Sick parent refusing food and treatment in the nursing home.

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My mother in law is in a nursing home in another state. She has MS and is wheelchair-bound (and has been for quite some time), but until recently had been in otherwise decent health. Over the past couple of years, she has had a series of UTI infections that have required treatment.

Most recently, she's had a UTI for several months (!!). At this point, she needs hospitalization and a blood transfusion. The UTI is presenting cognitive symptoms and she's a bit mentally mixed up. She was never a particularly religious person, but she's started telling us to just "pray for her."

She's been refusing to go to the hospital and refusing all treatment, and has refused to eat for the last three days. Her home won't give her treatment or food without her consent, and we're pretty far away. We've tried reasoning with her, but it doesn't seem to be working.

What do we do? Should we try to pursue legal guardianship (and if we do, do we need to get a lawyer in her state or ours)? Is there anything more we could do if we drop everything and fly out there? Any suggestions on reasoning to use to try to talk her into going to the hospital like she should?

Links/resources/advice all very much appreciated.

18 Comments

Went through this recently with my MIL, who died early in December. She'd had open heart surgery and the rehab was too arduous for her, she decided. She stopped eating, insisted that she be given palliative care only. She was a strong minded, perhaps stubborn lady all her life and decided that enough was enough. There was no reasoning with her; my husband, who disagreed with her decision vehemently, withdrew from the situation; her other two sons faciliatated the transfer to palliative care. You need to have a mental health assessment done (perhaps the nursing home can help identifying a resource for this) to show that she is of sound mind and is making this decision rationally. Might she accept anti depressant therapy if this is suggested? Best and hugs, Barbara
I am not a lawyer and only know what we experienced when dealing with out of state elderly parents. In our case, the parents and their proposed guardian had to live in the same state. We had to move his parents to Texas where we live before my husband could apply for guardianship.

My ILs siblings were in the same state but all declined the responsibility.

Is someone living near your MIL that is currently overseeing her care? If so, what do they say?

Sometimes older people begin to do what my grandmother called "cramming for finals". She was referring to people being concerned that religion might be important after all as they deliberate their own possible deaths.
There will always be something that can be done to prolong the inevitable. And, doctors will be right there to offer it. But, your mother in law should be in charge of when all of that stops.Only she can decide whether she has a life worth living. Try to be grateful that she's able to express her desires and make the decision. This is hard, but it would be harder if she continued to decline without making her wishes known one way or the other and it was up to her loved ones to determine if she'd want to linger or go.
hospice, hospice, hospice. Please consider it
No it is noteasy to accept the inevitable. Unfortunately many do not realized the importance of DNR and medical end of life choice documentation. I agree with you and am sure many others do, though I have talked with some that do not and will try to circumvent wishes. I see this often when I vist my assigned NHs.
And what would you do if you had legal guardianship? Force-feed her? Require her to undergo treatment against her wishes?

How old is MIL? How long has she been in the NH? How often is she visited by family members? Friends?

I think the bottom line question is whether she is in her right mind. (And if she is, I'm not sure you could obtain guardianship.) Do her doctors think she is incompetent to make her own decisions?

My heart goes out to you. You are in a very difficult situation. Competent adults are allowed to make their own decisions, even against family wishes.
Father (95 and 11 months) passed away last week- alz problems and body giving out. DNR and ready to move on- combination of him not wanting to eat and maybe the mind/body was causing problems in desire to eat. Couldn't even swallow a sip of water (even if he wanted to) without choking near the end. About two years ago he tried to stop eating but it wasn't his time- now the mind/body said it was time to go. Difficult for the family but nature/God is the way. Hospice is great support- please call them for their help.
FBG, I am so sorry to hear your father passed away. I know age doesnt matter but wow he lived a long life and thats great. Take care and hang in there :o(
Hi FriendlyBedGuy..I'm sorry about your father passing away. I may not comment on the threads that you have commented on. but, I just wanted to let you know that I have enjoyed some of your comments. Some were helpful on how we can improve with our caregiving patients. HUGS!!! to you. Sincerely, Book
I'm sorry for her. Why does she not have a choice in this? Maybe she's ready to move on and, I'm sorry, but why are you so determined to stop her? Death is difficult to accept, but at some point it's going to happen no matter what we do. What's wrong with just being supportive and allowing hospice to step in and help everyone? You don't say how old she is or give any reasons for why you think she needs to keep going, against her wishes.

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