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

ITS TRUE

Also, your area has an adult protective services that you may be able to speak with for help.

Yes it is

They should be giving her shakes to drink

It is wrong to let a family member to starve.Been their don that.

Putting aside the moral, ethical issue, the guardian needs to seek legal advice, advice from elder abuse agency social service, etc so she covers her you know what. Forget the moral that is not what I am talking about, if they decide the guardian is liable she will be criminally charged and have more problems than Carter's got pills. She is not in the hospital with a do not resusitate proxy, she is home and the guardian is responsible for her.

haggismom, ((hugs)) to you. It sounds hard and you seem very caring.

I cannot help but think it is a natural part of dying- this not wanting to eat- if a disease is at the end stages. I do not know if this is the case with haggismom's Mom but I do think it can be the case for many who have suffered from a wasting disease.

My grandmother, in her logical mind- before Alzheimer's - made the legal decision of not having any extreme measures taken to keep her alive- I cannot recall the legal term for this- but that meant that my Mom was not able to stick a food tube in her when she refused to eat. This was so hard for my Mom. She even consulted her priest to see about the moral ramifications of this and he said as long as there was no way to get her better and she had made the decision of sound mind my Mom would have to respect it and it was not considered suicide- just the progression of the disease. My grandmother did not die hungry- her brain stopped being hungry and I do not think she was in any pain. Eventually her heart just gave out. Soon after she stopped eating.

Doctors need to be consulted, however, I think, to determine the right course of action.

I can't imagine how difficult that was for your mother, I think that the time I dedicate to this process is mostly because I am stubborn. When my mother returned last year my entire family thought she was near the end. She could hardly walk or even sit upright in a chair for more than a couple of minutes.Couldn't sign her name or tell time. In all honesty she was probably prepared to call it quits but I simply wasn't prepared to allow (my personal hang-up) her to slow down and cease to be. I developed these shakes (900 or so calories each twice a day), lied to her about they're being prescribed by her Doctor (he backed me up beautifully at a subsequent check-up) and, as stated earlier, managed to put the weight back on her and consequently restore her motor skills and much of her daily routine before her next trip. Now I'm back in the same boat and wondering if it is some form of insanity (on my part) to devote this much (it is taking a toll on my health) for such a temporary victory. Did I mention that we have two family businesses, plus a farm w/many animals and wildlife rehab and our youngest is a college freshman with all the trails that go along with that. I am constantly tired and feel pretty non-productive in so many aspects of the balance of my family life (yes wondering if one can return to some sort of normalcy should I actually survive my mother)but more importantly, I am really soooooo glad to have found this site where I can associate with folks who are in such similar circumstances and learn how others are addressing the same issues that confront me and my family. It's good to really understand and be exposed to so many solutions and perspectives and I thank you for your consultation.

Haggismom, I was so surprised to see someone like myself on here with the long feedings. For about 2 years now I spend 2.5 hours feeding my Mom breakfast and 2-3 hours feeding her supper. (we gave up the lunch meal) Yes, I sit that long and feed her day in a day out and have to say "oh look what I made you" or something else half the time to get her to open her mouth. When I make her thick cinnamon french toast (most every morning) with real maple syrup she eats well. I puree her other foods and I just started feeding her 6 ozs of a protein shake to fill her. also . I dont know if she lost weight as she cannot stand to weigh her. It also takes me 2-3 hours to hoyer her into her wheelchair, into the bathroom, lift her on the toilet to bathe and empty her bowels there every morning, its a tough job for sure! Sometimes I open my front door and just look into the sky and pretend I am on vacation, no lie! I am very housebound and am training weekend help to keep my sanity, but I still do the morning routine of bathing, etc as no one can handle it it seems. Moms in late stage dementia and has a health care directive for no feeding tubes. Could you share the high calorie shake with us/me please? Does it replace a meal, I bet it takes just as long for them to drink right? Thanks much and I hope sstevens gets the help she needs. Thank you.

Unfortunately, the starvation has already occured. I had always been supposed to care for my relative in her late years. She refused to do a Will, POA or HCPOA believing the family would heed her wishes. Unfortunately, when the dementia set in, everyone was "after her" and being in the house with her, I was the primary target. The remaining got my relative to sign a will, POA and HCPOA, although she refused to sign a Living Will. The Will excludes everyone except them. They claim when my relative returned home from the guardianship proceeding, she requested from the person granted guardianship that she be allowed to starve to death. No one else heard this. A neighbor spoke with my relative and discussed how thin she was and she said she would try to eat. Needless to say, she received no further medical care after the relative was awarded guardianship until she had lost 40% of her body weight and was down to 67lbs. Hospice was finally called in and she died about 12 days later. I am heartbroken. We have just found this out through Court documents and I am just sick. I know what happened deep in my heart and honestly hope the Court will see this. Considering the way these proceedings have already gone, I am afraid my relatives will get away with you know what.

I appreciate everyone's input and suggestions. Unfortunately, we were barred from seeing my relative by the family members that were caring for her. Four aides and a Guardian believed a woman with dementia could make a decision to starve. Their response is we can't make her eat and we got her meals on wheels and ensure. We knew things were bad, but we were kept out. In fact, we weren't even allowed at her funeral. I miss her every day and really wish I hadn't listened to the attorney I hired to try and help, he was worthless. Thank you everyone for your responses.

Reverseroles, although my mother is nearing her 100th birthday (this May) I am so fortunate in that she still takes care of bathroom needs including (as long as I am present to direct soap/water/towels/toothbrush etc. to her) showers. What I have devised in order to accomodate her inability or unwillingness to "eat" normally has pretty much altered all of her caloric intake. Bare in mind her very advanced age, relative good health, consistant medical monitoring (her Doctor has been very cooperative and supportive). She used to take her medicine 4 times each day which has now been combined into twice daily to coincide with her intake of shakes. The contents of our shake formula varies but on a daily basis includes protein powder/Ensure Plus/banana/yogurt/instant breakfst/pudding/fruits/peanut butter/other ingredients blendable and available. Initiallly I was concerned about the amount of sugars but her blood work has actually improved (as per her Doctor, she gets a multi vit.+ cinnamon cap.each day). While she still "nibbles" on solid food given the amount of protein/calories/carbs contained with her liquid intake I really am not concerned with what or how much she eats. The combination has seemed (for her) to quickly improve her physical and mental abilities and it is such a relief not to worry about how I'm going to get the daily 1500 calories the her Doctor recommended into her - two of these shake (depending on actual contents) are about 1600+ calories. Recently (again, being the stubborn "nurse crachett" persona that I am) I have informed her that her Doctor (remember I used the "Doctor prescribed" shakes to get her initial cooperation) has "requested" that she takes her meds and drinks all of the shake within 1 hour. Knowing that at least for my mother her Doctor is a wonderful man who is looking out for her best interest the logic has worked. I have prepared written reminders (large letters with important words like "Doctor" "all" "1 Hour" written in red) so that I don't feel and sound like a non-stop shrew and place them on her table with the shake.

PS
I have discovered that my mother can no longer decifer roman numerals but she can, with some encouragement, not only tell time with a large numeric clock but can also calculate the time remaining to accomplish the "recommended one hour" time frame. It's sort of mind/body exercise. So far so good for the past few days we have finished each drink in approx 1 hour each and we have the added benefit of getting her to interact with the process by trying to figure out how long she has been working on the shake and how much time she has left. (And I have gained a couple of hours of my life back while using many less "mom finish your shake" words. - yeah!!!) Undoubtedly each individual's needs/ability/cooperation varies greatly but this formula seems to be working for us. Interestingly, my daughter in Law has successfully adopted the formula (less the protein powder as it is more difficult to digest and plus Hagendaz ice cream which is too pricey for us) for her father who has been losing a dramatic
amount of weight due to chemo treatments. His weight stabilized quickly and now is improving. fortuntely he never lost his appetite for solid food and the shakes are simply an additional source of calories for him.
Obviously it's an individual process but this has been helpful for us.
On another note, my sincere and heart felt "hugs" to sstevens for your loss. Hopefully you will realize the results needed within the legal process but in the meantime know that there are many here who know some of what you have endured and are supporting you in your path forward.

haggismom, yu put ALL that into one shake or what? Can you give me an example of one shake please? Thanks for the info, wow almost 100, incredible! My Mom is very bad, no walking or talking hardly, doesnt really see much nor understand. I puree fruit for her and beef stews, raviolli, etc. and give her about 6 oz of am HMR Protein Shake . Thank you, sounds good and hope to hear from you, you can post on my wall so I will get it, I just found this by mistake!! ha

Last Fall, my Dad with dementia started saying he was not hungry and did not want to eat. We cooked for him and bought things he liked but he would not eat and started sleeping a lot during the day. We thought he was going to die, but took him to the MD, who prescribed an 'appetite' pill called Megace. It's actually a hormone I think, but it increases appetite. She told him it would make his stomach feel better and hopefully he could eat again. She also talked with him about depression and a desire to die. He said that he wasn't trying to die, but if or when it was time, he was ready and accepting that. He was 90 at the time. The med helped him have an appetite and he started eating like crazy and has gained back most of the 20 lbs he had lost. We placed him in a memory care unit in January and after a couple weeks of adjustment, where he wanted to leave all the time, he now is happy, smiling, talking with others and thinks he's lived there for about 5 years. So he is settled....and I am now dealing with how to keep my Mom at home. So get this lady to a doctor and says she's not eating...plus be able to say if she's losing weight. Perhaps ask about Megace? She may have more good years left for her to enjoy!

Oh, sstevens, how sad. I am so sorry for your loss. You did everything you could. You did. We all think we could have done more but in reality that is just not the case many-most - of the time. Maybe you and your family and friends could hold a memorial for your Aunt-seeing as you were not allowed at the funeral. My heart goes out to you.

MSDaizy- my father (almost 96) died in January and it was very similar to your situation. Several years ago my father (alz/dementia) attempted to stop eating but it wasn't his time. After 5 months before his end he mentally/physically declined, then he stopped eating (but would drink the Assure "shake" for a while) and then for about 2-3 weeks would not drink because of gagging. It was rough on the family but hospice was extremely valuable during this time. He didn't suffer and he is in a better place right now- it is God's way.

FriendlyBedBuy...I know what you are saying. It's the brain that is deteriorating and the signals are not getting the connections. The disconnection will discourage them from swallowing. Its like the brain sending out signals to choke or gag instead. It's such a horrible thing to witness..and with my mom she was happy not to have to swallow. So the Hospice was here..we got a respite week and she stayed the last days at a Hospice House to which I never left her side during the last 48 hours of her life. They don't suffer..we suffer the most watching the whole ordeal. They are sleeping and comfortable. Mom had a smile on her face the first 2 days she was there. I was so relieved that we had scheduled the respite week a whole month out...not expecting it to be her last week on earth. It was God's will. January was a rough month for both of us. Thankfully they are both at peace. God Bless.

I am a bit confused. My Mom has choked on liquids for over 2 years but I use Thick-It and then she is ok, I also puree her foods except french toast which I make soft. Do you all mean they choked even with Thick-It? I feed my Mom 2 french toast , a yogurt and fruit and 14 oz decaf liguid for breakfast. No lunch and then puree ravioli or something, maybe ice cream with prune juice for supper. Sometimes I can barely get supper into her, each meal takes 2 hours, anyone else go through this, is this bad signs for my Mom? She cant walk or talk and is incontinent, I hav no idea what stage she is in. Her Dr writes severe dementia on her bloodwork slips. I am so sorry for your losses, I cant imagine how or when we will go through this and it scares me!

Reverseroles...They can be in the last stages for years. But the thing with choking..mom refused to eat. I would make it and she would push it away. The only time she would try and drink was if I gave her medication. When she would take in a mouthful of water she would hold it...and not swallow. Because she was afraid of swallowing. And sometimes she would swallow only to have a gag reflex to throw it back up. My mom was 91 she stopped eating and with a DNR with no life sustaining procedures. No feeding tubes or iv fluids. She signed the DNR over 10 years ago when my dad passed away. I don't think she knew at the time she would live this long. But with that advanced directive the only thing we could do was keep her comfortable. Hospice was there for the last 3 months. But she only stopped eating the last 2 weeks before she died. I hated for my mom to go this way...it was a horrible thing to witness...but now I know she is finally at peace. God bless the caregiver. It's truly the hardest thing I have ever done in my life.

Shakes are a good step, I did my shake as a take off of the old "Orange Julius"
Orange juice, ice, egg and honey but soon, threw in yogurt, strawberries, etc.
When the body gets down in weight, the mind doesn't think clearly anymore, and sometimes, malnutrition can mimic dementia.

Our 86 year old recovered from her bout, it went on for 3 years lack or desire thereof for eating, as a side effect from being on Exelon. (Exelon's side effect for her was (diarrhea) for one year that she was on Exelon, and not watched or fed while she was on visits. She still is shy on the water, but regularly eats three meals a day, but only the type of food she used to eat, when she was on her own.
The meals used to take a long time, but are around 45 minutes each, now.
There is no denying that care giving for an elderly often moody, defiant senior who has developed the strength of ten people is difficult, no doubt, I just hope ours goes in her sleep.

I don't think this is a legal issue. I think it's an end of life issue. My mother-in-law made this choice to stop eating and to stop her medications. She did not have dementia, she had Parkinson's and she was trapped in her body. So while she was of sound mind, she chose to leave this world. She decided on a Tuesday, all of her family (11 kids and their spouses, most of her 40+ grandchildren and great grands) had a chance to say goodbye, and she left us peacefully, on her own terms on Sunday, surrounded by her children. Hospice was involved.

I think it is both a legal and an end-of-life issue. With no proper end-of-life legal documents in place (DNR, living will prohibiting use of feeding tube, medical POA), the caregiver might well be held liable. On the other hand, starvation is often nature's way, and I feel medical science too often intervenes when it should not, prolonging the misery of many who would far prefer to go naturally. So the best insurance is to have those legal documents in place, and to give the medical POA to someone tho will see that they are enforced.

My mother stopped eating about 2 days prior to her death. My Aunt Jean who is 92 has also stopped eating and is dying. Sometimes this is a textbook example of the body shutting down. But they are on hospice and receiving comfort care. Also my mother had COPD and had caught a virus and was filling up with fluid and was not very
responsive. My Aunt had broken her neck and is in a c-collar and is extremely weak. Weak enough that putting in a eating tube might kill her. So the hospice is
just trying to keep her comfortable. Now if your grandmother is in a dire medical situation I could see her not eating, but if she seems to still be sound of body and have some quality of life, I would call adult protective services and see if they can help you. Or go to the court, and ask for some help. I would see if she qualifies for hospice, sometimes eating can be painful depending on the condition they have, but at least if she is not going to eat they can give her comfort care.

FYI to all...sstevens, who asked the initial question and started this topic, while she/he didn't make it clear, is asking about recourse AFTER her aunt's death. Additional information was provided in a later post which noted that her aunt died. In other words...the Aunt passed away and sstevens is wondering if "the guardian" can be held accountable since she "allowed a dementia patient to starve without intervening".

She stated her wishes. I often wish I had not fed my dad so much when he could no longer feed himself. It isn't a life it is death. It is quality of life that is important. He wouldn't have wanted to live this way. I'm so sad about those who prolong a life like this. Respect her wishes, for heaven's sake.

I guess what I am trying to make clear is my aunt supposedly stated these wishes only to the Guardian, only after she was deep in Alzheimers and without a living will. This was not something that took place in 2 weeks, she was starved over 3 months. Hospice was only involved the last 9 days of her life. The Guardian didn't involve family, didn't involve the doctor, just did this on her own. Then after being barred from the funeral or even seeing my aunt before her death, we find the Guardian had everything signed over to her.

Sstevens...I am sorry I misunderstood your question. It does seem to be a little fishy that this all transpired without any of the family's knowledge. It seems there should be some accountability there. Check with a social worker from any Aging agency. There are Ombudsmen which are advocates for the aging in your state. I certainly would check into it. They might be able to give you advice in the direction to go with this manner. Good luck and God Bless.

Since when is starving yourself to death going naturally?
Sure it is a chore to take care of someone, but that doesn't give us the right,
to end their life for them, what is this world coming to?
Kevorkian did time, remember, does anyone remember?
We could all be trapped in our own bodies, does not mean we are going to starve ourselves, are we? It sounds like a kid saying I am going to hold my breath unless you give it to me? If we wanted to, we could all find a reason to starve ourselves, it doesn't make it right. Get a grip everyone, DNR's are if you were in a car accident and you are in a coma or brain dead, part of you is dead already, but take a living person starving over as three month period is murder, in my book.
I am just wondering, if you had reported them to senior abuse? Again wondering what the autopsy showed, death certificate, etc. I wonder what the states attorneys' office would think, death and a motive...

sounds like a lot of this situation is a bit fishy. You mention that, "The Guardian didn't involve family, didn't involve the doctor, just did this on her own." Was there any reasons why the family members didn't intervene or call to check up on her? Or did they feel comfortable with the guardian at the time? However, I am not sure anyone that is in the late stages of Alzheimer's disease that, they r capable of making any decision for themselves. Yet, I could be wrong on that one. I am sorry for you loss of your Aunt n not sure how she was able to manage a barred from the funeral? Either way, I would have it check it out for the whole thing sounds fishy. Good Luck.