What to do when your elderly parent is starving themselves?

Wishing you peace as you continue on this difficult journey.

This is what people are forced to do when our country forbids people from dying with dignity.

A year ago I would have read this and felt a bit of concern.

However, after almost a YEAR of my MIL's decision to enter Hospice, she stopped eating. She has subsisted on >400 calories a day and she is still here, kicking up a fuss and causing incredible anxiety for the whole family.

She's not healthy, by any means, but evidently, you can subsist on a 'starvation diet' for a very long time. She also only drinks about 24 oz of water (in coffee & diet coke) throughout the day.

While there will be a pretty rapid weight loss in the beginning of this, in her case it seems she's plateaued off to a weight that she maintains somehow on barely any food.

Nobody pushes her to eat or drink. I imagine somedays she only has a Boost and that's it.

I have experienced this. My ex-husband was very ill with liver disease. He was in fact dying. He wasn't eating and drinking very little. Sometimes he'd have a few sips of juice or an ice pop.
He always said he wasn't giving up, but that was for his parents and everyone else. It was his time and he knew it.

Your mother probably does too. She's 92 years old and has serious health issues. If she's in hospice care they should be managing her pain and anxiety if she's suffering from it.

Spend time with her. If she asks for a drink or something, bring it in. Maybe she'll take a couple bites of it or will drink a little.
Take things one day at a time with your mother and don't have expectations. If she's having a "good" day take it as a win and enjoy it with her. I think this is about as best as you can hope for now.

No, I haven't experienced this and my heart goes out to you and you mother.
I'd recommend: Get / give her massages. Gentle - wherever or however she enjoys. Head / scalp massages are good as most people never get these and they are relaxing. Feet are good.

The feet, hands, ears reflex to the entire body. I am a massage therapist.

In essence, shift the attention to 'trying' to keep her alive to giving her comfort.
Play her favorite music. Try scents if she still enjoy aromas. My sister loves ROSE. I love lavender.

As you can, consider smoothies, if full of bananas and cream / ice cream.
You can add (as I do in mine): collogen, green powder, protein powder, fruit / jam or even CHOCOLATE / syrup or caramel syrup, wheat grass. There are almost endless supplements in health food / Whole Food stores.

The key is her enjoyment. Sipping through a straw may be more ... inviting for her.

Personally, I would try to keep her alive; I would focus on the quality of the moment - being present with her.

Reading below, if she isn't in Hospice, get it set up.
While they may require her consent, do what you can (with MD authorizations - I recall / believe they can set up w/o client's permission (I went through this). It will help you to help her due to the extra care. She doesn't have to be diagnosed terminal to qualify for Hospice. Blessings to you,

Gena / Touch Matters

Keepurheadup: My mother ate VERY little at age 94 when an ischemic stroke claimed her life. I hope that your mother agrees to go on hospice.

Don’t leave it up to the nursing home whatever you do. The nurses aids are overworked and so is everybody else and they don’t have time.. go in there every day and make sure she drinks a liter and a half of water or else she should be on an IV that gives her the same amount of fluids every day. Make sure she drinks at least three bottles of ensure or boost nutritional supplement every day. if she is too weak to do this insist on getting her a tube feeding immediately until she’s strong enough to drink those every day. If you don’t do this, I don’t see how she can survive.. also make sure that a urine culture is taken to see what kind of bacteria are happening in her bladder, so that the antibiotics can be given to her immediately either orally or preferably IV. Because you don’t want the urinary tract infection to go to her kidneys, causing her back pain or going to her blood, which is even worse. Those doctors will put a patient in the nursing home and just let them expire there, you have to vigorously advocate for your loved one, get her stable and then get her out of there and care for her yourself at home but you must make sure that she gets adequate nutrition and critically adequate water!!!! She’s probably too weak to take it herself right now, so she needs to be on IVs and possibly a tube feeding until she is strong enough to start drinking water and drinking those nutritional drinks on her own. If you don’t do this, I’m afraid you will lose her. Don’t let it happen. You have to stay on top of it because they won’t!!!

I have and understand what you are experiencing. It’s distressing and very sad for both of you. Hold her hand and tell her how much you love her. Just be there for her-as much as you can. Sometimes they will eat sweets at the end of life. It was donuts and a little milkshake in my situation. Starvation can take a few weeks. I would continue to encourage a few bites of food and water every hour even if you have to hand feed her. Sending hugs and prayers for you both.

Letting go is the most difficult emotion, especially when we are the fixers.

Look "Letting Go" up on the Internet, there are many offerings of wisdom.

Hi, so sorry this is happening to your mom. My family and I went through a similar situation with my Dad. Yes please get her set up with hospice that way she can be given pain management, because your body shutting down from not eating and drinking is very painful. Your mom will be able to cope much better with pain meds.

Wishing you strength during this time.

Is she intentionally trying to starve herself or is she not dating due to depression and overall decline?

I know she has a lot of other problems, but if she has a UTI, my experience with my 96 year old mother showed a great loss of appetite, including fluids, before her UTI, and even for about a week after her antibiotic treatment ended. She then came back to eating her normal amount. Just a consideration.

My mother didn’t want to eat when she got older and had challenging health issues. She didn’t even weigh 100 pounds. She completely lost her appetite.

I am grateful that my mom was agreeable to going on Hospice. It is the only sensible approach for people who are not going to get better.

People who live in these circumstances are tired of living. I would be too if I were in their shoes. What is the point of living longer if a person has no quality of life left?

I am sorry that your family is going through this situation. Wishing you and your mother peace.

I’m also so sorry everyone is going through this. I’m there too, with my 85 your old. Dementia Bedridden. I believe it’s cruel and wish I could give her something for her to go to sleep and rest in peace.

I wish your mom had stuck with her decision to go on hospice. It must be hell for you and for her to go through this now. I hope your mother is at peace soon and has now decided to allow hospice to keep her comfortable.

I feel for you. I have experienced something similar.

The last 3 months were pure torture to both my Mom and I. For the last 3 years, she had been formally diagnosed with dementia and really bad arthritic pain in her lower back. The pain was controlled by Aleve (naproxen), Tylenol and CBD.

It started when she had sepsis. In the diagnosis for sepsis, they found a spot on her kidney. They couldn't diagnose the spot, because the chemicals for the dye in the contrast xray were too toxic for someone her age. It was recommended that we remove naproxen from her pain pill cocktail.

2 weeks out of the hospital, my Mom complained anytime someone touched her. When I touched her arm, that hurt. When I held her hand or transferred from wheelchair to car, that hurt. I reasoned that maybe she really did have cancer so we should try to remove the naproxen. We couldn't get a diagnosis of that "spot" as her dementia prevented her from getting an MRI (she would not lay on the MRI bed, nor stay still.)

Once we removed naproxen, we were never able to manage the pain again. We even tried oxycontin. She no longer cried out in pain when someone touched her. However, the pain in her back (what the pain pill cocktail was controlling) was so bad that she began to not want to eat (everything taste terrible), drink (taste of water was terrible). Cookies and fruit and juice all tasted bad. It accelerated the dementia as she couldn't remember how to take pills. She could no longer stand up because it hurt too much to move, much the less to balance. She no longer knew how to use a fork; she ate with her hands, however, chewing was very hard so she spit out most of the food she took into her mouth. She started to become combative and call out at night (she didn't remember calling out). The only good thing about the removal of naproxen was that the edema in her legs went away in about 2 days.

We had previously changed her POLST and Medical Directive to "do not resuscitate" and "no artificial nutrition". We had heard horror stories of CPR breaking bones and we knew that she didn't want to live. She really hadn't wanted to live for the last year.

She finally got bad enough that I ordered hospice/palliative care. They took her off everything (with my approval), vitamins and pain pills and gave her morphine. The morphine killed whatever appetite or thirst she had (but not the arthritic pain) and she passed a little over 2 weeks later.

I was relieved that she was no longer suffering. It was a horrible last few months. The worst part about it is that I would not have been able to get diagnosis that would have allowed assisted suicide since I could not say she would die within 6 months.

Horrible, horrible last few months. Someday, I hope we can figure out a way to not go through this horrible torture, especially if it involves the later stages of dementia.

My FIL just died on hospice. He was also wasting away , no appetite due to cachexia , triggered by worsening CHF and COPD. He thought he would get better too . He was not going to get better . He also had bad back and neck pain from spontaneous compression fractures of vertebra from osteoporosis . He was slowly dying for months. He got Covid and a few days later finally agreed to hospice to control pain . Covid killed him a few days later . Many older people avoid hospice . Find out what is making her moan and tell her that hospice will come and treat ( pain , anxiety, depression ) whatever it is . Get hospice to evaluate her . Sounds like life is too hard for her since this big surgery at her age .

My dad is 80. He was diagnosed with frontotemporal dementia 3 years ago. He was losing weight and getting extremely picky. Then about 3 months ago he was down to about 300 calories per day, and very little liquid. He was having all kinds of physical problems as well, and I was taking him to lots of Dr appointments. Then about 10 days ago he fell and hit his head and just wanted to lay in his bed with his arms folded across his shoulders, no pillow, just waiting for death. He would crawl to the bathroom about 2-3 times per day. I kept asking the drs for a hospice referral. Finally had to take him to the hospital where he stayed for 24 hours and was then discharged with adult failure to thrive. He has lost about 1/3 of his previous body weight (and was thin to begin with) He almost certainly has stage 4 cancer of some kind, poor kidney values, anemia, low blood pressure, etc. he is at home again and barely eating or drinking and very grumpy and uncooperative with the home health aides. I want to honor his wishes insofar as I can. Even though he has dementia, I feel like it’s his life and his wishes are of primary importance. He says he has no pain, had a good life, and just wants it to end. The grumpiness and demands are hard on the family though, and of course the waiting and wondering.

Best wishes to you.

My MIL has been in active Hospice for going on a year.

So Hospice does not mean "EOL" for us. It's palliative care, really, and MIL eats >400 calories a day and drinks about 20 oz of fluid and is still around. Not well and looks like a cadaver, but it very much alive.

It is amazing what the human spirit can overcome to stay alive. we have all been truly amazed and befuddled at the same time.

At least MIL is pretty comfortable with the meds which keep her calm. But, death is NOT imminent and the Hospice RN says MIL will probably live another year.

I'm glad she has chosen Hospice. This is much easier on her kids, whom she has appointed her primary CG's.

I found an article that may help you see things in a different way

https://www.virtualhospice.ca/en_US/Main+Site+Navigation/Home/For+Professionals/For+Professionals/Quick+Consults/Symptoms/Can+you+provide+some+guidance+about+oral+nutrition+at+the+end+of+life_.aspx

I agree with the others, it is time for hospice care.

I am truely sorry that you are suffering along with her as you watch. When my brother went on hospice for treatment for his symptoms, he frequently expressed hope. We had good hospice social and pastoral support as things got worse. Your mom is truly suffering. I wonder if her moaning is related to anxiety. She can receive meds for that.

May I ask who you are angry at?
Grief counselors recognize that we often choose anger so as to avoid fear and grief. Fear and anger allows us not to go into grief, which has a hard finality.

I am sorry for your mother that she made this decision. I am an old retired RN. It is one I would not make. I in fact am looking now at a probable second bout with the big C. I beat 35 years ago. I am very clear in my own mind what I will and will not do in the next battle. A second mastectomy is fine. But no chemo and no radiation (the latter I refused the first time, too). To me, having seen much suffering at the end of life, death scares me very little. But suffering scares me very much and I think your Mom is looking as that in quantity of time left without quality.

Were I your mother I would now ask for hospice and I would do VSED which is "voluntary stopping eating and drinking" which is legal in almost every state of our union. I would go to my peace. We all die. To me it is unconscionable to ask our loved ones to stay suffering we we cannot recognize the inevitable. I hope you will honor your mother's wishes now to ease herself out.

It may (or may NOT ) be of interest to you that at exactly her age my father told me he wanted the "last long nap", that he (a WELL MAN) was happy with the life he had had, but exhausted with his current life, and ready to go. That he longed only for the peace of sleep. That it was very hard for him to "try" for my mom. My mom said later she wished she hasn't asked him to stay, that it was selfish to get him up on the scale, as him to eat when he had no appetite.

I have given you my own personal opinion.
Please speak honestly with your Mom and honor her wishes.
Do know that I heard many patients tell me at end of life they wanted to go/were ready to go, and could sadly not discuss this with their families because their families would not hear their truth. They were left discussing with their nurse, a stranger.

By the way, needing blood, and refusing it? One of the most peaceful deathes there is. A bit of shortness of breath only, and that fixed with morphine.
I am so sorry for your pain and the coming loss, for your mom's pain and travail, and I wish your entire family great peace and comfort and relief from pain.

It sounds like her body's shutting down. Do you feel like there's a good quality of life and that it will improve over the next few months? If you don't see a reasonable chance of recovery it wouldn't hurt to talk with the hospice team and get their opinion, at least.
I think there's a big difference between allowing a person's body to progress naturally through shutting down and asking them if they want to give up. Not a criticism at all--I'm in a similar boat, and my mom is much the same with the eating and apathy, but if I ask her if she's 'done' she'll say 'no'. And that's fine. We can support whatever level of eating and functioning she's up for, but we're not going to artificially prolong things.

Hospice has changed over the years and is no longer just for "end of life" comfort. Perhaps your Mother should understand the changes, since most elderly do not. It might look more enticing to her to have Hospice help.

My uncle had a similar situation occur and did not thrive after surgery. Hospice was called in and he passed a few months later. I think offering such a huge surgery to such an old person is ludicrous, personally. They wind up even sicker afterward with more issues than they had beforehand. How very sad for both of you to be going through such a thing, my condolences.

I hope mother is on board to bring in hospice now. They will keep her comfortable and totally out of pain, with God's help.

Best of luck with a difficult situation.

It definitely sounds like it's time to bring hospice on board. In her mind she may not be giving up, but her body is telling her otherwise.
Not eating and drinking is all part of the dying process, as the digestive system is the first to shut down.
Hospice will keep her comfortable as she transitions from this life to the next. Please don't keep allowing these needless procedures or rehab to be done to a women who is dying. Just let her die in peace and comfort. Hospice will allow her to do just that.
Please call them today.(yes you can call them on a Sunday)
God bless you.