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My grandmother turned 90 in March, we had a little party where she was dancing and such. Maybe a month later her health just suddenly declined. Prior to this she never really ate much, we noticed her appetite slowly dissipate within the year prior and she never complains but we could tell her stomach would hurt. It started with only eating a few bites to now not eating anything at all, it's even hard to get her to drink an ensure. During this time we've noticed traces of blood in her urine which led to her being bedridden after being the most active 90 year old I know... She vomits if she drinks too much of anything and sleeps all day. Please note she has never taken medication ever in her life and has only been to the hospital once over 60 years ago when she gave birth to one of her children. She HATES hospitals and even the mentioning of bringing her to the doctor makes her very upset. She's too weak to sit up and sometimes even too weak to speak, my family isn't sure what to do because we know she's dying. We ask her if she's in pain and she says no, only some discomfort when she urinates and a stomach ache every once in a while. We can't take her to the hospital or the doctor and we can't give her medication. Wouldn't we get in trouble if she was to pass and we did nothing? My mom is so stressed and I just can't think of what to do to help...

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Contact her Dr. And get a referral for Hospice care. If she doesn’t have a Dr., you can contact the local Hospice and they will guide you.
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Ysebab: Imho, perhaps your grandmother's way of thinking may be short sighted., but you could still call for EMT service. These medical professionals will come in and make the assessment. Let them.
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She needs to be on hospice care to keep her comfortable. She is dying and deserves to not be in pain. Hospice can happen in her home. It’s her decision to not “ do anything”. You can not get into trouble for following her wishes. Good luck 🍀
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rovana Dec 2021
What is the best way to go about making sure that you cannot be blamed because you follow her wishes?
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I like Barb Brooklyn's answer. At the least call 911 and if GM refuses to go to hospital, the EMT will have it documented of the refusal to seek treatment. I would say that is the line of least resistance.

If GM is competent, she can decide for herself what she wants to do.

The other options mentioned is to get her urine checked, and see if hospice can evaluate her.
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GMA is free to refuse, but in your shoes, I'd call 911. Those handsome EMTs can be very persuasive.

And if she refuses, you have an official "refusal of care" with EMT witnesses to back you up.

You local Area Agency on Aging may keep a list of doctors who make house calls for elderly homebound pateints. Consider going that route.
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It is very difficult and stressful when your loved one reacts badly to the idea of seeking medical advice.

Strict ethics also dictate that this is your grandmother's choice.

But that doesn't mean you can't give it to her straight. Blood in urine is a clinical sign which any responsible adult would report immediately to a licensed medical practitioner. Not to do so is plain daft. The chances are that this is something easily treatable, and if not curable then manageable. There is no *need* for her to continue to decline at such a rapid rate and in such clear discomfort.

To avoid you and your mother being, as you put it, in trouble for neglect - get her refusal in writing. Type out a document that states "My daughter [name] and grandchild [name] have urged me to seek medical advice regarding blood in my urine because they have serious concerns. However my decision is not to seek medical attention and I wish this to be known by whomever it may concern." Put it in front of her and make her sign it.

Alternatively (and much better because what if she calls your bluff and signs it?) tell her you're contacting a doctor to take advice, and then ask the doctor to speak to her. Make sure she is reassured that even if she does agree to see the doctor, nobody can force her to agree to treatment; but for her to go on pretending there's nothing wrong would be plain stupid.
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Right or wrong, if we have our minds, we have a right to make choices that affect us. Some people just simply refuse to see a doctor and unless it is forced on them, it will not happen. You can ask Adult Protective Services what they think you should do. I think she is nearing the end and knows it and wants to be left in peace. I would honor that.
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My feeling is that every person should be free to choose their medical care (or choose not to have medical care), especially after age 70. Looking back, I believe my mom knew something was wrong with her (and our family doctor believes this, too) and she chose to let it get past "the point of no return" before seeking a diagnosis. That was her choice and I supported it. We made the best of her last month of life. She was 79 years old. It was her choice. If the time comes that she has pain or discomfort you can begin Hospice and/or get medical advice and care virtually.
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DrBenshir Dec 2021
You can't get hospice without a diagnosis and medical referral. This family is on their own. If there are relatives not onboard with just letting GM go, they could have some problems down the line.
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I was in the same position with my 94 year old father. I did manage to convince him to go to the hospital and after his release we had a virtual follow up appointment. At that appointment my Dad was adamant that he would not go back to a hospital and the only treatment available in his condition was medication. He was placed on Hospice and he passed away at the end of September. I am glad he was able to have control and doubly glad he did not suffer at the end of his life. He was comfortable and passed very peacefully.
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A very good friend of mine had similar symptoms. In her case it was colorectal cancer. Has grandma ever had a colonoscopy? At 90 the procedure may be too risky.
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Davenport Dec 2021
I’d say no colonoscopy at 90–and it sounds like Grandma would never do it in any case.
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Call in for a hospiice evalation. A hospice doctor will only come if she is accepted as a hospice patient. It is all paid by Medicare.

The requirement for hospice is that someone does not receivre certain kinds of care. However, a hospice dcctor will visit her at home as well as nurses, aides and she will receive what she needs to bre comfortable.

She has obviousl made the decision that she does not want to prolong her life and that is her choice to make.
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Can you get a hospice organization to have a home visit from a doctor to evaluate her and qualify her for care?
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I don't think that vomiting when she drinks is a UTI symptom. Although UTIs can become serious if left untreated because they can devolve into sepsis, she has something more going on (and she could also have a UTI at the same time because they are very common in elderly women and are not necessarily caused by hygiene habits).

Your grandmother has put your family into a challenging situation. Since she resists going the the doctor or hospital, it has to be explained to her that if she doesn't get an exam, she won't even be qualified for hospice which may mean that when your family is then forced to eventually call an ambulance when her conditions goes beyond what she and her family can endure, the medical staff will be required to employ heroic efforts to "save" her life. This means lots of medicine, IVs, treatments, CPR (if it gets to that)... she should at least assign your mom as her PoA and create an Advance Healthcare Directive (Living Will) so that she can waive off any further "therapeutic" medical actions and decisions and just receive comfort care at home. The irony is, she is less in control by not going to the doctor or lawyer. If you can impress this upon her, if she is able to comprehend it and has the strength to respond, it may move her forward so that her wishes can be respected without duress to her family.

I think if it gets bad enough your mom can certainly call 911. If she allows herself to be taken, your mom can ask to speak with the hospital staff and also a social worker to figure out where to go with her care and perhaps getting hospice set up. Even if Grandma musters up the strength to wave off the EMTs, there is record that your family did the right thing. May you receive peace in your hearts.
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Debstarr53 Dec 2021
Vomiting can be a symptom if it has progressed and spread to the kidneys.
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One thing that is easy for you to do would be to take a urine sample (you can get a "hat" for the toilet to collect it) to check for a UTI, which could account for many of her symptoms, it is be easily treated and would make her much more comfortable.

Personally I'd want her checked out so I'd know what exactly I was dealing with even if you choose not to treat it, but if she is adamant then I think you should enroll her in Hospice. While she may need an initial check from a doctor in order to qualify beyond that their goal is to keep her comfortable and to offer support to her caregivers, it also eliminates any difficulty that might arise with a home death.
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