I am a friend and advocate for an 85 year old woman with stage 4 COPD and congestive heart failure. She has a trach and is on a vent. She has been on a vent for 8 weeks, occasionally going onto CPAP and BiPAP. He initial goal was to get better, go to rehab, and go home to her life, but she has had several instances of respiratory failure during which she had to be bagged and had deep suction to remove thick secretions. She was recently sent to the ER for low blood pressure, erratic and sometimes high heart rate, and respiratory failure. She currently has n lung infection but has been battling for on this to keep pneumonia at bay. She has shared with me that she no longer want to be on a ventilator and wants end of life care. There is a lot of resistance from one of her children and does not any of them to know. I have let the doctor know that she is requesting a consult from Palliative care. She does not want me to tell her family and does not want them to be there.
I want to advocate for her but know how to respect her wishes Bout comuniating withthefaily. She does not want them to be there at the time of death,
Any advice?