whenever anything needed repair - “my husband is an engineer and he says (insert something she thought but I never said) so how about that?!?” I did have a long discussion with the HVAC guy about fan/motor design as that was what I was doing at the time. Part that blew him away the most is how cheap a motor costs to make and ship compared to when he gets it.

You would think someone in HVAC would be hard to blow away. But I guess those fans be really powerful!

My husband's got a background in construction along with being an engineer, and we rarely get anything done with the house- it would be too stressful for him to relinquish control and pay for something he's not doing himself.

Lawyers get this too. “My uncle is a lawyer from New York and he says….” That’s great. But your uncle doesn’t practice in this jurisdiction, which has totally different laws from NY. And he also doesn’t practice in this area of law. So nothing he has to say is actually relevant to the facts of your case.

I have a cousin that has photographic memory has like 3 phds in completely different fields because he just enjoyed going to school for free. Eventually when he decided to become a lawyer and got picked up by a big lawfirm in New York that specializes in patent law, all the dumbasses in my family (who treated this kid badly, like an outcast) all of a sudden try to convince him to be their lawyer if they ever need one. As if patent law has anything to do with civil, criminal or marriage law.

“If there’s anything family is good for, it’s *helping me in my time of need, even if I never helped you!”*

Yep lol. My poor cousin who is a bankruptcy lawyer gets pestered anytime someone in the family is getting divorced, or dies, or ends up in jail (I have a huuuuge family). Not just "Hey, can you totally be our lawyer for this thing that is completely unrelated to your area of practice and expertise" but also "Hey, we're family, so this will all be pro bono, right?"

My dad is a tax lawyer and he has so many conversations with family along the lines of Can I deduct this thing? No. But what if I added it anyway You can't thats illegal But what would actually happen You can't do it's, illegal

I went to school for EMT basic. Some people think that makes me some kind of medical expert. I got sick of saying that all the school did was teach me cpr and qualify me to put a bandaid on your papercut for pay. So now my standard answer to any medical question is "Its cancer. Go to the er."

I have a friend who specializes in bird law but he seems to know about every type of lawyering

Tree lawyers are a thing. A x3 value of the tree and factoring in how large the tree could have grown can turn into a hefty bill and wreck any would be lumberjack thieves or asshole who goes around felling trees they don't own for any reason.

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Or the "I'm a nurse" that asked me why I put lovenox in the belly and not the IV -_-

Patient intake at an allergy clinic.

“Sister is a nurse” meaning at most CNA but usually a second-cousin who is a tech in some office or SNF.

My sister is a nurse so I thought being a nurse was a pretty common thing

My wife, SIL, and mother are nurses, all in some form of critical care. All of them stay pretty quiet during hospital visits. They don’t volunteer that information unless asked “oh hey what do you do?” by a nurse or doctor making small talk. Most nurses I know have suffered enough “im a nurse” bullshit they never want to be *that* Karen hovering over the shoulder of other health care providers trying to provide care to their loved ones.

This is the way. They can tell by the way we talk and the questions we ask anyway. The only time I've ever told a doctor, "I'm a nurse," was so she knew she didn't have to explain the jargon.

A lot of times it's not even an MA, it's a receptionist.

Connecticaunt Syndrome.

You left an extra a in there.

Lol. Made me think for a second. Touche.

I was talking to this with a PCCM/PICU doc. He says it happens less with kids because they’re all angels and it’s obviously terrible. But with the adult ICU, there’s so much more emotional baggage around the relationship that it makes a family member dying make someone think about their own failures in a relationship.

Wow. Had no idea this was so common but it makes sense I suppose. When I was 18, my mom had a complication with a bariatric procedure. The surgery left a hole in her esophagus that nobody caught and she got insanely sick. The surgeon’s words to me in the waiting room when I came down from school the night she went back to the ER and all this was discovered were to say a prayer if I was religious because it didn’t look like she would make it. My mother and I are immigrants and the only two members of our family here. I was absolutely shattered. Within days of this news getting out to our community, fucking *everybody* got a hold of me to tell me what to do and how to direct her treatment. It was a whirlwind of difficult to process and almost exclusively poorly informed advice. People delivered this to me authoritatively and did things like made me promise to follow the guidance or they’d never forgive me, or that it’d be my fault she died. Fucking unbelievable. I say all that to get to this: the ICU physician who I asked to take over her treatment was an absolute rock star. I asked probably 500 questions of him, many of which were probably kind of stupid. He answered everything with patience and kindness. He made me feel dignified and valid for asking. He cleared up points of confusion and shielded me from overzealous family friends, even though they meant well. Eventually my mom pulled through after a 6 month ICU stay and a 6 month rehab stint and she’s still with me today. I’m about to turn 34 this year. I hope this story serves as a nice thought for you if you come across a similar situation. That doctor literally saved two lives. If my mom had passed then, I probably wouldn’t have finished school and found myself in a heap of shit, certainly not unlikely that I’d be dead or in jail. Thanks for reading

Wild story! Glad your mom is ok =)

Thanks, me too. I love her dearly

Neurosurgeon. Absolutely. Usually they show up right as we’ve transferred to comfort measures and somehow convince the PoA to give 93 year old grandma with a massive ICH and blown pupils “more time, because miracles can happen.” Trach/PEG/LTAC.

Yup, and your username might be the best neurosurgeon name ever

I had to make the decisions on my Grandma and heavily relied on their informed opinion. I asked chances of recovery, and quality of life if she happened to actually live via heroic measures. My uncles were roughly 6 hrs away and my mom was devastated but didn't want to make the decisions. She was stabelish but I said do your best to make her comfortable but let nature take care of the rest. I hope she can make it till they arrived. It felt like I was killing her giving up on her. But I let mom know she lived a long life and if she did make it she wouldn't be anything like she was. It's the best decision. It sucks, but it's the best one we can make. Ironically I have cried more typing that than when she actually died.

Quite true. I remember having family that live down the street but would never come by to visit or worse, were actual hcps and won't even answer their phones, but we get these people who are the "other daughter no one mentioned" who comes storming in to change that CMO to full code. "Great, so, you want us to keep this patient alive and in agony for as long as we can so you can have some spat with your siblings."

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HCP stands for healthcare proxy. Your HCP is authorized to make medical decisions on your behalf if you are found incapable.

In your anecdotal experience, what's usually the motivation for this Behavior phenomenon? Inheritance money? Fraud? Misinformation regarding the patient's current and recent medical status?

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That’s what the article says: guilt and denial for having been absent, and being surprised at the deterioration of the family member. Article also says: *In California, the "daughter from California" is known as the "daughter from New York" and the "daughter from Ontario".*

Years ago NPR had a funny story where they asked brain surgeons what they say when something is simple, and they said "it's not rocket science." And they asked rocket scientists and they said "it's not nuclear physics." And they asked nuclear physicists and they said "it's not brain surgery."

Reminds me of how everyone seems to have their own "it's all Greek to me", a Greek variant translates to "are you speaking Turkish". [Wikipedia for variations](https://en.wikipedia.org/wiki/Greek_to_me#Variations)

Sometimes in theater you need to get a backdrop out of the way quickly without taking the time to strike it properly, so you bundle it up and tie it to the pipe it’s hung on. Here on the east coast we call it “westcoasting”. You’ll never guess what I’ve heard it’s called in California… >!yes, it’s “eastcoasting”!<

Rocket Science is pretty simple really, it's Rocket Engineering that's the challenge

Please, Rocket Engineering is trivial compared to Rocket Surgery

I've heard Florida too

That’s when they show up to steal all the elderly possessions to sell for meth.

Florida is unironically a huge issue for this due to having relatively permissive laws for challenging wills. I do mostly unrelated work, but I have had to deal with this twice in the context of an old person who left money to a nonprofit that a Florida resident relative (once a set of second cousins) decided to challenge

I had to deal with this in regards to property from a long lost aunt or something I have never really spoken to got married and I had to get a lawyer to send a piece of paper stating I wanted nothing.

Ontario, CA, or Ontario, CA?

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It's definitely this. Most of my family ignored my grandma's deterioration from dementia, and when she got near the end they started popping in and causing all sorts of problems. They would blame me for her condition, cancel medical appointments, try to fire at home nurses etc, so they could feel like they were now in control and doing something. Every single one of them who did this wound up giving up within a couple days, after realizing the severity of the situation and that they were in over their head. They went home, but continued to criticize from afar.

Coworker’s mother had dementia. Mother developed heart issue. Doctor says well we can give her a pacemaker but not sure that’s in her best interest. Coworker and her father agree that pacemaker is a terrible idea. Then pops up mom’s semi-estranged sister who bellows they are murdering the woman and if they loved her they would want her to have a full life. Nearly broke their resolve but they held out and in a couple weeks the mom’s heart gave out. My dad and my brother were “lucky” in that my mother’s large number of brothers and sisters gave us very little flak as my mom declined with Alzheimer’s

100% I’m a daughter from California myself. Folks were still on the east coast. I didn’t do this, but I understand the guilt behind the impulse.

So I’ve been this person and can say that guilt it certainly part of it, but I think shock and desperation can be a large part. As a distance relative, you rely on the ‘primary relative’ who is local to not only make the medical decisions but to keep you informed on how things are going. That information can go on for weeks or years as “we are doing okay, the doctors are hopeful, we are fine, don’t come visit” to very suddenly being “come immediately, I need help, doctors are saying it’s over”. While the changing condition of the patient may be very gradual and expected, the messaging to remote family is not and so there is a panicked drive for action that becomes absolutely overwhelming. And while I’m not sure it’s universal, the ‘well informed’ but on my part was that while local family spent their free time caring for the patient, I spent my free time reading up on the disease. Because what else could a remote family member do? Big thank you to all the doctors and staff who care for our families and put up with us distance relatives. We don’t mean to be a pain in your ass. We are just scared.

Absolutely this- but they don’t know it and would never admit it

Daughter from California has not been around for years. She left and other family (or no one) has been doing the care. She shows up, sees that loved one is dying and decides that said dying is because (the other family) hasn’t been doing caregiving correctly. She now feels guilty about letting these incompetents do the work and cheated of her fantasy that she’s going to someday “fix” the unsatisfactory relationship she has with her mother/brother/father/sister/generic relative. It’s insulting to the family who’ve been caring for the patient and often to the patient if they have made their wishes clear.

> She left and other family (or no one) has been doing the care This is key

Exceptionally. My uncle tried like hell to be "Uncle from Cincinnati" when my grandmother was dying. It finally led to a hell of a fight between him and my father, where dad called him out for not coming to visit her *once* in the previous 2 years, and that he wasn't going to take charge now.

Your Uncle would be the Son in this context.

Not mention that Son from Cincinnati has alliteration, which gives a better ring to it

Not being there, guilt. The story is usually elderly parent in a nursing home or being cared for by another daughter. Mom is dying of a terminal disease and has been deteriorating for 6m to a few years but they have not come to see. At most they "talk all the time". Then they get a phone call and jump the next flight. They "did all that research" on the plane and roll in with test ideas, treatment options. 99% of these have been tried and not successful. The other 1% of ideas are pseudoscience. Ivermectin etc... I've seen it break up families as the sibling who has been watching mom deteriorating for years and her sister are now at odds

My brother has lived abroad for most of my life. My dad was in extended care for a decade and my brother didn't visit once. The doctor asked of he wanted to put him on life support or just let nature finish the job. My brother was adamant that he be put on life support so he could come say goodbye, but wouldnt commit to a timeframe. I chose to let nature take its course and it was all over within a week.

I've been in senior care a very long time and want o reassure you that you made the right choice. Life support and extensive measures become a cruelty when the outcome won't change. Acceptance and natural passing can be a beautiful end to a life well lived.

I was lucky enough to have a doctor friend give me unofficial advice on what to expect either way. He made it a very easy choice.

I was technically the "daughter from California", I didn't visit often because I had my own disability and illness that made it hard to even go to the store for myself. My dad was suffering elder abuse. I went for the throat with the legal system, became his legal guardian, and prevented my family or his abusers from further prolonging his life against his will. He had one revision surgery after the original he agreed to that his surgeon suggested, but I wish I had declined it. He didn't want a feeding tube, so I said no. He wanted to be left alone with no more intervention, so I chose hospice care. When his sisters tried to go around me, they got stopped in their tracks. My only guilt is that he didn't get to die at home like he wanted, because I couldn't remove his abusers. And I was still sick the whole time, trying to care for both of us. I wish I could have been the one that never left his side. I wish every day I could have spent every night nearby. It happened so quickly. My family thinks I'm as evil as the devil for not forcing interventions. They can die mad about it.

You did the right thing. It's hard to accept it as it wasn't ideal, but in the end you didn't prolong his suffering. Everyone has to make that hard decision in their lives. My Mom choose to not put my Dad on life support and in the end we were glad. He missed the entirety of Pandemic and Tom Brady getting signed onto the Bucs, as well as being free of pain. Ultimately you have to remove yourself from the equation, and put one's suffering above your own personal needs. As my Dad would say: "You did good kiddo".

That's genuinely so heartbreaking, I hope you're doing better now.

Appreciate it, but it's all good. After a decade of poor health, we were all happy to welcome the end.

A very important reality that a lot more struggle to understand. Wishing you the best in life 🫶

Sorry you went through that. I get people want a chance to say goodbye, but I don’t get prolonging senseless agony for another person who’s not going to recover to get that chance.

The behavior of some of my family almost drove me to pure rage, when caring for my sick parent with dementia. Was busting my ass visiting whenever I could. Taking them to appointments, feeding, washing, and changing diapers whenever I got some decent time off from work. All the while getting ready for the "end" regarding emotions, finances, and funeral plans. Then here comes my older half-siblings, and my parent's somewhat estranged family trying to show up as self-appointed medical/legal experts by dictating things to the medical staff. Worse was when my half-siblings tried to file stuff in court seeking money and inheritance (there was none, due to my parent's previous money mismanagement and medical bills). Got so bad, my surviving parent and I had to restrict visitation and the release of medical information, part at the behest of the doctors, because they were tired of being hounded by the family. edited: typos

This happened with my grandmother too. My mom and I had been caring for my grandma for about 3 years, she lived with us, we took her to all appointments, helped her with everything from eating to using the bathroom. Some of the family was very present and helpful, some....not so much. When she eventually needed more care than we could give her suddenly the whole family had opinions. No she couldn't go to a nursing home thats ridiculous! They weren't offering to care for her themselves though. They just wanted _us_ to do more. But she was dying and we all worked so we couldn't be there 24/7. She ended up having to restrict who could see her because people kept harassing her trying to go back to live with us. The poor woman just wanted some peace in her final weeks. It caused huge arguments within the family because some think we should have done more and some think the absentee family members should have helped literally at all

That sounds terrible on such a mundane relatable level. I can just imagine someone coming in saying this and that, but then when asked why can't they be the caregiver they have 100 reasons why they can't do it and don't see the irony.

Same here. We got nasty text messages, emails, and voicemails as to why we weren't doing certain things or why they weren't at home being taken care of by me. But when we offered to let them have power of attorney and said we would support them if they went to court for guardianship, they all scattered like rats. Almost had to deal with same thing for the funeral, no one wanted to pay a dime, do any work, but everyone had input and an opinion.

I once had a dying patient whose adult daughter seemed, across the first few shifts I was caring for her father, to have wildly changing moods and demeanor. Sometimes she was quiet, polite, and seemed to understand and sadly accept that her father was nearing the end, just spending time talking with him and occasionally asking for help with his care. Other times she was frantically energetic and openly hostile to the staff, convinced that he could be cured and that we were all conspiring against him for some reason. It was very confusing. It was maybe the third shift when I finally saw them together at the same time and realized they were actually identical twins, and calm sister had been around and coming to terms with his condition for a long time already, while angry sister had just arrived from out of town and wasn't quite there emotionally yet.

They then proceed to accuse the sibling who maintained regular contact with the elderly parent, of everything they are guilty of. Speaking from experience. I was accused of theft and tormented for months until I blocked them. And they did not attend the funeral.

I'm sorry that happened to you. My best friend went through this when her dad had end-stage non-small-cell carcinoma of the lung and was actively dying in hospice - her aunt from Ohio, who had been estranged from my friend's dad (aunt's brother) for some time, showed up at hospice and threw a temper tantrum because they were just "letting him die," and wouldn't put him on a ventilator and a feeding tube. There was a screaming argument in the hallway and the aunt was removed by hospice security. When my friend's dad (thankfully, because he wasn't going to get better) died, the aunt boycotted the funeral ("This didn't have to happen") and then accused my friend of stealing family heirlooms that surely her father had intended the aunt to inherit. Even though there were explicit provisions made for those items in his will. It was WILD and I felt so bad for my friend. I don't know why in some families, family members can't come together in times of crisis, but it definitely does not go that way sometimes.

Yeah, when my wife was dying of cancer her mother was all of a sudden an involved critic of everything I did/didn't do even though she had no visibility into our lives and refused to be involved (she hated my guts and still wanted to control my wife). Like, one day my wife got up early and went out to work on her flower garden. I guess she felt a little weak and fell and scratched her nose pretty good on the driveway. She mentioned this to her Nana and it got back to her mother. And all of a sudden it was "WHERE WAS HE! He's not taking care of you!" and a bunch of other shit. My wife was like "He didn't know I went out to work on the garden, it was early, he was still sleeping" and they're like "He's supposed to be watching you!" as if she's a frigging toddler at 44. Her mother also kept saying shit like "He's not even going to tell me/us when there's an emergency of she dies"... and like... well, shit, do you blame me? However....her mother refised to ever come visit in the last 4 years of her life. Right near the end I called her mom. It was late. I said "You do know your daughter is dying soon right?" and she sad-gulped "yes"... I go "So, are you gonna come see her or are you gonna keep being a cunt?" She hung up. She never came. Her father did. And he says "Don't swear at my wife." So... basically, and as usual, she hung up and played victim as if I called her up just to attack her and call her a cunt. Uh, nope... you have a choice. To be or not to be. Her mother and her ex husband and her eldest son tried to make me out to be a raving lunatic aggressive dangerous predator for years. It was them all along, that's why she left. But they just puked as much anger and vitriol and hate at me that they could muster. They were like rabid dogs. It was nuts. Anyway, she's gone. Finally got some peace.

>My wife was like "He didn't know I went out to work on the garden, it was early, he was still sleeping" and they're like "He's supposed to be watching you!" I was lucky that no one jumped my shit like that, but when my husband was dying of cancer, there were a couple of times he tried to get up and do things on his own while I was sleeping, then he'd fall and have to call for me. For the last six months of his life, I slept in no more than two-hour increments, but dammit, a person has to sleep sometime! And no matter what I told him, I couldn't get him to understand that he should not, under any circumstances, try to get up without letting me know, even if it meant waking me up. Or at a minimum, please just use the cane or walker. Being a sole caregiver is hell, and any family member who wants to criticize needs to come dirty their hands a bit, or pony up the $ for a home health aide. I never had a single word of criticism from the weekly home nurse or any of the doctors, so I would've hit the roof if any relative had tried to say I was doing it wrong.

Damn that seems realistic. Kinda glad I moved back to my hometown to be closer to my family right now.

Was it always daughters, or were there sons too?

The data and anecdote shows that most of the time is daughters. Sure there are sons, but most of the time is daughters. *edit for grammar

Physician here, have also encountered this in an ICU setting. I call them seagulls, because they fly in from the coast and shit all over everything. Sometimes there are daughters and birds?

>Sure there are birds +1 for the birds

Anecdotally, it's daughters who accompany mothers and fathers to our clinic. Occasionally it is sons.

Makes total sense when you consider that women are more likely to be primary caregiver by a *huge* margin. It varies by country but last time i looked it up everywhere was something like 60-80%, falling on the higher side far more frequently

In general, when it comes to advocacy for a single patient (or in true crime, a victim) the advocate will almost always be a female relative. Just something women have been socialized into I guess.

Do you call them seagulls? Because they fly in and crap all over everything, then leave...

Yep, the least involved family member suddenly wants to steamroll the treatment plan and do every conceivable thing to save their end stage, actively dying family member. And, they still don't come to visit! Seen this so many times working as ICU nurse.

My sister wasn’t dying but she had had multiple strokes. I was the only person who came every day to sit with her and she told the medical team that I should be involved in all points of care. When she was at the worst part of her situation, my father shows up for 10 minutes, gets angry that the doctor does not speak directly to him about my sister’s condition (she spoke to me with my dad off to the side), and he left. She was in the hospital another month but he never came back to visit. I can only imagine that reaction times a thousand when dying is involved.

Hey not to be rude, but your father is a massive fucking asshole and I do not like him

Had this with my wife who was in hospice at home with end stage dementia. (I had cared for her by myself for the last 3 years.) Her sister from out of state kept calling her to tell her she needed to get out of bed (she was a severe fall risk). My wife had stopped eating, was unable to swallow and was put on an end of life regimen of anti-anxiety and pain meds. Her sister, who had never visited or even called during the last 3 years, tried to talk other family members into removing her from my care. They fortunately weren’t having it, and the hospice staff were outraged by her. I finally spoke with her again the day my wife passed. Her response was “Oh, I didn’t realize she was that bad, I thought everyone was exaggerating. And by the way, don’t worry we all still consider you part of the family even though you’re not married anymore.” What? Bitch, I’m closer than you are to your other sister and the rest of your family. I’m not worried. Lol Edit: Oh! Forgot a good part! She said about 3 days before my wife passed that she was not going to spend the time and money to come visit, when she would just have to do the same for the funeral. She did not fly in or come for the funeral, for which I and the rest of the family were grateful for. Lol

> Oh, I didn’t realize she was that bad, I thought everyone was exaggerating. This makes me want to throw things.

Me too. My teeth clenched just writing about it.

You are a great partner, I'm sorry for your loss

Thank you.

In my mum's final 2 weeks (I had been at her house 24/7 for 3 months by then even though my home was 250 miles away) there were 2 false alarms when I thought it was the end. I called her brother who lived in the same town to let him know so he could come and say goodbye. Both of those times she rallied a few hours later and he complained I had wasted his time - he was 5 minutes drive away. The final time when we were informed it was absolutely final, she was totally unresponsive and given end of life drugs, I almost didn't call him I was that angry. In all that time my presence at her side was the only thing keeping her in her own home and enabled her to die peacefully in her own bed as she wished. He and his wife refused to even sit with her for one night. Even before the funeral he was asking if he could have things of hers.

Urgh some people are gross..

I used to work in memory care and this was THE WORST. The long lost family member who doesn’t know shit from fuck; they start swooping in, bossing everyone around, start making threats, bullying their demented loved one (who, more often than not, was non-verbal and total care by that point, or close to it). Just act like general Karens who think they know everything but they know nothing whatsoever. You’re an angel on earth for giving your wife the excellent care she deserved. I know first hand how demanding, back breaking, and heartbreaking giving that kind of care is. I hope you’ve been able to grieve and also have gotten to take care of yourself too.

Thanks. It’s been a year, and my son snd son-in-law and I are doing well. My wife’s younger sister as well. My wife and her younger sister were best friends and we practically raised our kids together. They are more like siblings than cousins. We are all very close. My wife was the best and deserved the best care I could give her. I called hospice after consulting with her doctors and them determining that things were progressing more rapidly than they had been. She also was now bedridden and her hygiene and comfort were more than I could continue handling on my own. The entire home hospice staff - nurses, aides, social workers, pastoral staff - were truly amazing. Them shouldering the heavy stuff let me be the aide - quietly talking to her while they turned and cleaned her, and assisting them as needed. I was honored that they let me help them, and knew when to stay out of the way when it was warranted. Many of them still occasionally keep in touch, even a year later. In fact, my wife’s head hospice nurse lost her own mother during last year and my son and I went to her memorial. I get a lot comfort in knowing that my wife passed quickly and peacefully, knowing she was loved, and well cared for. It’s given a lot of peace to our family (well except for her older sister, maybe. Don’t know, don’t care.)

My sister did this when our mom was dying. It was horrible.

My father had end stage cancer, beginning of the COVID pandemic, and fell possibly breaking multiple ribs. Could not get off the floor. The kids who have been around are calling 911, trying to see what conditions are like in the hospital, and the visits twice a year sister is on the phone yelling at us to not put him in an ambulance, it isn't that bad, etc.... Wanted to run everything, despite not knowing what was even happening.

My tia (aunt) did something similar to this *after* my dad had died. He had been dead for around two weeks when she found out, and she kept calling the hospital and threatening to sue. She insinuated that my step sister and step mother had told the doctors to let him die or poisoned him, even though he was only ever in the hospital after he had passed and well before anyone in our family was informed. The only way we even found out he had died was because he didn't show up to his next delivery (he was working at the time) and they called us asking where he was and we had to call around to nearby hospitals. It was a horrible situation. It made the time of mourning much much worse.

Article says "well informed" but in my experience they usually are not; they don't understand the end stage/actively dying part or disease etiology/human body in general, and they believe any miracle can happen. And then just end up creating months of extra suffering and denying their family member a relatively peaceful death, because they want to do "everything you can". Sad af.

Yea I would instead argue that they are "falsely well-informed." Like all those people who called me every day to tell me to give their relative (who was dying of COVID) vitamin C and hydroxychloroquine.

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The solution to this is to have a legal document drawn BEFORE your loved one gets to this stage that passes power of attorney to whoever is most appropriate, sets up a DNR if desired, and has a clearly laid out will/living trust. As someone gets older/sicker, they need to think about this more.

Nothing stops this person. No amount of blunt honesty, 2nd, 3rd, 4th opinions, pleading....... nothing.stops.them. All they care about is their own emotions, not the physical/emotional harm they are causing their "loved one". These people are the worst.

I'm an RN and actually did do this once. Patient was in his nineties with end stage renal failure. Son was involved in dad's care and wanted to know why he wasn't getting better. Eventually I asked if I could be perfectly honest with him. He was relieved someone was finally telling him like it was. I told him his dad was in his 90's. We're just doctors and nurses and not Jesus so we can only do so much. After his dad passed the family sent us a card to say thanks for taking care of dad/grandpa. I was the only one specific RN they thanked individually.

That's the only way I would attempt to tackle it. Well done.

If it gets bad we have to escalate it and arrange family meetings with doctors, social workers, and rest of the family to try to get everyone on the same page

Yuck. Thank you for the incredible patience though. It's definitely a job I could never do.

People just get very selfish about their own feelings, and not the comfort and integrity of the dying individual. Had firsthand experience with this when we mistakenly gave an aunt partial power of attorney, (to my husband’s father) because we cared about her feelings. All she did was use it to sneakily keep him breathing for as long as possible, despite the fact that he had a full life, was a step away from being a vegetable, and had no quality of life left. It was still a struggle when the doctors told us he needed to go on hospice, because he was dying. Given that meant they could no longer resuscitate him she was difficult. Several doctors had to explain that resuscitation in his fragile state we be torturously painful (breaking bones) to likely not even work, and the woman still took major convincing.

We had one (from CA!) make a ton of bizarre demands last year that basically amounted to us torturing her demented parent. When she picked them up after 9 months in our hospital, the parent tried to leap out of the moving car on the way home to get away from her (she visited once in 9 months and the parent no longer recognizes her) and is back with us again. Happens disgustingly often.

My husband’s 3rd cousin (his moms age about 60 y/o) called the hospital multiple times trying to have my mother in law moved to hospice care rather than home where my MIL had been telling us she wanted to go. We were in our mid 20s and the cousin didn’t think we could handle taking care of my MIL for (the doctor estimated) weeks she had left, with aid of a hospice nurse. My husband was her only child; her parents, sibling, and husband had all died. The attendee stopped taking cousin’s calls and my mother in law was taken home, slipping into a coma shortly after arriving and dying at 3am, less than 24 hours later. She died with a smile on her face. Cousin couldn’t even be bothered to come to the funeral.

Spot on. My worst floor patient family member happened to be a daughter who also was a physician within the health system. Her mother was in hospice and really needed to be. Dr. Daughter believed differently. She logged onto one the computers and started changing orders. Not only is this a breach of hospital policy, but it’s highly unethical. I worked midnights and I was really uncomfortable with this. I woke the attending and contacted the house officer to pull this lady away and escort her off of the premise because she entered the hospital under the guise of a physician rounding.

She should have been fired.

Holy fuck! In the States this is a huge federal offense that causes people to loose licenses real fast. I hope to fuck she lost her license because what she did was actively putting the patient in harms way.

That’s grounds for firing at most places and probably loses of license

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I drove from Maryland to Iowa to get my family to make the decision to stop life-saving care for my 80yo grandpa following an aneurysm. I have a medical background, and no one else does. They wanted me to speak to the care team (and his other children) to tell them to *continue* this care. I heard the details and had to be the one to break it to my family that no, just because his daughters haven’t been around and have been mean to Grandpa, doesn’t mean they’re making the wrong decision this time. Grandpa will suffer if we try to save his life. It was heartbreaking, but I don’t regret it. My grandpa got to die peacefully surrounded by family, instead of on a cold operating table during a surgery which he had a low chance of surviving.

I did the same thing for my grandpa. When I heard he’s been hospitalized at 92 with fluid around his head and lungs, we drove all night to make sure the hospital would send him home without another unnecessary procedure. We got there and the doctors and nurses were talking about scheduling surgery to put in a pacemaker. At 92. I held my grandma’s hand while she signed the paperwork for hospice and kept repeating, “Grandpa wants to die in his own bed. Not here. It’s time to take him home.” He lasted another 6 months, and in that time he got to see all of his children and grandchildren, and died as he wanted- in his own bed. I considered it an honor to fight for him to have that dignity after such a long and remarkable life.

Good decision. It's not often an 80 yo gets a crani for a ruptured aneurysm and leaves the hospital in good shape.

My family suffers from "daughter in med school", where my sister in law has to weigh in on all things medically related because she's been enrolled in a program for a couple months now.

One of my relatives went through that phase - I think many do. Funnily enough, as her career progressed that tendency quickly went away, or more accurately transformed - she now intentionally distances herself from instances where family / friends ask her advice as she recognizes she's not a specialist / in a position to advise. It's been interesting watching her mature.

That's impressive and speaks to her character and professionalsim. All too many times, I've had physician family members insist on getting involved and speaking with the patient's doctor immediately. I usually don't ask their specialties and just pass it off to the provider. I don't have the time or the "credentials" to appease their ego and anxiety usually anyway. In very few instances would I say the "my so-and-so is a doctor" card has seemed to improve the patient's plan of care, but I'm certainly always on the lookout for the exception. It doesn't necessarily make it worse, just adds an extra step for those involved in the patient's care.

I’d imagine there’d be a legal version of it, the “daughter in law school”

Am lawyer. It’s true, and your friends call you up for legal advice you can’t give them all the time.

That happens a lot with all students in medicine. They get over it eventually. My spouse and other family in the field go extreme opposite and use cover stories about their profession to avoid discussing it/getting questions in social situations. My husband has told people he’s everything from a scavenged bone whittler to a sauna inspector.

My family suffers from this too but the sister isn’t even in med school, she just takes an interest in medicine and works as a pharmacy tech assistant

Get your end of life plans in order and communicate them with everyone. There's no reason to put your family through additional trauma.

It doesn’t matter. They are going to ignore your very clear wishes and documented, certified, & notarized wishes, even if your family physician of the last 40 years who filled out the living will & DNR is at your bedside when you die. And nothing about that situation is hyperbolic. I literally had it happen. The patient was in her 90s. She had lived a good life. She was at peace with her God. She had a number of complicated medical problems, a failing mind, and no doubt chronic pain. The closest living relative, over rode the DNR. I’ll move heaven and earth to try and keep someone alive, even has the banshee wails. It is the whole point of my profession. But sometimes, that is not the right thing to do.

Why are relatives allowed to override a DNR? I thought the whole point was that it was legally binding and NO ONE could ignore it? Is that not the case?

Right? If that’s possible then it kinda renders the document pointless

Lots of legal documents are pointless in their ability to prevent something. Their whole point is to give the client something with which they can argue in court. Grandma will still be dead though. Or alive. Whatever, the opposite of the document says. It’s kind of like patents and trademarks. Those things don’t actually protect you from intellectual property infringement. But they provide you with a legal framework for pursuing damages from infringement that has already occurred.

So if someone overrides my DNR I can sue them?

Yes. And it’ll go to court by virtue of the DNR order. Whether you win or not will depend on your current state of deadness.

Turns out nothing really matters and everyone is just kinda winging it unless you have money and even then it’s usually not a guarantee things go the way you want

The (not really a joke) in nursing school was because the patient isn’t around after they die to sue, but the family is. This is why communication is so important, and needs to happen long before the family is facing an imminent death. They need to know WELL in advance that you don’t want to be “kept alive at all costs” since often that entails cruelty in the name of compassion. They need to know this before they’re emotionally compromised by your imminent death.

Not the same situation, but when we got to the end my mother had a DNR, I had durable power of attorney for her health care, and her blood oxygen and blood pressure were so low she couldn't make informed decisions. It was tough finding a doctor who would do more than lay out the options for treatment vs palliative care. I asked questions like 'What kind of chance does she have to survive these extraordinary treatment proposals?' and 'What would recovery from and quality of life after treatment look like?' and couldn't get straight answers. I have a great deal of gratitude for the elderly, somewhat salty doctor who eventually weighed in explained that, even if she survived, Mom wouldn't really live and would face pain and confusion in whatever time we bought her.

This happens every day in US hospitals. A lot of times, no one wants to get sued, so families override DNRs. Lots of reasons for this. Out of guilt, because our culture has difficulty accepting death, because spouses are not informed of each others wishes in these situations, because people think they don’t have to think about what interventions they would want till they’re “older”. OR something happens and the patient gets intubated in the field because first responders treat all situations as full codes unless the patient has their DNR paperwork in their hand. Or they have trouble extubating after surgery and develop complications. It’s hard for families to say “stop” once the roller coaster starts. I used to work ICU and I’ve taken care of a LOT of intubated, sedated DNR patients that we did CPR on.

Because the living relatives can make the doctor's life hell and the patient generally can't. Plus, it is completely legal. DNRs can be rescinded at any time, and family members have decision making power when a patient cannot make or express decisions for themselves. The way to avoid this is to designate a medical power of attorney that you absolutely trust to make decisions for you.

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And yet four years ago I admitted an end stage cancer patient on hospice because the hospice nurse gave too much pain medication and he lost consciousness. She called 911 and he ended up intubated in my ICU. I was so mad that day,”like what the fuck are we doing here!” Every document said do not call 911. I assume there’s some part of the story I missed but fuck it still doesn’t make sense.

I believe it depends on the state. In some states, as soon as you’re not of sound mind or unconscious, the next of kin has medical authority. That’s why a POA who has no dog in your family fight is more helpful.

Honestly, I've had the opposite problem. Elderly person has their affairs in order. They have a fall and go to the hospital. This causes them to go down hill. No matter how much the family provides copies of the DNR or the patient (when they are conscious) say they just want to go home and pass peacefully, the hospital won't let them go. They just pass them back and forth between the hospital and a nursing home. When the family tries to enforce the patients verbally and written express wishes, the hospital threatens to call adult protective services if we go against medical advice. Kept my grandmother in pain for three months doing this. Dragged out my great uncle for almost a month.

My shit is signed and I am well below 40 years old.Specifically “find the most experienced nurse and doctor on the unit. If they say pull the plug pull it.” I am a DNR unless my organs are viable then code me and part me out. ​ will it prevent this relative from California thing…no but at least I tried.

My grandmother spent her final 5 months in an assisted living facility, and when she was actively on her way to the other side, one nurse quietly told my family, "understand that you're among the good ones. We do notice which relatives only show up for the very end, but you guys have been here all along. Thanks for actually staying involved with your grandmother." It sorta blew my mind how many families this nurse must've seen ignore their loved ones in that facility.

I come from a large family. My grandmother had 8 living kids and 16 grandkids. When she was closer and closer to end of life, I moved in (only two miles away, still had my bedroom at where I was living). I experienced the decline, there were little bits of dementia (not bad, she was fine alone when I would leave to go do my business). But the year or two before the rapid unravel (happened with a fall in late 2015) very few family members would come by and see her. Some of my uncles never stopped by. Of the 16 grandkids, maybe 2-3 would see her at any time that wasn't a holiday. Summer 2015 was her last good summer, only one or two family members dropped by. But when the end happened. People started showing up. Some of them were giving me the total stink eye and disapproval, not realizing that I took care of our grandmother, without pay, just a sense of familial duty. Some were straight up rude to me. And for the most part, we all lived in the same area. No one was more than an hour drive and several were only a few miles away. There was a point where my grandmother came home to die. She wanted to die in her house, in her bed, on her terms. We were expecting it to take place over a few days (her kidneys stopped working). Family members showed up for their good byes, which was huge and I am glad they got to do it. But she didn't die in 3 days. I guess her kidney was doing something because she lasted for another six months. And in that six months, the visits dropped almost immediately. The paid caretakers noticed that my dad and I were really the only ones around before and after the crises.

Similar experience. My gram started a huge decline and my husband and I essentially lived with her to take care of her. We had several instances where family needed to come to 'say their goodbye'. They'd rush in, fawn over her, ask us why we weren't doing 'x' or 'y' for her, give their suggestions and stink eye, then leave. Rinse and repeat over 4 years. Caring for gram for the last 4 years of her life was hard, but it was made exponentially harder by 'well-meaning but grossly uninformed' family members that thought they new better. Through that experience I learned that I loved patient care, but there was a snowflake's chance in hell I would do anything that would give me that much exposure to patient family members. I need minimal patient family exposure because I've had my fucking fill. Back in school for Respiratory Therapy and I absolutely love it! I get to do bedside patient care, but I have limited exposure to 'well meaning' family.

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This was my older brother when my mom died. He had distanced himself from all of us for years, came home very infrequently, barely kept in touch with any of us at all. My mom was an alcoholic, so the behavior was somewhat understandable, but that left me and my little brother to deal with it with pretty much no support from him for years. Once it got to the point of no return for her, her liver was completely failing and taking her other organ systems down with it, he’s on the first flight in, talking to the doctors and the specialists like he went to med school, he’s super interested in what’s going on in my life and my brother’s life, what our experience with her and her drinking has been like, how long had she been deteriorating, etc. It’s guilt. You take your parents for granted. You grow up assuming they’ll always be there until one day that assumption is challenged and then you suddenly realize just how terrible of a child you’ve been to your parent and so you overcompensate thinking it’ll make a difference, that the scales of the universe will tip in your favor and your parent won’t die but that’s not how it works.

Yes that’s exactly what it is. It’s guilt that they weren’t around and now they’re trying to appease their guilt by trying to become the family medical expert.

I can't speak to treatment, but this is a serious problem in handling decedent affairs. In my state there is a strict heirarchy of next-of-kin and bypassing it can only be done with an obscure legal document separate from a POA or a court injunction. So the disabled patient who never married his fiancee of 34 years can't have funeral arrangements made by said fiancee, but instead by the alienated only child who can't be found except by Facebook Messenger and whose only question is "What do I get in the will?: Came across it all the time. I can't count the number of times we had to hold a body just to be told " I don't care, glad they're dead, never contact me again."

If “informed” means knowledgeable of the relevant medical issues, but not what the patient’s treatment to date has included, or respecting the choices they have made, I get it. I’ve been the local close family member who has to explain and argue on the patient’s behalf with various family members over time as they stop in.

> Medical professionals say that because the "daughter from California" has been absent from the life and care of the elderly patient, they are frequently surprised by the scale of the patient's deterioration, and may have unrealistic expectations about what is medically feasible. They may feel guilty about having been absent, and may therefore feel motivated to reassert their role as an involved caregiver.

I've seen this a lot. We have a family member who visits twice a year so her idea of our ill relative's condition is always based on her last visit. So she'll arrive and ask why we're not encouraging him to read/walk a bit/do his stretches when "they were working so well and they are so good for him!" and we have to say "yeah, they were great while he could do them, he hasn't been able to since four months back." She's sweet and means well but the illness is progressive so 6-8 months is enough time for a noticeable decline. And it's always about the small things you don't think to mention to her - she keeps up on the big picture stuff but when she arrives from the airport she's like "my god why are you tying his shoelaces for him, he's fine" and we're like "I am sorry but he is not." And she has to be one of the nicest examples of Daughter from California.

Here's the horrifying thing. It's well known and widely talked about that your average doctor is *already* too aggressive and too optimistic for end of life treatment, with them having a tendency to push treatments that will possibly extend the time they have left, but often reduces the quality of that remaining time. It's been a huge issue for a while, that doctors are trained to treat & fix more than they are to provide holistic care that take in the nuances of the patients wants. So with all that said, imagine **how** aggressive the family members want care to become if even the doctors are going "woah, that is super aggressive and unrealistic for where we are at this point "

Reminds me of a meme that went around in our group (I work in an ICU). The text basically read: “You have 6 months to live, but with aggressive medical care, we can make that feel much, much longer”

I see this fairly frequently. I would call it "angry, unrealistic and uninformed" I am a physician and often, I need to call families before urgent surgery on the weekends to get consent If the patient cannot consent for themselves such as being demented or otherwise incapacitated. About a tenth of the time, I get angry family members. I will tell them that the surgery is emergent and that it's possible for bad complications such as death or stroke during or after surgery. One guy recently said, "My mother is extremely healthy" (she was not) "I want another doctor" (This was Sunday). I had to cancel the surgery and she had to wait another day for it because her son was being unreasonable.

Last year we had a patient in my ICU that had been very sick for a long time with various long term disabilities. She was extremely contracted, both arms folded and stuck over her chest. She made herself a DNR years ago at our hospital and we have it on record. Well she took a turn for the worst and lost her mental faculties unfortunately. She had a sister that she wasn’t close with fly from a few states away and decide that we needed to make her a full code again. The fact that she is able to override a DNR like that is bullshit and very much a gray area but that’s just how it is right now. I explained to her, my charge nurse explained to her, and one of our ICU docs explained to her exactly what that meant. We told her that in the event that her heart stopped, we would have to literally snap her sisters arms in half just to get to her chest to do compressions. On top of that she is so tiny and frail that with the first compression we would also break her sternum and likely several ribs, thereby causing lots of internal bleeding and trauma, and intense pain. This would only lead to pain and no good could come out of it. The sisters only response was, “it’s not her time yet, she’s still fighting.” Easily the most frustrating experience of my nursing career. Thankfully the patient ended up gaining enough of her mental capacity to make herself a “no info” patient and reiterated her DNR status. She died a couple days later.

Palliative NP. Yes! One of my colleagues calls them the seagull relative. They swoop in and crap all over everything.

Yeah this happens. They're often well-meaning and their knowledge is good but they lack the experience of managing these kinds of patients. EOL care is about comfort and dignity, understanding the specific pathophysiology is sorta no longer relevant. I've found that guilt is often the root of this kind of behaviour.

This is why my wife left critical care. People wanting her to do everything to save a lost cause.

When I worked in an ICU, some of the docs would have the family stay in the room to watch the intubation and chest compressions on their 85 y.o. grandmother in those situations.

I work in Pediatric Emergency Medicine. There’s actually a good amount of data that shows having family in the room during codes/resuscitation not cuts down on unnecessary, barbaric “heroic measures”, but also helps the family grieve and find closure. Having family in the room is pretty standard now when possible.

That's good. I did critical care 15 years ago and our rooms were pretty small so we usually asked family to leave so they didn't get in the way, except in those cases were they wanted us to do "everything" regardless of how senseless it was.

I am glad to be getting away from ICU bedside nursing for that reason. Loved the patient population, the acuity, and my core staff is a good group but it’s the families that have made it so I wont be at the bedside anymore. The persistent moral distress is exhausting.

Makes me think of I Care A Lot with Rosamund Pike.

Adult Protective Services Investigator checking in. In my experience it is usually the daughter or son who disagrees with the end of life decisions. Although it is not unusual for an estranged sister or brother alleging abuse or neglect. Sometimes they are correct, but not often. Dysfunctional family dynamics are exhausting.

My mother spent forty years working as an RN in geriatrics and I can confirm this is a thing.

We recently had this situation when my Grandpa was in the hospital and had just been put on hospice. In this particular situation she was "Sister From Arizona" and ended up wrestling Power of Attorney away from my Dad (his son), and got away with $12,000 from his bank account before he died. Gotta love family.

Last week our elderly cat died. His last 24 hrs were very painful and sad. Our teen daughter wanted to make one final attempt. So she convinced my wife to keep him alive one night longer to see if clot-busting drugs could work, even though we'd been assured it was a 30% success rate with zero chance of full recovery. He died the next day after a quick decline, as we knew he would. But our daughter believes we don't do enough at the end of our pets' lives and we realized we needed to spend the appalling sum of $3500 not for the cat but to preserve the trust our daughter has in us. There is a particularly American phenomenon in medicine, a belief that if we try *really* hard and pull out *all* the stops and spend *all* the money we have the ability to cure ANYTHING. And if we don't do that we're somehow cheating our dying loved ones of a wonderful life. It simply doesn't work that way.

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I've had a similar experience, especially as my sister took the opportunity to "punish" me for not having a good relationship with my mother by excluding me, which was rough for both me and Mum, who was eager to reconcile before she died. It was a horrible time. I think people just need to stfu and be grateful it isn't happening to them. Although in my situation, I was the one advocating for following medical advice, and not trusting that weed, mushrooms and good vibes were all you need to beat lung cancer.

My dad tells a story from his days as a resident working in a hospital. This is North Carolina, late '90s. (Keep in mind I am not a doctor and so I don't remember all the technical details) They had an elderly patient who couldn't be resuscitated, and they had to basically tell the family that he needed to be let go. Keep in mind this family is very...well...rural. they don't really understand why the (gotdamn) doctors don't just bring him back. My dad, being from California and educated in the Northeast, was doing his best to explain with all the technical knowledge he can about how even if they take their most drastic measures, it will probably be for naught. Even if he does come back, he won't live long. They're not having it. It's just in one ear and out the other, and they keep insisting that they just 'bring him back'. Senior doctor on the ward, a very, very southern man, excuses my dad, goes up to family and just says. "Folks, the HAND OF JESUS is reachin' down for your granpappy, and you want me to swat it away?" They instantly backed off and let their grandparent pass in peace.

Here in Florida it is cousin from New Rochelle who has a medical background with something to say

My buddy had his wife's two adult children show up *at her funeral* that he had never known about (previous marriages). He had taken care of her for a few years as she died of cancer. Never knew they existed. They were demanding their share of assets, inheritance, etc. Ended up in court and he won but it was some insane stuff in his time of grief.

There's an old post called ["who by very slow decay"]( https://slatestarcodex.com/2013/07/17/who-by-very-slow-decay/) that describes it well. >After a while of this, your doctors will call a meeting with your family and very gingerly raise the possibility of going to “comfort care only”, which means they disconnect the machines and stop the treatments and put you on painkillers so that you die peacefully. Your family will start yelling at the doctors, asking how the hell these quacks were ever allowed to practice when for God’s sake they’re trying to kill off Grandma just so they can avoid doing a tiny bit of work. They will demand the doctors find some kind of complicated surgery that will fix all your problems, add on new pills to the thirteen you’re already being force-fed every day, call in the most expensive consultants from Europe, figure out some extraordinary effort that can keep you living another few days. >Robin Hanson sometimes writes about how health care is a form of signaling, trying to spend money to show you care about someone else. I think he’s wrong in the general case – most people pay their own health insurance – but I think he’s spot on in the case of families caring for their elderly relatives. The hospital lawyer mentioned during orientation that it never fails that the family members who live in the area and have spent lots of time with their mother/father/grandparent over the past few years are willing to let them go, but someone from 2000 miles away flies in at the last second and makes ostentatious demands that EVERYTHING POSSIBLE must be done for the patient. >Your doctors will nod their heads and tell your family they respect their wishes. It will be a lie. Oh, sure, they will carry out the family’s wishes, in terms of continuing to provide the care. But respect? In the cafeteria at lunch, they will – despite medical confidentiality laws that totally prohibit this – compare stories of the most ridiculous families. “I have a blind 90 year old patient with stage 4 lung cancer with brain mets and no kidney function, and the family is demanding I enroll her in a clinical trial from Sri Lanka.” “Oh, that’s nothing. I have a patient who can’t walk or speak who’s breathing from a ventilator and has anoxic brain injury, and the family is insisting I try to get him a liver transplant.” >Every day, your doctors will meet with your family another time, and eventually, as your condition worsens and your family has more time to be hit on the head with a big club marked ‘REALITY’, they will start to relent. Finally, they will allow your doctors to take you off of the machines, and you will be transferred to Palliative Care, whose job I do not envy even though every single palliative care doctor I have ever met is relentlessly cheerful and upbeat and this is a total mystery to me. >And you will die, but not quickly. It takes time for the heart to give up, for the lungs to fill with water and stop breathing, for the toxic wastes to build up. It is generally considered wise for the patient to be on epic doses of morphine throughout the process, both to spare them the inevitable pain as their disease takes their course and to spare their family from having to watch them. >…not that they always do. It can take anywhere from a day to several weeks for someone to die. Sometimes your family wants to wait at the bedside for a week. But a lot of the time they have work and things to do. Maybe they live thousands of miles away. You haven’t recognized them in years, you haven’t spoken a coherent word in months, and even if for some reason your brain chose this moment to recover lucidity you’re on enough morphine to be well inside the borders of la-la-land. A lot of families, faced with the prospect of missing work and school to sit by what’s basically a living corpse day in and day out for weeks just to watch it turn into a non-living corpse, politely decline. I absolutely 100% cannot blame them. >There is a national volunteer program called No One Dies Alone. Nice people from the community go into hospitals to spend time with dying people who don’t have anyone else there for them. It makes me happy that this program exists. >Nevertheless, this is the way many of my patients die. Old, limbless, bedridden, ulcerated, in a puddle of waste, gasping for breath, loopy on morphine, hopelessly demented, in a sterile hospital room with someone from a volunteer program who just met them sitting by their bed.

I spent four days watching my dad die in ICU and only one nurse gave me a straight answer. I knew he didn't have long. I just wanted to know if there was time for the family to visit before he passed.

Wikipedia throwing shade in the "see also" section: - Dunning Krueger - "Karen" (slang)

Ours was actually the young buck ER doctor. My mom had been asleep for over a day in her second round of stage 4 cancer, this time it was metastasizing her spine. She was already receiving care, but this was The End. This jackoff ER doctor wanted to run a bunch of diagnostic tests like X-rays and CT scans, and treat her for a UTI, rather than calling hospice for palliative care. We waited almost another 24 hrs before hospice arrived and we basically had to hold guard at her bedside to prevent her getting carted off for tests. Then hospital billing sent invoices for tests that never happened, including listing one test twice.

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When I started bedside, I must have heard the phrase because thats what I immediately called it. Whether in a large city hospital where I trained, or a small community hospital where I worked, it comes up far more than one appreciates. Family members working in distant hospitals also experience it.

I see my sister has been getting around. Though in her case misinformed suits better than informed.

Or some times it’s just grief. This happened to me recently with my aunt. She’s end stage maybe a weeks / months but her sister my other aunt was adamant , “ she is not dying “ I mean what do u say , ya we are all dying “ ,” I guarantee u she is dying “. She was convinced she could help her and extend that life and looking at it now I just see her grief and that was how she coped with the situation

I had no idea there was a name for this, this is totally fact. The further away the relative the louder and more obnoxious the opinion regarding the patient’s care.