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Old 11-24-2013, 05:34 PM   #1
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stroke victim refusing hospital

Just got word my gpa had a stroke and is refusing to go to doctor. Possible 3 days ago. He isn't making any sense on the phone.

Any one know if there is a way to get an ambulance to pick him up as he isn't in his right mind. He told them no last time and so they left
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Old 11-24-2013, 08:28 PM   #2
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Is this your grandpa?

If yes:
Who told you about the stroke? Is it a family member?

Do you live in the same area? Sounds like its time for a family reunion to his house and literally pick him up and get him in the ambulance. Or...If having some serious family PUSHING and have the entire family drive him there.
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Old 11-24-2013, 08:30 PM   #4
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his wife called us today... 3 days late... anyhow, he lives about 6 hours out. plans to drive out and try to get him to go. hospital won't treat him without his consent same with ambulance wont, he was able to answer the questions they asked just enough
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Old 11-24-2013, 08:41 PM   #5
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I'd hate to be in your position. How old is he? How's his health otherwise? Does he have an advance directive or does he have anything in place that describes what, if any, treatment he wants in the event he is unable to decide for himself? Without something in place, I would guess there is some method using diminished capacity to get it done but, I'm really not sure man if it's from a legal (court side) or medical side.
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Old 11-24-2013, 08:45 PM   #6
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Quote:
Originally Posted by Bennett707 View Post
his wife called us today... 3 days late... anyhow, he lives about 6 hours out. plans to drive out and try to get him to go. hospital won't treat him without his consent same with ambulance wont, he was able to answer the questions they asked just enough
Perhaps the wife.....is reaching out to you and the family for some help!!

Stubborn old man won't listen to his wife!! (imagine that??)
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Old 11-24-2013, 08:47 PM   #7
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65-70. He has always went to the hospital for other issues, he couldn't comprehend things and would loop off onto different subjects while he was on the phone w/ my pops. We called his local first response and the sherrif said he questioned him and agreed he had a stroke but he was able to answer questions and refused to go to hospital, so they couldn't take him.

best shot now is just trying to get him to go in person. thanks for the replies, been a busy night.
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Old 11-24-2013, 08:54 PM   #8
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Quote:
Originally Posted by Bennett707 View Post
65-70. He has always went to the hospital for other issues, he couldn't comprehend things and would loop off onto different subjects while he was on the phone w/ my pops. We called his local first response and the sherrif said he questioned him and agreed he had a stroke but he was able to answer questions and refused to go to hospital, so they couldn't take him.

best shot now is just trying to get him to go in person. thanks for the replies, been a busy night.
Good luck man. I'm guessing if the local police visited him and decided he understood what was going on, it's going to tough to get him any treatment man.

Again, good luck.
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Old 11-24-2013, 09:08 PM   #9
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Quote:
Originally Posted by Bennett707 View Post
65-70. He has always went to the hospital for other issues, he couldn't comprehend things and would loop off onto different subjects while he was on the phone w/ my pops. We called his local first response and the sherrif said he questioned him and agreed he had a stroke but he was able to answer questions and refused to go to hospital, so they couldn't take him.

best shot now is just trying to get him to go in person. thanks for the replies, been a busy night.
So, the sheriff agreed he had a stroke.....and wouldn't take him?

WTF?

Thanks Sheriff.
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Old 11-24-2013, 09:11 PM   #10
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What makes you think he had a stroke?

For Stroke victims there is a 4-6 hour window From the last time they were seen "normal". (depending on county protocols) The window is vital in that the patient can be helped significantly to prevent any permanent damage. But unfortunately after the window closes the damage (if any) that occurred is permanent and there is nothing an ED (ER) can do. (so no reason to go by ambulance)

The best thing to do is to have him see his doctor. There should be some medications and rehabilitation that can help him.
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Old 11-24-2013, 09:20 PM   #11
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The thing is EMS can not force anyone to go. If a patient is able to answer questions appropriately in our presence we can not make them go no matter the circumstance. It would be considered kidnapping. He would have also had to sign a form, against medical advice, stating that he knew and accepted the risks of not receiving treatment. Now, if he is confused now or unable to answer appropriately, EMS can take him without his consent ( at least where I work). And just as someone posted above, unfortunately there is a 4-6 hour window from onset of symptoms to receive treatment. He definitely needs an eval, but it may be best to have family get him into a car and drive him to the hospital. In an unfortunate situation I know many people, including myself wish you and your family the best and hope for a favorable outcome.
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Old 11-24-2013, 09:28 PM   #12
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Quote:
Originally Posted by jr114 View Post
The thing is EMS can not force anyone to go. If a patient is able to answer questions appropriately in our presence we can not make them go no matter the circumstance. It would be considered kidnapping. He would have also had to sign a form, against medical advice, stating that he knew and accepted the risks of not receiving treatment. Now, if he is confused now or unable to answer appropriately, EMS can take him without his consent ( at least where I work). And just as someone posted above, unfortunately there is a 4-6 hour window from onset of symptoms to receive treatment. He definitely needs an eval, but it may be best to have family get him into a car and drive him to the hospital. In an unfortunate situation I know many people, including myself wish you and your family the best and hope for a favorable outcome.
+1
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Old 11-24-2013, 10:01 PM   #13
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Advanced directive or power of attorney. If neither has been established and his mental capacity has deteriorated so badly he will likely have to go through a mental capacity test. If he fails, care options will likely be with family members. This is assuming he is stable enough to swallow and breathe on his own.
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Old 11-24-2013, 10:27 PM   #14
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Quote:
Originally Posted by jr114 View Post
The thing is EMS can not force anyone to go. If a patient is able to answer questions appropriately in our presence we can not make them go no matter the circumstance. It would be considered kidnapping. He would have also had to sign a form, against medical advice, stating that he knew and accepted the risks of not receiving treatment. Now, if he is confused now or unable to answer appropriately, EMS can take him without his consent ( at least where I work). And just as someone posted above, unfortunately there is a 4-6 hour window from onset of symptoms to receive treatment. He definitely needs an eval, but it may be best to have family get him into a car and drive him to the hospital. In an unfortunate situation I know many people, including myself wish you and your family the best and hope for a favorable outcome.
+1

We always shoot for a three hour window, but current studies has shown 4.5 hrs to acceptable. And confused or absence of normal (baseline) cognitive status can warrant an EMS ride. I believe they used the MMSE back home in the field for a quick cognitive exam. The immediate family makes that call. But, like you stated he can refuse. Best thing for your situation is to call his regular doctor (someone he trusts) and schedule an immediate appointment. Because he needs a CT scan like 3 days ago. Plus you don't know if he hit his head and has a slow leaking head bleed. If he is on blood thinners then that makes it even more dangerous. Good luck man.

PM if you have any questions.
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Old 11-25-2013, 12:48 AM   #15
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I'm sorry to hear that man my grandpa died 5 years ago and he suffered a stroke but that was what finally got him. I would say tell your grandpa to get his ass to the hospital and do try to set up a power of attorney for him if he is gone mentally.
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Old 11-26-2013, 10:40 PM   #16
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Quote:
Originally Posted by jr114 View Post
The thing is EMS can not force anyone to go. If a patient is able to answer questions appropriately in our presence we can not make them go no matter the circumstance. It would be considered kidnapping. He would have also had to sign a form, against medical advice, stating that he knew and accepted the risks of not receiving treatment. Now, if he is confused now or unable to answer appropriately, EMS can take him without his consent ( at least where I work). And just as someone posted above, unfortunately there is a 4-6 hour window from onset of symptoms to receive treatment. He definitely needs an eval, but it may be best to have family get him into a car and drive him to the hospital. In an unfortunate situation I know many people, including myself wish you and your family the best and hope for a favorable outcome.


True, except under certain circumstances such as: he cannot appropriately care for himself and his wife does not feel that she can adequately care for him. The local area physician may also be able to assist in persuading him to seek tx if contacted. This is all assuming that there are no advanced directives/ DNR, but several days in this is beyond emergent live saving efforts and moves into a quality of life situation.
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Old 11-27-2013, 05:38 AM   #17
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True, except under certain circumstances such as: he cannot appropriately care for himself and his wife does not feel that she can adequately care for him. The local area physician may also be able to assist in persuading him to seek tx if contacted. This is all assuming that there are no advanced directives/ DNR, but several days in this is beyond emergent live saving efforts and moves into a quality of life situation.
There's always a work around to 'a refusal'

For the OP: Not that I openly share this type of information - but - It's a story of 'dealing' with a similar situation kinda.

My own father-in-law never had a stroke, but he either had onset of Alzheimers or schizophrenia. I don't know the details closely - but he refused to see a doctor as well. Try telling (accusing) a grown man of hearing voices and seeing things. In his mind.....there's absolutely nothing wrong.

Somehow, with the help of family....He went to the doctor and the doctor submitted him to a mental hospital. After a week (and medications), they rendered him safe to come home.

After some time of being back home - he still wasn't 'right' and they found out he stopped taking his meds. Back-n-forth in & out of doctor visits and the medical community rendering him SAFE. The really really really bad thing.....
They rendered him SAFE to go back to work. And of course, he loved his job as a security officer and was happy to go back to work.
The family did not feel 'warm & fuzzy* about him going back to work.

Unfortunately - he had access to firearms and decided to take his own life (this was about 5 years ago).

Whether or not he knew this originally or he became to understand his own problem. But, we believe he was struggling with himself and those voices and the only way to rid himself of the voices, was to end it all. He was the type of man who never wanted to inconvenience his family for him.

So yeah, its a mental struggle for both family and patient. Even after pushing the issue .... You wished you could've done more.
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Old 11-27-2013, 05:43 AM   #18
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Since it sounds like he's outside of the window for treatment, what about having someone come to the house to evaluate him? Is he against the hospital or doctors in general. Doing the evaluation in his own home might make him more comfortable to where he'll allow it and the family would have the piece of mind of having him checked out.
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Old 11-27-2013, 06:11 AM   #19
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take him to his regular doctor, tell him he has a normal checkup.
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Old 11-27-2013, 06:14 AM   #20
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slip him a roofie
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