Angel or Predator?
October 4, 2017 8:44 AM   Subscribe

A woman has insinuated herself into the life of Ann & Jack, who are facing terminal illness, and the family is unsure if they should be concerned.

Ann’s husband Jack has a chronic disease that has been progressively debilitative and was recently given a prognosis of end of life within 6 months to 1 year.

Less than a year ago, Ann met Susie. Susie claims to have a nursing background and has quickly gained the trust of Ann. So much so, that when Ann chose to take a trip out of town recently, she chose Susie as one of the primary caregivers for Jack while she was gone.

During this trip, Susie makes a series of increasingly anxious and dramatic calls to Ann relaying a sudden down turn in the health of Jack. Other caregivers (including doctors, nurses, and the at-home caregiver, Gia, who has been with the family for 10+ years) were not reporting the same level of concern. Some reports were directly contradictory. Examples:

-Susie reports Jack has not urinated in 24 hours. Gia says this is false and gives exact times and amounts of urination.
-Susie reports Jack is confused and disoriented. Several people who are around him regularly report he’s fine and behaving normal for him.
-Susie reports Jack is aspirating and cannot get liquids down. Gia said, not true, I’m feeding him right now.

Susie’s calls became increasingly dramatic, ending with a call to 911. Jack, who is in an extremely fragile state, is then put into intensive care at the hospital and subjected to a cascade of tests and procedures. His prognosis has now gone from 6 months to 1 year to a matter of days.

Susie was the sole contact person at the hospital for around 24 hours (other family members were traveling to get there). Decisions were being made by Ann, solely based on the reports of Susie. (Gia had been denied entry to the hospital room.)

Ann relayed stories of at least 3 instances where Susie has become “like family” to other people in distress. She also said Susie “has no money.” Ann is solidly middle class and gives off the impression of having money. (Example, Ann was worried Susie had not eaten at the hospital because she would not have enough money to afford food).

Ann is obviously in an emotionally delicate state and is keeping Susie close (like, Susie is staying at her house level of close) and continues to rely on her advice and support.

Susie is setting off alarm bells for everyone but Ann. Do we need to be worried? Is Susie really just an angel/ hero who happened by at the right time and is selflessly helping Ann? Or are there sinister implications? Is this a scam scenario? If so, what’s the scam?
posted by myleftsock to Human Relations (33 answers total) 5 users marked this as a favorite
Sounds like Susie gets off on causing drama among people who are vulnerable and dependent on her. If nothing else, she's lying about someone in fragile health and causing panic, and if someone takes her misinformation seriously it could have negative consequences for Jack's health. She may enjoy the attention that comes with caring for someone who is very ill in a way that crosses over into hurting someone so she can have attention for "saving" them.
posted by bile and syntax at 8:57 AM on October 4, 2017 [13 favorites]

Who has control over the finances? That would be my first thought.

Do Ann and Jack have adult children? Get them involved if so! Good luck!
posted by Hanuman1960 at 8:58 AM on October 4, 2017 [9 favorites]

(like, Susie is staying at her house level of close)

Is this a scam scenario? If so, what’s the scam?

Stealing things in her house? If she has access to that, it could be anything. Major alarm bells here.
posted by Melismata at 8:59 AM on October 4, 2017 [8 favorites]

Is this a scam scenario? If so, what’s the scam?

Getting in the will. Free place to live. Susie's a grifter. I'm especially concerned that Gia, as the long term caregiver, was denied access to Jack's hospital room. His prognosis has decreased because the medical team was not given Jack's accurate recent medical history and subjected to unnecessary tests and procedures in a fragile state.
posted by Ruki at 9:07 AM on October 4, 2017 [49 favorites]

This is seriously bad news. She's either after money or has some kind of Munchhausen's kind of thing, or both.
posted by amro at 9:09 AM on October 4, 2017 [36 favorites]

Unless there's more information that we don't know about, Susie is seriously bad news. She could be after money or a place to stay or this could be some form of mental illness where she wants to control people.

The family needs to try to do something, but there are legal issues here that we don't know enough about. How was Gia denied access? Has Jack or Ann given Susie power of attorney or is the hospital just believing what Susie says? (One thing that was really shocking to me when my childless, elderly aunt and uncle were hospitalized was that hospitals will often just give legal control to anyone who claims it, including overriding the wishes of a patient if the hospital really wants to do a procedure the patient objects to. I saw this in two hospitals in two different cities.) Someone needs to see if the hospital has an ethicist or talk to a social worker.
posted by FencingGal at 9:18 AM on October 4, 2017 [10 favorites]

Is Susie really just an angel/ hero who happened by at the right time and is selflessly helping Ann?

Doesn't matter, clearly she is not a competent helper if she's passing along bad info and unnecessarily putting people in the hospital.

As for any possible scam, there are a lot of ways to bilk people you live with. Identity theft, stealing blank checks for later use, etc. Or it could be just a free place to live, and then she's offering to help with shopping, and figuring out the bills, and some pressure later to put her in the will.

Ann should be talking with her husband's medical team directly without an intermediary.

His prognosis has now gone from 6 months to 1 year to a matter of days.

So he was given another 6 months to live after the hospital visit? I'm sure that sounds good to hear but these prognosis are notoriously inaccurate. I imagine Suzie is trying to take credit for helping him but it doesn't sound like she's helpful at all from your description.
posted by yohko at 9:26 AM on October 4, 2017 [3 favorites]

Could this be a form of Munchausen Syndrome? Being someone's medical guardian angel, "saving" their life by taking care of them? Or is she seeking attention or money? This is a terrible situation, whatever it is, and red flags are flying all over the place.
posted by jhope71 at 9:27 AM on October 4, 2017 [4 favorites]

I'm sorry that I can't help with how to untangle from this person, but I can somewhat answer what the "scam" is here.

I think that for people who are generally emotionally well-adjusted and not, well, complete narcissists, it can be difficult to understand this sort of "scam" because we assume there most be some sort of financial motive. Getting a free place to stay and some free meals may be a part what Suzie is looking for, but it's likely more about Suzie needing to find people who will be susceptible to a codependent bond so that she can suck up all of their time, attention, and energy. The very close relationship with a vulnerable person that developed extremely quickly is a warning sign in and of itself. So is separating Ann from other components of her support network like Gia.
posted by muddgirl at 9:27 AM on October 4, 2017 [22 favorites]

Is Jack prescribed any drugs that someone addicted might be interested in stealing?
posted by ThePinkSuperhero at 9:30 AM on October 4, 2017 [10 favorites]

Susie is, at the very least, a grifter, and at worst a professional scam artist. Who else do Ann and Jack have in their lives - relatives, friends, church, neighbors? Can any or all of them step in?

Seconding FencingGal that hospitals sometimes are pretty slipshod over who gets control over a patient, especially an elderly or impaired one. This is not always due to malice, but being overworked and burnt-out and just wanting problems to go away and get solved.

Finally - if Jack is on hospice, those patients usually have all kinds of hard-to-get drugs available - specifically opiates and benzos. It is very likely Susie is helping herself to them. This is sadly very common.

Ideally, someone will give Susie her walking papers. If she's stuck in Ann and Jack's lives like a limpet, then at least keep an eye on her.
posted by Rosie M. Banks at 9:31 AM on October 4, 2017 [4 favorites]

Good lord yes Susie has got to go, the sooner the better! She's a scammer of one flavor or another, whether she's out for control, drugs, money, a place to crash or all of the above.

Susie has already effectively shortened Jack's life; and the next step, after Jack is gone, is to totally isolate Amy from all her friends & family, so no one but Susie has access to Amy's property, person, drugs and/or money. Step in now to remove Susie, because soon enough Susie won't let anyone near Amy anymore.
posted by easily confused at 9:45 AM on October 4, 2017 [7 favorites]

Yes, Susie is a troublemaker and a danger to Ann and Jack. It's all been said. She could be after anything from emotional payoff to financial gain.
posted by tel3path at 9:52 AM on October 4, 2017 [4 favorites]

Predator. Susie reminds me a bit of Pam Hupp, to be honest.

Private investigator might be a way to go here, but time is short. Are there adult children in the mix? Can someone call Ann & Jack's attorney and see if they've changed power of attorney or wills?
posted by anastasiav at 10:28 AM on October 4, 2017 [3 favorites]

Couple of follow-ups:

-Yes, there are adult children. (Asking this question on their behalf)
-I think I unintentionally overstated the living situation. To clarify: Susie is not living with Ann, but is going back and forth from hospital to house with Ann, staying with her wherever she goes now. Susie did spent the past night at Ann’s house.

So he was given another 6 months to live after the hospital visit?
No, his prognosis was ”6 months to 1 year”. It is now “a matter of days”. The terminal diagnosis was already very new, but he was in stable condition, stable enough that Ann felt comfortable leaving town for a few days (encouraged by family - she needed a respite — so that when she returned she would be rested enough to deal with decisions regarding hospice, etc)

Who else do Ann and Jack have in their lives - relatives, friends, church, neighbors?
They have strong church and neighbor relationships. There are adult children. Which is why it is especially confusing how Susie is suddenly the confidant. The children are all asking each other - where did Susie come from?

As for Gia - trying to keep this as anonymous as possible - but there is a language barrier, and as an employee of the family, my guess is she was trying not to step over any boundaries. She did, however, refuse to leave the hospital (over 24 hours!) until one of the siblings was able to be there.

The adult children are all a bit shell-shocked with grief right now. None of them live close enough to be there daily. And I think they are feeling some guilt for questioning the motives of anyone who is there to help.

I guess the follow-up question is does anyone have advice on how to intervene with their mother, Ann, and extricate Susie?
posted by myleftsock at 10:28 AM on October 4, 2017

Good - there are concerned family, friends and neighbors! This will make getting rid of Susie easier. Most predators zero in on elderly people who have no or very few social connections.

One first step might be for the adult children and any close family friends/neighbors to get together and talk to Ann and Jack's pastor, rabbi or other religious leader. Then family and pastor can go and confront Susie and say "We have your number, Susie. We are watching you. Scram or we're calling the cops or Adult Protective Services." Knowing that Ann is no longer an easy mark and that she's being watched, Susie might leave of her own accord.

If Susie has her tentacles sunk in deep - especially if she has any power of attorney or her name is on checking accounts or she has any kind of legal hooks in Ann and Jack's lives - an elder law attorney might be a good idea. Googling "Aging and Adult Services" or "Aging and Disability Services" for Ann and Jack's city and/or county will bring up services that family can access - social workers, elder law attorneys, people who can help get Susie out of Ann and Jack's life.

Good luck to all concerned! People like Susie need to be named and shamed and prevented from preying on the vulnerable.
posted by Rosie M. Banks at 10:43 AM on October 4, 2017 [7 favorites]

Yes! The adult children and any close family need to show up and push Susie out of the way!

"We're here now, Susie. We'll take over. Thank you for your help." They need to take up available space and make sure Susie does not sleep there ever ever again. Once she moves in, she will never move out.
posted by jbenben at 10:44 AM on October 4, 2017 [24 favorites]

As she is someone who is working in their home (paid or not), Ann really needs to run a background check on Susie. If she won't, I'd say the adult children or someone close to them should. The local hospital should have instructions from Ann and the children that Gia is always allowed to see both Ann and Jack.
posted by soelo at 10:57 AM on October 4, 2017 [5 favorites]

The hospital also needs to be informed that Susie is not on the visitor's list.

Have you googled her at all?
posted by TWinbrook8 at 11:16 AM on October 4, 2017 [19 favorites]

Nthing talking to the pastor and getting a lawyer....also get in touch with local elder abuse orgs.
posted by brujita at 11:53 AM on October 4, 2017 [2 favorites]

Funny I just read this today in the New Yorker – not exactly the same scenario, but might have relevance: How the Elderly Lose Their Rights.
posted by StrawberryPie at 11:54 AM on October 4, 2017 [5 favorites]

My husband works with elderly and their families. The situation you describe is not super common but it does happen.

Can the family afford a geriatric care manager? When you have a messy, emotionally laden tug-of-war, the elderly parents often become wary of their children's tugs, no matter how well intentioned. When the children try to wrestle control from Susie (as they should!) the parents are all but guaranteed to view it as children attempting to take away what's left of their independence. It becomes especially pronounced when the parents have lost their ability to see reason due to a combination of prolonged illness, caregiving/hospitalization stress, and layers upon layers of medications. If the children push too hard, they may dig in their heels and put themselves in a very bad situation. In these cases, an independent third party can work miracles.

The GCM will also coordinate with primary doc/gerontologist/hospital/etc. so Susie is no longer in charge of communication and therefore care decisions. If Jack has just a few days to live, this is Priority No. 1.

If a GCM is not possible, try good cop/bad cop: one child to provide kind, free-of-judgement emotional support to, another child to deal with care decisions and legal stuff.
posted by rada at 12:19 PM on October 4, 2017 [3 favorites]

If the prognosis is a few days the kids need to be there NOW. It can be hard for adult kids with responsibilities to make this decision. But they need to get there. Susie is almost a red herring. Their parent is dying. They should be there if at all possible, starting now.
posted by Rock 'em Sock 'em at 1:34 PM on October 4, 2017 [12 favorites]

They don’t live there so hard to visit daily but they need to do whatever they’d otherwise do for a multi-day visit. If they need to pool resources, credit cards, anything to get at least one kid staying there 24/7 they need to do that. Abusive caregiver, parent dying—�this is an emergency and they need to get there.
posted by Rock 'em Sock 'em at 1:37 PM on October 4, 2017 [5 favorites]

While I agree that there are red flags here, I want to take a position that I haven't seen anyone else in this thread express, namely the concerns around Jack's changing clinical situation and prognosis.

I have no way of knowing from reading this question if Susie was lying about Jack's symptoms or not, but reading between the lines, patients are not admitted to the ICU unless they have a need for critical medical care. Likewise, those decisions tend to be made based on the clinician's physical exam, labwork, and imaging, not because a caregiver says "he hasn't peed for 24 hours" (the ED can pretty easily tell if this is true or false). Certainly terminally ill patients are sometimes admitted to the ICU when it is not concordant with their wishes for the end of their life, but I'm not seeing anything in this question to suggest that Ann and Jack wanted him to stay out of the hospital regardless of his clinical situation.

Doctors are notoriously terrible at prognostication. As patients get sicker and sicker there is typically a greater ability to acknowledge that death is imminent, but it is very well researched that a prognosis of "six months to a year" is generally very imprecise. All of that is to say that to hear that Jack's prognosis went rapidly from "six months to a year" to "a matter of days" does not overly surprise me, especially if he really has had an aspiration event or suffered acute kidney injury.

Susie's behavior sounds emotionally exhausting and not exactly a net positive influence on the family overall, but absent the possibility that she literally took steps to actively harm Jack and hasten his death, your description of the situation sounds like an unfortunate but not uncommon sequence of events near the end of life.

In terms of extricating Susie, my reading of the situation is that Ann is Jack's surrogate decision maker at present. It is really solely up to Ann. As uncomfortable as the adult children are with the situation, if Ann is finding her to be a supportive and positive presence -- and the adult children cannot be that for her -- this might not be a fight worth having.
posted by telegraph at 1:43 PM on October 4, 2017 [3 favorites]

If the report of confusion and disorientation was false, what does Jack think of all this, what does he think of Susie? the whole question is about Ann's decisions and Susie's hold on Ann alone -- it's scary all on its own that Jack has no say over who's with him if he's mentally present enough to tell one person from another. Even when people are very ill and confused and near death, they like some people better than others.

it sounds like a bad and upsetting situation, but just as much so because Ann has this power over Jack as because Susie has this power over Ann. If this isn't all happening because of money -- meaning, if Susie isn't offering to "help" Jack for "free" in return for room and board, because Ann can't afford 24-hour home care, which is the obvious explanation -- then it's happening because nobody who is not either unfit or absolutely exhausted is in charge. I know exactly how quickly a person's store of energy and good judgment can be depleted and I understand people get to a point incredibly quickly where they'll accept help from anyone who offers if it means they can leave the house and just stop thinking about it for a bit. but it's negligence.

The question is not whether the children live close to their father, but whether they live close to an airport. If they know this is happening and are not going there in person, they are complicit in what their mother and Susie are doing or allowing to be done. I do not say this lightly and I allowed some notable catastrophes to occur when I had this responsibility myself: the temptation to let other people take care of it just as a brief respite is so strong, even when those other people may be doing harm. and everyone needs a respite. but everyone also needs to get on the fucking care schedule and do what their mother is very clearly unable to do. it is just too much work to be both a carer and an advocate/protector at the same time and round the clock; the children need to assume the latter role even if they refuse the former.

also, Susie is very probably not a nurse and maybe never was. that can be checked.
posted by queenofbithynia at 1:57 PM on October 4, 2017 [6 favorites]

I think the answer here is not to confront Ann about Susie, because then you're questioning her judgement and her faculties which comes across as insulting and is likely to just get her back up and alienate the family further. The answer is for someone in the family to step up and replace the support/service that Susie is providing. (On review, everythingqueenofbythnia said.) Anyone can criticise but they need to put their money where their mouth is and actually help and be there.
posted by Jubey at 2:00 PM on October 4, 2017 [4 favorites]

I hadn't realized that it was a matter of days.

One or more of the children and/or other trusted family members needs to be there. You say they live to far to visit daily, so they will be traveling and staying for a while.

I can't think of any reason why they shouldn't go unless their health is not in the right shape to go (including things such as late stage pregnancy). Nearly anything else can be rescheduled if you let people know that your parent is dying.

After Jack's death, Ann is going to need some help and emotional support. I don't understand why at least on person isn't planning how to travel there.

If the expense is an issue, ask for donations from the church members and neighbors. If my neighbor was having this issue and a child wasn't able to afford to come help, I'd be donating as much as I could afford towards a ticket.
posted by yohko at 3:31 PM on October 4, 2017 [4 favorites]

Nthing that Susie must go and the only thing that’s going to get rid of Susie is the arrival of at least one and ideally all of the adult children to stay -hopefully until well after the funeral. Chase her off and don’t leave town until good solid POAs and plans for elder care for Ann - perhaps she could leave town as well? - are in place.
posted by mygothlaundry at 1:07 PM on October 5, 2017 [2 favorites]

Susie sounds a lot like a relative of mine, who has displayed this kind of behaviour with several people, most of them distantly related to her. My relative generally is good-hearted and genuine in her desire to help, as it makes her feel necessary and purposeful – but she is definitely not blind to the potential financial benefit to her.

Since Susie isn’t related to Jack and Ann, there may be some opportunity to prise her gently away from them, or at least begin Ann questioning Susie’s position in her own mind. I agree that the adult children and others should now step in and thank Susie for being such a help in a time of crisis, but also be firm about being there to take over now. And if at all possible, someone else should always be around when Susie is with Ann, to dilute her influence.

I would also be asking Ann some casual questions about Susie – and probably get someone other than the adult children to do it, since they are already feeling guilty.

“Susie’s been such a support to you, Ann! Where did you meet her?”
“Wow, that’s fascinating. Do you know what kind of nursing she did?”
“Do you know who said Gia wasn’t allowed in Jack’s hospital room? Oh, why do you think Susie did that? Gia has looked after Jack for so long!” etc.

The aim is not to criticise her judgement but to make her start questioning out of her own accord.

Definitely follow up queenofbithynia’s suggestion and see if you can check whether Susie was ever a nurse. At the very least, if she wasn’t then you have a bargaining chip to confront her with, if it comes to that. Hopefully it won’t.

I think any confrontation of Susie herself should be a last resort – if she’s anything like my relative, that will result in her approaching Ann in visible distress and spin her a story about how she really doesn’t want to leave her all alone without support, but of course she is going to do the honourable thing since Ann’s family have taken against her for some reason, and she will beg Ann to let her know how Jack is every day, because she worries that he won’t be looked after properly without Susie there, and she hopes that someone will be able to support Ann, because she feels so sad and sorry she is being made to stay away, but what else can she do? etc. That’s just going to be traumatic for Ann, and begin a deeper rift with the family and friends.
posted by andraste at 6:01 PM on October 5, 2017 [3 favorites]

The hospital will for sure have social workers and likely an ethics committee that you or the children could go to and lay out your concerns, which I encourage you to do asap. Our ethics lady was super nice and grounded and helpful. Good luck, it's a hard time but you all are doing the very best that you can. Please let us know how it goes.
posted by eggkeeper at 10:36 PM on October 7, 2017 [2 favorites]

Update: Jack passed away. Although Susie had spent the night with Ann every night since I asked this question (and was present when he died), as soon as the siblings were all in town for the funeral, she skeddadled (only spotted at funeral - otherwise stayed away).

Siblings had a chance to talk in person about their concerns regarding Susie. Unfortunately, I think the conclusion is what telegraph said, "if Ann is finding her to be a supportive and positive presence -- and the adult children cannot be that for her -- this might not be a fight worth having."

I really appreciate everyone's advice and perspective. For Ann's sake, I hope that Susie was just thriving on the drama and now that Jack has passed, she'll move on without causing further harm.
posted by myleftsock at 11:40 AM on October 23, 2017

Thanks for the update - sorry for the loss of Jack, and I hope that Susie is gone for good! Count the spoons, and check the medicine cabinet. And continue to keep an eye on Ann and be a support for her - the more social support Ann has, the less likely Susie is to think Ann is a lonely mark ripe for the fleecing.
posted by Rosie M. Banks at 2:29 PM on October 23, 2017 [3 favorites]

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