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He is a decades-long alcoholic and his Labs read like a who's-who of illnesses. CT Lung scans done yesterday show a nodule 4B, which is probably going to end up being cancer. He came to live with me last December 1st after a vehicle struck him while he was walking- not at high speed, but it knocked him down and broke his pelvis. None of us knew until 3 weeks later. The ER in Springdale AR didn't even do any Xrays they just sent him home...he doesn't drive, so he took a bus. He has some brain atrophy due to the alcohol, and acts like he doesn't even know what detox could do for him. At this point it feels too late, as he's gone downhill the past 2 weeks, and has dropped 15 lbs in the last 3 weeks. He was eating along with the drinking a pint most days, but now he has stopped eating. I'm trying to deal with watching this slow death, yet managing his health and providers at the same time. He goes back to the doctor tomorrow to discuss the results of the CT Scans. I sat down with him to gently plead my case that he try to eat something...I even pushed a bit and said if you don't, you will not live. He was oblivious. He thinks he's fine. He's not fine. He's 120 lbs at 5'9" and his clothes are bagging on him. My husband has no clue how to help me as his suggestion was simply to raise his voice and have me challenge my brother as to why he's not eating when his sister is doing so much for him. This was absurd to say. My brother is possibly entering the dying phase, where his body doesn't want to eat because it uses too much energy in digestion. Or, it could be renal, or cancer...or numerous other problems. I am brokenhearted here, and I will not force food or shame or anything else. I am offering all the Ensure he will drink (one a day normally) and I feel that is not what I want for him, but it is all I can do- this is out of my control. I am going to ask the Dr. tomorrow if there is anything that will increase an appetite. I am sure he will want a PET Scan for diagnosis. My brother is so frail and weak now, I don't know how he can possibly recover. I am so sad. My gut is telling me end of life is near and I'm scared for all this coming, and knowing whether I'm doing the right things. He was legally blind until we got cataracts removed a month ago. It did not bring about the happiness I thought it would for John...he just didn't react verbally much at all to being able to see again. He is keeping to himself a lot, watching TV, never changes the channel. This is the worst thing I've ever experienced in my life so far. Caregivers, I salute you for your selfless care and sacrifices.

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I’m so sorry. I understand. I wouldn’t force him to eat either.

My oldest brother was an addict. He died several years ago. My brother suffered from a horrible motorcycle crash. It’s hard to see our family members suffering.

There is no point in shaming a person who is dying. I didn’t shame my brother when he was in a hospice facility.

I am sorry that your husband said that hurtful comment to you. Follow your heart.

I will say a prayer for peace in your life and for peace in your brother’s final days.

Hospice was a great help for my family. Please check into hospice organizations for your brother and they will make sure that he is comfortable.

Sending many hugs to you. I know how hard this is for you.
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So very sorry you’re watching this with your brother. Please inquire about hospice services if it’s determined that he’s nearing end of life, which it certainly sounds as if that’s true. They were a huge help to me with my dad. I’m glad you’re choosing kindness, your brother is blessed to have you in his corner
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NancyDY Mar 2023
I've looked up Hospice facilities in my area, as I have this feeling it is coming. The days ahead are one day at a time, and a week feels like a month to me. I will need some help and guidance because this is scary. I should know tomorrow after speaking with the doctor, and am counting on him to guide me to hospice when it is that time. Thank you, I am just on the verge of helplessness and sadness, where I cry easily when I hate crying...trying to be strong, but losing that one. My brother will be with me to the last moment, and he will remain with me at my home if that will work out for him. So funny, I just went to check on him and he's sitting in front of a blank TV wondering where his remote went. How long would he have sat there like that? It was apparently taken into his bedroom by him. He is often like a 5 year old at times...I see in his eyes, and remember when we were kids having fun. Yes, it's really hard. Thank you again. Hospice should help.
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Thank you from the bottom of my heart- you know. I will never look at Caregivers the same...a day seems like a week, and this past 3 months like a year. My brother can't help what his body is now doing, say a prayer for my husband too, that he soften his heart and try to understand what words cannot answer. It's possible he's afraid for my brother dying, but it felt like he hasn't spent a minute trying to read up on death & dying...I could use his support. Hospice is foreign to me, but I hear good things and will definitely use them when the Doc says I should. There's no way I want to go through this alone, second guessing everything. I want it to be safe and peaceful and as pain free as possible for my brother...and yes, it is so very hard. Thank you for hugs and prayers.
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NeedHelpWithMom Mar 2023
Nancy,

Take advantage of everything hospice has to offer, the social worker, clergy, volunteers, etc.

My brother was enormously comforted by his hospice staff.

Come back to your posting if you need to talk.
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I am so sorry you are facing this. The beauty of hospice is that, if your qualify, you can go on hospice, and if you recover, go off of hospice. While I know your situation looks difficult, hospice is not a death sentence. I have heard of folks that go on to hospice and get better and come off over time. The right hospice facility is absolutely wonderful in a time where you are upset, stressed and not sure of your next step. Many of us on this forum has faced what you are facing. They provide guidance, supplies, a bed etc. They also provide counseling, of which I am participating in now. My heart goes out to you and your family. Take one day at a time.
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And we salute you for your love and caregiving.
I would first suggest that you go to Al-Anon, not to learn, because your instincts here are good; you already recognize there is nothing you can do. But to go there for the support, for suggestions, for the comradeship that your hubby right now seems unable to offer you (he is likely suffering at seeing you suffer in this manner, and frustrated himself, and if he would attend Al-Anon WITH YOU he would understand that you two are not alone.
Firstly you are correct. There is nothing you can do. Let your brother take the lead. You are likely right that he is now dying. You are right that food should not be forced upon him (for what reason? To keep him alive another month in this misery?). You are right that there is so much deterioration due to the alcohol that it little matters what other systems are under threat.
Let him talk. If he understands this is close to the end, ask him his wishes and talk about hospice care with him. Let him know you will support him. Don't suggest and force food on someone who already constantly feels FULL and uncomfortable due likely to a very swollen liver mass.
This is the end for the alcoholic. If you can tolerate giving this care (and it will get worse, perhaps MUCH worse toward the end) then give it, but stop giving it with hope of cure. Follow your brother's needs so far as you can. If you CANNOT give it, if you are risking your marriage then it is time to consider placement for your brother.
I am so dreadfully sorry. Not everything has a fix and I know you know that this cannot be fixed. You have all the information already; I can tell that from your post. It is important that YOU and your HUBBY survive this. Your brother cannot. And you are correct that the strain of detox if not done in facility would kill him, and he has no wish to detox. He understands on some level where he is and he will not want to give up the one thing he has, his alcohol. Do know, as far as nutritional intake goes, we can live on almost nothing in these instances. Let him take what he wants.
My opinion, and my opinion only. I lost a brother I loved very much and my heart goes out to you. When we have a brother we care about so deeply they are almost, in the eyes of our hubby's, a sort of "other man". The connection for some siblings is about as deep as connection goes. Again, I am so sorry. Just tell him you love him, you will do the best you can for him without drowning yourself, and you will be there.
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I want you to know that I pray daily “….for those who suffer and for those I love….”.

It sounds as though you are providing safety and as well as you can, comfort in his present life.

Often we as caregivers come to the point with our LOs when NO CHOICES are left that will result in happiness.

When that happens, we must take all the facts, say a prayer for guidance, and choose the very best among the sad choices. If you find yourself there, please be at peace that you are doing the best, with love that a caring loving sister can do.

You’re not alone in your fears and struggles and anxieties. Many of us have known them too, and we’re here for you and your brother.
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You can get Hospice now, not when he is already dying. I so hope you get some answers today.
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Have you gotten hospice to come in and do an evaluation? It’s the hardest thing to do but they are professionals and will give you a good idea of what is going on.
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My guess would be that you are correct. Please go with your brother to his doctor and suggest that Hospice consults happen now for his comfort. Pushing food is no answer for end of life care, and it does look as though this is what you are facing. I am so dreadfully sorry.

I do believe it is also time for you to sit with your husband and have an honest thought about whether your brother should enter care now for his own safety and best care. This is a difficult journey at the very best of times, and impossible as things worsen day by day. With alcoholic withdrawal happening at some point because of the inability to tolerate it there may/will be serious and unmanageable confusion and agitation. You will almost certainly be unable to handle this in a home environment. If you wish to try until you can no more, then EMS transit to the hospital and calling in social workers for discharge planning and placement can occur when you cannot manage at home.

Yours is a loving heart. I am so sorry for you all and I wish you the very best.
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