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My father-in-law is in the final stages of copd/emphysema. When the doctors have tried to talk about end of life decisions, he acts as if he doesn't hear them. He has refused any type of pallative care or hospice. He does not want any type of pain management or anxiety medication either. He is in complete denial about his condition. How do I help him face the future? I hate the thought of him gasping for breath and suffering in his final days.

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Jeanne mentions the possibility of dementia. I read your profile and you mention there that your fil is an alcoholic. His alcohol intake may act as a means of self medication. He's not going to make sensible decisions when he can numb himself with alcohol, so in a way he does have a form of dementia. Just self induced and, who knows, maybe there is some real dementia in the mix too.

At this point in his life, he doesn't want to listen to the docs, he just wants to go home and drink and that's his palliative care.

I think Jane B had a good suggestion. His doc can make a referral to Hospice for your fil. They can contact you and you can explain the situation. Get them lined up to be on board for what is coming. That's a very merciful thing to do for your fil and it may be the best option you have to feel that you have taken action on his behalf. He's not going to change his ways, so just be a step ahead and do the preparation for him. He's lucky to have you as his guardian angel. Hugs, Cattails.
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This must be very sad and painful for you to watch. You don't mention dementia so I assume fil is of sound mind. Presumably he can change is mind at any time and accept pallative care and pain control. Maybe he won't be able to face the future until it is here.
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Can you doc give him a referral to hospice now, so that YOU can have them ready to call in, when your Dad might be more open to it? As he struggles for breath, perhaps he will be open to resources that will make him feel more comfortable.

Sometimes people die in denial. My mother had a cold until the day metastatic breast cancer killed her. hospice came in, under the guise of making her comfortable, and helping her family some, since the "cold" was lasting so long. There was never a moment when she acknowledged what was really going on. Her right. In my view, her loss, too. But in HER view, the way she wanted to go.

All this to say: maybe all that can happen, or really HAS to happen, is to "make him more comfortable during this long illness" and see what happens from there.
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