Heartbreaking situation - advice needed

[Juggletits]

I'm posting on AIBU for traffic.

My darling sister has been at the bedside of her beloved ex-DP for 9 days since he suffered a massive heart attack. He nominated her as next of kin (NOK)whilst lucid to the paramedics.
Neither of them were aware that he was having a heart attack when the ambulance arrived. He's only just turned 46, that day.

DSis has been the only person in his life for years. He barely sees his family and has no friends anymore.

I'll call him Tom for ease.

Tom is a an addict. Alcohol, cigarettes and weed. He cannot function without any of these crutches.

DSis met him 18 years ago and they were in a serious committed relationship for 13 years. When younger his addictions weren't so concerning but as they grew older and started discussing children etc it became clear he wasn't able to make healthy choices and was deeply in the grip of a spiralling addiction. DSis financially supported him for years, begged and pleaded with him to get support but ultimately realised he was not able to change. So in 2020 she made the desperately difficult decision to end their relationship and leave their home.

She still loves him and he loves her. She has stayed in his life as a friend and as the years have passed he has lost anyone else who may have cared once as it's very hard to understand and support an addict who is slowly destroying themselves.

Rewind 7 years - DSis, knowing that Tom needed help and at her wits end with what to do, appealed to his parents for help. This backfired hugely as they took it as criticism of them, there was a massive falling out and they have refused to speak to her ever since. They have very little to do with Tom. They give him money when asked but don't seem able to accept how very unwell and in need of support he has been. They absolutely HATE DSis for asking them to help Tom.

Following the heart attack they did not come to the hospital for 8 days. His mother still hasn't visited. His father arrived on thursday and by yesterday afternoon he had managed to get his delirious, gravely unwell son to revoke DSis' status as his NOK.

He has now banned her from visiting Tom and also told the medical staff to no longer update her on his health.

She's been there every hour she's been allowed to be. For 9 days. Despite the fact they aren't together, they love each other. He needs her to advocate for him. He has been asking the staff for her when she isn't there.

His prognosis is dire. He needs a heart transplant. His heart is destroyed by years of alcohol and smoking.

As she was told to leave yesterday, she learnt that things look even worse with a further clot in his heart.

His father watched them saying their goodbyes, both distraught. And cared not a jot. He has sent away his son's only person for his own selfish reasons.

I've been googling frantically and trying to figure out where to turn for advice but all the avenues look shut for the bank holiday. We don't know if he'll still be here on Tuesday.

So I'm appealing to you wise MNers for any advice.

Is there anyone who can intervene?

It is so cruel so keep them apart and the only reason is a bizarre form of revenge...

It seems he must have coerced the change of NOK as Tom hasn't been lucid for days

Anyway - it's long and complicated. I hope that someone has some advice for us.

No point in anyone sending anyone to rehab if the person themselves doesn't 100% want it!

This. Hospitals are public places, and if Tom's family do not want his former partner there, then tough. As long as she is respectful and does not cause a scene for Tom or the hospital staff caring for him.

It sounds like he's barely conscious and about to pass away.
Your sister has said her goodbyes.
Presumably he could phone her to talk if he's aware enough.

I don't really see what next of kin has to do with anything at all. It doesn't matter who is next of kin does it.

Your sister just needs to accept he's about to die, say her goodbyes.

What else is there?

Hospitals may be public place, but wards have visiting hours and restrictions for a reason, especially places like ICU.
Staff are not there to police visitors, they have enough to do, you know, caring for the patient.
If the patients father has for whatever reason said that she isn't to visit, and Tom cannot verbalise his needs to his father, then his father has every right to say no to her.
I am not saying its right far from it, but these situations are never straight forward and staff do not want a showdown at the bedspace

Forget about NOK. It’s not important.

what is important is that if Tom wants her there she should be there? Has he told her not to visit?

Can she visit when his dad isn’t there?

To your sister

Call the ward and ask for the name of his consultant. Email his or her secretary and let them know that you were the patient's nominated NOK. His father has revoked this but DOES NOT HAVE MEDICAL POWER OF ATTORNEY so can't easily bannish someone from the ward without reason. Ask the consultant to clarify with the patient himself, independent of either of you, what he wants. Unless the patient says you can't visit him, the father can't stop you from spending time with him. Similarly, unless the patient says you can't have information, the father can't block you from information unless he has medical POA.

Capacity is a complex and variable thing to assess sometimes. But if he still has the capacity to make this decision for himself, his father can't overide the decision.

If you are worried over the weekend. Ask to speak to the nurse in charge on the ward. She won't be able to give you information. But you can explain that you were nominated by the patient and you question his capacity at the time his father changed his mind. Ask for her/ him to pass on a message to the on-call medical team to redo a capacity assessment for this simple question " is ex-partner allowed to visit and to be his NOK and advocate"

Has your sister put her whole life on hold for this guy? Or did she find someone else and have the children she clearly wanted?

Don’t be dragging the bloody consultant in ffs.

You don't understand what medical power of attorney means, it allows you to make medical decisions if the person who has nominated you (by a proper process involving submission of a form to the Office of the Public Guardian, not simply saying "X is my NOK" - a term which as others have said has no legal standing). Whether someone else visits the ward is not a medical decision so even if there is someone who has LPOA for health, they can't use it for that.

Tom's parents might have been dreadful and the absolute worst as parents. But at some point in his adult life he has made the decision to continue on this downward spiral, despite having the love of your sister who was willing to help him. So I don't think we can blame his parents entirely - Tom had free will but never used it to sort himself out. However much money his parents didn't throw at his problem - it wouldn't have helped if Tom himself didn't WANT to sort himself out. It would just be money pissed up against the wall.

I think your Dsis needs to make peace with the fact that she's going to lose Tom, but that he wasn't perhaps as great as she wanted to believe him to be. She needs to see him realistically as the agent of his own destruction. She is allowed to grieve, of course, but beware her becoming a Professional Griever, if she tries to talk this - clearly doomed practically from the beginning - relationship up into being The Great Lost Love of Her Life.

I think you have completely misread the situation.

She has tried to move on and meet someone who would be good dad.

Rapidly approaching 40 she self-funded 2 rounds of IUI. Neither were successful.

I am heartbroken that it now seems she stayed with Tom for far too long trying to help him and now he will be dead and she will be left full of regret, too old for NHS fertility treatment and feeling completely devastated by it all.

She's SUCH a good person. I hate this has happened to her just because she fell in love with such a troubled person.

I did too, which is another thread, for another day.

We are both the result of a completely emotionally absent father and a skewed view on what a healthy relationship looks like.

As Philip Larkin wrote;
They fuck you up, your mum and dad.

They may not mean to, but they do.

They fill you with the faults they had
And add some extra, just for you.

But they were fucked up in their turn
By fools in old-style hats and coats,

Who half the time were soppy-stern
And half at one another’s throats.

Man hands on misery to man.
It deepens like a coastal shelf.
Get out as early as you can,
And don’t have any kids yourself.

i don’t know what experience you have of a loved one in addiction but this is entirely unsurprising to me. Just like his parents abandoning him and his mother not visiting for the first eight days are unsurprising.

You don’t need legal standing to be NOK you just need the persons consent for them to be updated. Yes, they can’t make any life changing decisions on that person’s behalf but it would be odd for them to be just sent away of the person wanted them there. That wouldn’t happen in our trust. Anyone can visit a person in hospital, it’s not a prison, and anyone can be updated and discuss a persons condition as long as the person being discussed has given consent.

No they’re not. The only person to blame is Tom.

That’s not how addiction works.

can he still make his own decisions?! If so, the nurses need to speak to him directly to gain his consent to add your sister as NOK and also set a password so that information can only be shared between him and your sister and also nothing can be changed unless they are both spoken too.
I work in a hospital and the only person who can “ban” visitors and change details is the patient, unless they lack capacity.

@Whataninterestinglookingpotatowe have to log all visitors on our ward for fire purposes, and we do regularly have patients who give us names of people they do not wish to visit them. We make it clear that we have to tell the visitor it’s the patients wish and not our decision.

Next of kin is actually a myth. It means nothing. Although the medical staff will ask about what the patients wishes would be, if the patient can’t consent, they will make a best interests decision. If ex DP had made it clear he wants EXp involved they should respect that.

We also get this. Although if it’s a patent with PR. We have to make it clear that we can’t stop them visiting. Even if the other parent says no. Unless there is a court order we can’t legally stop them.

There’s no such thing as next of kin. She has no rights and he can’t give them in the way suggested.

NOK is irrelevant, his father doesn't get to make these decisions on his behalf unless he has a form of power of attorney AND her ex-partner has lost capacity. If he is asking for her and is content for her to attend, she can go. If she is not nominated as NOK, she may not be called in event of a deterioration and may not get updates on his condition though.

My parent recently spent time in ICU - completely unaware of what was going on around them. I was told they were there by the neighbour who called the ambulance. I am their NOK - it meant I was asked questions about their life outside of hospital, about any medication they were taking etc. I was given a password which I needed when calling or visiting the ward. Only people with passwords were given access and maximum of 2 visitors at a time. The people making decisions about treatment were the highly qualified and quite brilliant staff. My parent was then moved to a coronary care department - anyone can visit but I am the only person who receives treatment and condition updates. There isn't a POA in place but the staff were very keen to hear my thoughts on their treatment plan because I know what my parents life is like but thats it - my opinion. The medical staff are amazing and they are giving my parent the best care possible (and it's been palliative for some time now).

Some might say the OP's sister has spent years enabling Tom.