Since her husband's death, she wrote an Advanced Directive and health care proxy giving her daughter durable power of attorney. In the advanced directive she stated, "I want to be treated at home, kept comfortable and treated without any artificial means of support." She did not have a DNR in place.
The son and daughter are at odds about their mother's care. The son wants his mother placed in a long-term facility since her condition has deteriorated to a vegetative state. The daughter disagrees.
Mrs. P.'s daughter and granddaughter moved in to assist with her care some weeks ago. N.P. was placed on long-term care and received aide service of 4 hours daily and a nursing visit one day a week.
Mrs. P's daughter is physically debilitated from arthritis and depressed at times. Her grand daughter, who does most of the care through the afternoon and evening, has decided she would like to be out and spend more time with her friends and boyfriend. The grand daughter and Mrs. P.'s daughter have a history of a volatile relationship in which the grand daughter would leave for days or sometimes weeks at a time.
A few weeks ago when the grandaughter was away , health care workers reported that Mrs. P. had not been repositioned or changed through the evening. Mrs. P.'s daughter requested additional hours of assistance to ensure adequate care for her mother. The nurse suggested possibly placing her mother in a long-term health care facility if she, the daughter, is unable to care for her. N.P.' daughter refused the suggestion. The granddaughter, who was away, returned home and continued care.
If you are the health care person assigned to Mrs. P, what ought you do?