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I've been caring for an 80 year old for over 2 and half years and over the last few months has refused food and now drink which is causing major problems; constipation and now keeps having illusions of the weirdest kind..spoke to the doctor a few times and did a blood test plus urine test both normal? He just keeps saying he wants out of this life and whatever is out there is better then his present life..I'm at a loss as to my next step that can help him...how do you care for someone who doesn't want to be here? Any advice would be very much appreciated. ...Michael

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Michael,

It must be a horrible feeling to be 80 years old, sick, and not want to keep living. I've seen it many times in my years in healthcare.

I've learned to not try to cheer the person up. That's the way they feel and it's annoying for most people in that situation to have a cheerleader bopping around them talking about how great life is and how fortunate they are to be alive.

Respect his feelings. That doesn't mean that you have to get down in the dumps with him and bemoan this awful life but you can be compassionate to how he feels. If he says things like, "I just wish I could die already" don't reply with something like, "Oh now you don't mean that!" Instead, tell him what you'd miss about him if he were to die or what you look forward to when you're coming to see him.

As far as food and water are concerned, there's nothing worse than being forced to eat when you don't want to. Try serving him food that he enjoys (regardless of whether it's good for him). If he'd like to have a chocolate shake from McDonald's by all means get him one.

The fluid situation is a little more critical. As he learned he can't stop fluids. Maybe he'd enjoy flavored water or iced tea. You can buy water flavoring drops in all kinds of flavors. Just squirt it into his water and it's delicious. But if he refuses and you've tried to coax him into eating and drinking just a little and he still refuses let it go for the time being. Try not to get yourself in a situation where you're arguing with him. Always keep a fresh beverage within his reach. A little trick I've learned over the years in dealing with this situation is if I have placed a fresh beverage within someone's reach, maybe a lemonade or juice, I'll ask them after a while, "Can I get you something to drink? Some ice water or maybe some tea?" It's a way to nag them to drinking more without actually nagging them. Hopefully my offer prompts them to take a drink of whatever I've put beside them.

Your question was: "How do you care for someone who doesn't want to be here?" It's easy. You just.....care. He wants to die, he's done with this life, so you care for him more. Be kind to him. Respect his feelings. Try not to get into a discussion about how bad life sucks but see if he'll share with you why he feels the way he does. Is it because of poor health? Is it because all of his loved ones are gone? Is it because he's lonely and depressed? Chances are you won't be able to change the way he feels and you shouldn't try but if you had a greater understanding of why he feels the way he does it might go a long way in how you care for him going further.

And always let him have his feelings. He's entitled to them.

Good luck.
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Did the doctor order a swallowing test? It is a speech pathologist who oversees that. Sometimes there can be adjustments that make swallowing easier. For example, sitting up straight in a chair, and not trying to eat semi-reclined; thickening liquids to keep them from going down the wrong way; swallowing twice after each bite, etc. etc. The suggestions would be based on what the test showed.

Glad to hear there is another appointment soon.

It must be hard to hear your friend say that he doesn't want to go on. "Friend, I'm with you -- I sure hope that whatever is out there that comes next will be better than being sick in this life. We all will die. Until your time comes I would like to try to help you be as comfortable and content as it is possible to be in your circumstances. Will you work with me on that? Help me see what I can do for you? You know that gives my life meaning, too."
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What you all don't realize is that the person is tired of the effort it takes to live on a daily basis. I'm 74. My husband passed away three years ago on my Birthday. I'm missing him more and more as time passes. I am not happy without him. I have been on dialysis for eight years. I have other health problems that affect my getting around to do the things I would like to do. I just want to be left alone to do what I want to until I can go to heaven. I'm also tired of hearing my kids argue about whose turn it is to take me to the doctor. I'm ready to go any time my Lord wants to take me.

You all need to just be there...don't try to talk us into wanting to live. Just listen to us...and let us go.
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Eyerishlass gets an A+ for her answer! My mom was admitted to NH in January, 2017 with a mini-stroke, malnutrition and dementia. Tests for everything including swallowing tests have been done and they are all normal for a 92 year old. She has been telling me since she was 83 that she wishes she had not lived this long. She has always had issues with eating and at the first sign of worries or having to face reality for any reason, she stops eating, dehydrates, faints, falls, has hallucinations, etc. She has always been a depressed person. For 8 years I have tried every way I can to cheer her up and this only annoys her. I believe her when she says she does not want to be here. My belief is that by not eating she is "controlling" what is left of her life. She has given up many times over the years and eventually it leads to being back in the hospital with malnutrition and dehydration. She has been on and off hospice. When she hears "hospice", she starts eating, drinking and walking. You cannot change the way a person feels about the end of their life and you cannot make them want to live. With my mom, I support her when she is receptive to some cheer, I listen to her every day but she says "you don't care" and when the conversation turns negative as it always does, I let her make me feel guilty for living as long as I can handle it and then I leave. It is a no-win situation as far as trying to change their attitude. It is very sad and I have all the empathy in the world for her, but I can't change the fact that she has lived this long against her wishes.
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Eyerishlass has the best answer I have ever read on this subject. My mom is on antidepressants, but still wants to die.
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GM Michael.

Fear of swallowing and choking could be Dysphagia and you can google it. The only way to tell is with a swallowing test (we had to have one done last year) and then HomeHealth can send a speech therapist to work with your friend re: swallowing exercises.

Other than that, the best thing is to ask him why he doesn't want to live. Sadly, we cannot eat and breath for others, we can only offer assistance and support. If he's in pain, ask where. My DH was having terrible pains and when he showed me where, I knew it was most likely gas and started giving him Gas-X and the pains went away. I had to switch to chewable pills wherever possible due to his swallowing issues. Always make sure you inform his physician as even Gas-X can hide other problems.

All his other medications are taken with ice cream and just this past week, he started finishing the ice cream. I read here at AgingCare.com that a bowl of ice cream is still better than a nutritional drink only because it is still eating. If he wants something, give it to him. It's an uphill battle trying to get anyone to eat what you think is best - like the old horse to water thing - I was told to give my DH whatever he wants and he is back to eating again after refusing almost everything for 2 months. The Dysphagia calls for thickening all liquids but it's doable.

Good luck to you Michael. I hope you find a solution.
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I think that suggesting a Hospice eval is a good idea. It's not a sign of giving up, but maybe assessing his "baseline" isn't a bad idea. Also, they surely deal with folks giving up and can assess appropriately. People can also go and off hospice (it's not a death sentence). If he's found not eligible, it may give him a new perspective.
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Thank you Eyeirshlass -- Thank you for your wise and compassionate answer. Same situation as Michaelroyale 4 mos ago until ER found problems from pneumonia from aspiration. Treated and now at new facility and a turn around. Before and after, your advice still applies. Thank you.
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My mom was the same way when she was still cognizant of what was happening to her. Once she snapped st me, "My father had the right idea!", and that's how I found out my grandpa had committed suicide, 50 years later.

Michael, I believe the man you care for needs more than a blood and urine test. If he hasn't seen his doctor for a physical lately, he needs to go. He made need meds for depression and perhaps have dementia. Refusing to eat is not that uncommon. If he's inactive and depressed, food may not seem appealing. My mom ate nothing but dessert and was always asking me for junk food. She lost weight but didn't starve.

This man is probably not very happy with himself, either. I am my husband's caregiver. He was a business owner. Now he is bedridden, immobile and incontinent. Neither one of us is very happy right now and we scream at each other at least once a day. I am headed for therapy. No joke.

Get him to a doctor for a complete physical. You can't tell if there's anything going on just by looking at him. The doctor may suggest an evaluation by home healthcare to give you suggestions on easier ways to cope.

Good luck. Keep us updated. Hugs!
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Hugs.
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