Is it abuse for a Guardian to allow a dementia patient to starve without intervening?

I don't think the court could force her to eat either, we all have that right to do as we chose, now if someone was withholding food that would be a different story, as hard as it is, she does have the right to not eat if she so chooses, will keep her in my prayers

It is not always easy to starve to death; I know two women who did so. First problem is not being force fed. You may need a protector to prevent that. Second problem can be the length of time it may take to die. It helps to have a hospice setting where comfort may be provided and a doctor who understands the patient's wishes. Do not go to an Emergency Room; their mission is to save life. Try to help if you can. Prayer never hurts.

It would seem to me that the Guardian would be held accountable for neglect and abuse despite anyones wishes. Given the emotional painful situation as it is this person is adding a criminal charge to make it more unbearable. I would seek immediate counsel from those who would make an arrest and levy a charge in the end. I think she would be put in some mighty hot water.

My mom has been suffering from dementia for quite awhile. Throughout the years, she has threatened to do alot of "insane" stuff. Does your aunt live with your cousin? Is it her parent? If she lives seperate, does a caregiver live with her? If your aunt lives with a caregiver and the caregiver prepares meals, I would bet that your aunt would eventually eat. It is not that easy to just stop eating when someone is preparing meals. My sister and I were threatened with a lot of stuff, one of the "plusses" of dementia is that they forget and are easily distracted, but it takes effort. If you cousin doesn't provide nourishment, as guardian, I think would be considered abuse. Why did she seek guardianship? The only reason she was appointed guardian was because the court felt that your aunt couldn't make decisions for herself. If a 5 year old refused to eat, would you quit trying to pursuade her to eat? Another angle is does your aunt have a living will that she created when she was mentally healthy? What were her wishes?

Some good answers above. I have always thought that refusing to eat is the last control I might have over myself should I wish to leave this Earth. I don't blame her at all for chosing this path. Does she live alone? If she lives with someone who is her caregiver, I'm wondering if it would be wisdome for them to keep a written log showing that she is regularly offered food, but refuses.

I complete agree with Rackem. My dad with dementia may have a bad day and say he wants to die, but he will forget about it later in the day or by the next day. Make sure food is available, but otherwise I would let it go. I personally wouldn't try to force feed a person who says they don't want to eat and then follows through with that. If wanting to die is a claim she stands by day after day, let her be. She's probably suffering and has enough of her faculties to understand she's different and will never be the same person she used to be.

I think its abuse! The sound of your cousin's attitude in the words she says are of apathy towards your aunt. there may be ways to convince your aunt to eat, but it doesn't sound as though your cousin is even trying. i know nothing of the legalities of it, but from a human love and respect perspective, your cousin sounds pretty awful to me.

Don't let's start judging people as good or bad on the basis of a couple of quotes. It's a complicated question. It is an ethical end-of-life choice, but it's not clear whether the person in question might also just be trying very hard to get some attention. Either way, it is -- or would become -- a Hospice situation because ultimately it's hard to starve to death and not painless. Does the person have advanced directives or is she too demented to have them? Get some elder advocacy going so that YOU are not alone with your concerns.

The only way to put nutrients into the body except for feeding orally is through an I.V. and if that was not in their wishes consider hospice for pain control. Many people stop drinking water in the later stages of dementia and at that point, you're near the end. If the food is provided (set in front of her and offered up to her mouth) than I say it is not unethical, but a natural way to go.

My grandmother had dementia, and in the end, she refused food and water. The doctor informed us that he had seen this with many patients. It is the last thing that have control over. However, my grandmother was very far along in her dementia. I don't think it sounds like your aunt is in that phase yet. And even if she were, the appropriate setting would be a hospice situation, where she can be made as comfortable as possible. It sounds like your cousin needs to take your aunt to see her doctor to make some adjustments in her care.

I would call in hospice for comfort care. Starving can be a very painful and slow way to die. Also, they may have other ideas to the situation.

Thanks to those who are not as quick to think the worst, but present an open approach to dealing with this type of situation. If the aunt chooses to start starving herself, she might also change her mind.

I look forward to learning what the authorities say. If the Guardian is not open to learning, THAT's when I'd be concerned. In the meantime, helping find the options and the understanding of the Aunt's plight is the way to go, IMO.

Please get legal counsel. There are sites such as justanswer. They have been a godsend to me. You do not have to pay, if you are not satisfied with the answer. I am a professional caregiver. There have been many situations, that if I did not know the law, I would have been in deep trouble. Problems can and will arise. Protect yourself.

This is a tough call and there is no black and white answer. This is a personal decision. If you notify the court, yes they can force her into eating by putting a feeding tube in her. But on the other hand what does your aunt want?

Perhaps you aunt does not want to face the phases she is going to go through and she has a right to make that decision as well.

I do not believe this is a legal situation, but a family decision. I am sorry but this is personal and if you involve legal counsel everyone of you will lose your rights and the courts will take over.

I will just say this my father had severe brain damage after a heart attack, we had to decide if he was going onto a feeding tube or if we were going to do what they call comfort care, which is basically starving the body. As a family we discussed it and made our decision. In turn, I gave the order to the doctor.

So I am sorry having been down a similar path, I disagree with taking the legal step, you need to discuss it. Your aunt and her family need to discuss it and make a decision that you can live with. This is a moral and ethics situation, not a legal situation.

I would call in Adult Protective Services immediately. If she dehydrates and didnt even call a doctor or take her into the hospital she could be charged. Remember when that happened on TV to that girl who was bedridden for years and they said it was extremely painful? At least if she refused to eat she could have morphine to stop her pain. Mild dementia? My Mom has severe dementia and I can still get her to laugh. Granted its not a good life but In the beginnings she went to Daycare and thought she worked there like most of them did, its not the end of the world to have dementia, its how you take care of them. I agree she isnt speaking rationally and someone needs to be called or who knows, that guardian could go to jail. And, if you know this and dont report it, you could be held liable also. Make come phone calls to the APS and ask at least. good luck, so so sad.

I agree with others that this is a moral and ethics situation, and would be best if not looked at as a legal issue. However, I've been down this road with my mother, who died almost 2 years ago. Ultimately, she starved to death. Sounds so cold and incompassionate doesn't it? The feeding tube option will undoubtedly come up. As I have found in my personal situation and on this website, it is highly controversial. I won't start that debate because it will distract from your question. But, I will note these points for consideration: Depending on how long your aunt has not been eating, you probably won't have time to deal with this in a legal fashion. If your cousin is legal guardian, that is who medical pros will listen to. However, if most other family members disagree with her, you might have success in pressuring her to reconsider her approach/consider other options. In my situation there was no "guardian" or legal authority named in a living will, so it was my father who made decisions for my mother. My family members didn't agree on what intervention should take place. The decision that was made, I didn't agree with. And my mother's death IMO was premature and unecessary. That still haunts me today. Will you possibly wonder if you should've done more, if you do nothing? That is something you should consider. Finally, I think it is important to point out whenever the issue of someone not eating becomes reality...this should be understood. When the organs are not nourished they start to shut down. This is extremely painful. So, no matter whose decision it is to let them go by not eating, make sure a pain killer (usually Morphine) is apart of the process.

I wish you and your family...peace.

I would HOPE that you doing something rather than writing for replies.
And so take her to a Doctor&get things done so she is saved.!

There is depression that often goes along with demetia. I think a good assessment of this possibility cannot be overlooked for your aunt.
My father decided when he had terminal kidney cancer that if he needed to
starve himself he would . To me that was his choice as he dealt with a terminal
and painful condition. He said that he had a friend that did that with terminal
cancer. He ended up not doing that , but he needed hospice service for his
last month.
My mother has had dementia for five years- and it may be Altzheimer's- but she
is a scleroderma patient and takes strong medicine. She has a sweet and
cheerful demeanor most days, so she is able to bring a smile to others. Her
life contiues to be valuable, and she does have to take an antidepressant to
be able to have her personality continue though it is diminishing.Discussing these topics with health professional and/or mental health professional together with your cousin to give you some other perspectives on the situation.
Blessings to you and your family.

I think that the cousin would at least make some effort to encourage her aunt to eat. If she is not even monitoring her eating/drinking at all and letting the chips fall where they may, then I would call that neglect and that may have some legal ramifications. Maybe the cousin does not think the situation is really that serious and made that comment off-handed. I agree with comments that say that the aunt should be in a hospice environment where nursing staff can monitor her, but (I think) hospice care cannot be approved unless the aunt's doctor confirms that she is on her way to dying.

I am concerned that the aunt has only "mild dementia", which is not typically the diagnosis of someone in end stages of life. It sounds like she is frightened and depressed and wants to give up now, fearing how bad it WILL or MAY become. The cousin's answer of "gods will" is disturbingly passive-aggressive and sounds to me like she really doesn't want to invest in the substantial work that will be required to care-give her Mother. Yes, to intentionally withhold food and starve the patient would be elder abuse. Hospice is an exceptional program that will assist and advise both patient and family members on the most loving, humane and comfortable manner in which to assist a patient through the end stages of life. However, it does not sound like this patient is at that place yet and professional advice and guidance is definitely called for.

I agree with prsimon- the "mild dementia" has me concerned. I do know with Alzheimer's , at the very end stages, stopping eating is common- my Grandma did this and on my last visit to her I tried so hard to get her to eat but she refused-I came close to forcing the food in her but stopped ,as hard as it was , and realized that the visit with her would be my last. I then just sat with her and made peace with the situation. She seemed calmer than she had been for months then and , at the end of our visit, as I left her room she blew me kisses- she used to do that from her porch step every time we pulled out of her driveway after a visit before the Alzheimer's robbed her of her memory. It was the last thing I saw her do. But she was at the very end stages of Alzheimer's. I fear your Aunt's decision is based more on depression then a natural progression of a disease. I think she needs to be looked at by a psychologist or psychiatrist.

Absolutely it is abuse, she is not in her right mind, I would think you might be able to be charged with neglect unless she was starving under a doctors care... I would call an ambulance or take her to the ER or her doctor and make sure that her attitude toward her food is clearly stated as her desire. It may come down to her accusing you of not feeding her on a day when she changes her mind. Very sad. She has dementia. You cannot plan on her continuing with the same mindset on every day. The time may come when she decides she would like to live and she might believe you have starved her. Take care to get her the nutrition that she needs.

I am not judging you, your cousin or your aunt, unless the person is brain dead and being kept alive artificially, as in Terri Schiavo's case, I do not think anyone has a right, to starve themselves to death or let someone let them starve themselves to death, but let us suppose, someone is that depressed, about their diagnosis,it would seem to me, that a proper doctor should be called in, to offer alternative choices in care.

As far as the court is concerned, the guardian, is suppose to help the person, (not go along with some idea, of a mild dementia patient?) usually a guardian gets appointed when the person is declared disabled....and the guardian eventually has to answer to the court...how does she plan on getting away with it? Your cousin, is assisting someone in suicide, it is only suicide if self-inflicted, other wise it is a homicide.

If this is a for real situation, your duty is to report her... this is done by making an emergency order to the court, or reporting her to senior abuse, etc. you could ask the question of the senior abuse hotline, if someone is allowing their mother to starve because the mother wants to starve or...is allowing someone to starve senior abuse or die by starving is something, that a guardian should be allowing their ward to do and from there, the decision would be in their (Senior Abuse Hotline's) hands.

I would get her assessed for depression and have a full work up by a gerientologist. You say she has mild dementia and perhaps the feeling that she is going to completely lose it scares her. Perhaps all or most of her friends are dead. Who knows. There can also be a 'flair for the dramatic' in some elderly folks. So all of that needs to be sorted out. There are drugs to slow the effects of Alzheimers and antidepressants too. I think maybe offering her food that she finds appetizing may interest her and she needs to have availability of fluids too.
But I guess I do believe it is her choice whether to eat or not to eat. After all the 'homework' is done she has to at least help herself or not. And, well, none of us eventually are getting out of here alive.

I don't think that honoring her wishes is abuse at all. My mom lived a good 91 years of life. She was diagnosed with progressive Dementia (Lewy Body Dementia) the last 6 months with mom was a roller coaster ride. I was moms caregiver and with the last stage of her dementia the brain shut off the abilities to swallow. It was a struggle for her to swallow even water. At that point the hospice nurse came and the last 2 weeks we would offer her food or water..and she would turn it away. They have a brain disconnect that makes it so they have no appetite or thirst for anything. Mom had horrible gag reflexes whenever she would try to drink. It was so hard to watch. I am sure when you see that the time is near. It's better to let them choose not to eat than to try and struggle with it. The hospice will keep her comfortable with the breathing and anxiousness of the whole dying process. And believe me, it's a big relief to have them there. I hope you understand and respect her wishes. And if she has an advance directive, the only thing you can do is keep her comfortable. God Bless the caregivers for their jobs are the hardest...watching their loved ones suffer. ((hug))

I would see about getting her checked for depression. She may also need to be checked for UTI. This can cause some confusion n not wanting to eat. Also, I would try some Ensure for they r loaded with vitamins n maybe some shakes or something that she use to like when she was young. My mil is in moderate Alzheimers n I know if I don't keep up with her to eat that she would only take a bite or two n wither away. She is now on depression med n I get her drink every night one Ensure n little meals in between. I see about one of you take her to her physician n see if something is going on medically. Please come back n let us know how she is doing.

Dear sstevens: If your aunt *really* suffers from dementia, she will forget this irrational decision she made. In the event that she pursues the issue, with a lot of love and compassion, she can be nourished. I'm sure you don't want to cooperate with this euthanasia. This is something you can work out by yourself, without the court's intervention. Remember, "love and prayer always work."

Yes it is abuse!! would you let a child starve? she is depressed and probably feels like a burden ESPECIALLY if the cousin is telling her ok!! thats a messed up cousin. please dont let it go- go talk to her!! try something- you too will be in that situation one day and will also be suicidal due to your circumstances and feeling like no one cares if you die. wish i was there.

I dont know how anyone could eat knowing there is a HOSPICE nurse in the house and she is there for you!! yeah im starved just thinking about it!! hello does anyone even think about how YOU would feel in that situation?

In reading the suggestions above it seems as though the majority think that it is just a matter of offering food to solve the issue of non-eating. My mother who has no short term recall at all and many of the symptoms of early dementia has been a problem eater for years. In the past two years she has lost 8 lbs and 9 lbs respectively while staying with my sibling (who thankfully was giving me a much needed break from her constant care). When offered any sort of meal she will nibble (literally) a bite or two - maybe 50 calories and she is done no matter how long the food is in front of her or the continuing encouragement from numerous family members. When she is here with me I have developed a high calorie/carb/multi vitamin/protein shake which I fix twice each day - if she is not constantly monitored she will only sip enough to consume her meds. It takes literally 3 hours each to get her to consume the contents enough to provide the number of calories her doctor says she needs to survive. that's 6 hours each and every day just to get enough into her to stay alive. It simply isn't just offer her food and eventually she will decide that she wants to eat it. It took me 4 months to put the 8 pounds back on her that she had lost and I am just beginning to address the recent 9 pound loss (she only weighs 109 lbs at this point) Now I am faced with the knowledge that there are (short of tube feeding) no resources available to monitor the 6 hour eating ordeal. Although she gets very little exercise she is generally in good health and is happy to visit with others she simply will not consume enough to stay in good health unless someone devotes a huge amount of time to that purpose. When left to her own devices (for hours/days/weeks or months) she quite literally wastes away - at this point I dread each and every day and the ordeal I am faced with just to ensure that I don't neglect her -