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MIL who has advanced dementia and many chronic health conditions (heart issues, kidney failure, strokes, clogged arteries, etc) has started refusing her medications and food. For two days, she has refused all food we have offered as well as her medications. She also has severe depression. She has slowed down in recent weeks, not loving around as much, sleeping more, and eating noticeably less. However, unsure how to proceed here. Afraid of a heart attack or stroke occurring. Do we talk to her doctor? Being her to the ER? She has so many health issues that without food and medication something will surely occur soon. She says she has “no desire to live any
ore.” Is this common with dementia?

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How old is your MIL?
Where does she live?
Is she getting any meds for depression?
If not, why not?
Has her MPoA spoken to her doctor about hospice care?

I have a 100-yr old Aunt with advanced dementia and she now mostly yells, "God, help me! Help me, Jesus!" a lot. I would not think she is cogent enough to understand that not eating would help brings things to an end sooner. dementia?
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Fawnby Dec 2022
My MIL’s friend had dementia, and when it became advanced, she’d cry, “Help! Help!” all day long. So sad, but obviously her mind was active enough to know she needed help. It was interesting that her instinct for survival was still intact.
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It's time to bring hospice on board as it sounds like she may actually be dying. When our bodies start shutting down preparing for death, we no longer need/want food or drink as the digestive system is the first to shut down. Forcing someone to eat or drink can cause great pain for the one dying, thus why you should be calling hospice now. They will better explain everything to you, and will try and keep your MIL comfortable and pain free, so she can transition from this life to the next.
And with all the health issues she has going on you can't blame her for not wanting to live anymore, so why prolong the inevitable by bringing her to a doctor or ER? All they will do is try and keep her alive. And for what? To keep living in misery?
There are no happy endings with dementia, so let her go in peace.
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It sound like it might be time to let nature take its course. I would call for a hospice eval ASAP. Keep her comfortable and let her go.

Sorry for your sad situation. I don't see prolonging what sounds to me like a fairly miserable life. I would want to let what happens, happen. But that's just me.
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Yes, it is common. Believe her and call hospice.
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I think in her way she knows it is her time. Respect that, keep her comfortable and call hospice.
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I cannot imagine why your MIL would want to stay alive any longer, can you? My advice is to allow nature to take its course. Trying to, or wanting to, prolong the life of an elder suffering with advanced dementia along with many chronic health issues is cruel, in my opinion. When my mother hit her 95th birthday and cried about wanting to die all the time, I prayed daily for God to hurry up and take her, please. She went on hospice on December 21, 2021 and passed away on February 22, 2022............2 short months later. Nobody was really expecting it, but her heart was weary of beating for so long, and her brain was worn out from dementia for nearly 6 years. It was a huge blessing that she passed so quickly from heart failure, and hospice kept her comfortable for the week she was semi-comatose in bed. I suggest you get hospice on board now for your MIL so they can keep her comfortable as she takes this last leg of her Earthly journey.

Best of luck and Godspeed to you and your family.
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I wouldn't say it is common with dementia. It is common at end of life. Yes also common with depression.

If she was on hospice, this would be considered kind of normal, at an announcement like that they would have their social workers or chaplains etc talking with her about her emotional state in regards to her health and state of being right now. As she is not on hospice and therefore doesn't have those resources already on hand to be dispatched quickly, I would contact them ASAP. You can call her PCP and see if there is a hospice group that they work with/prefer to use for their patients. They can at least help her with medications that will keep her comfortable - whether it is the body shutting down to prepare for death, *or* depression, they can handle both -- and they work with the primary care dr in caring for the patient. It's not automatic withdraw of all sorts of meds and the like either - you can choose to have hospice basically do "everything possible" that can be done at home (no IVs though I dont think) And if the patient wants they can basically call and say "Nah I'm going to go to the hospital now instead" and hospice can discharge them. They're not "locked in" to home hospice care or anything like that. From what I read, more often than not hospice is called in too late versus too early. So if MIL is at this stage it is starting to border on possibly too late.

So please do call PSP/Drs and get hospice arranged. Their work is to make the transition as comfortable as possible, which yes includes her mood as well. As all situations just be a good advocate for her care. <3
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I would say if Mom is saying she wants to die, her Dementia is not that far gone. My Mom was in her last stage. First hummed to the point they had to give her anxiety meds. Then closed her eyes and would not open them, then would not get out of bed or eat. Hospice was called in and she passed 6 days later.

I think if we are in tune with ourselves, we know we are dying. I would call the doctor, tell him what is going on and request Hospice. You don't say how old Mom is but I think she knows its her time. She is tired. The meds are probably just prolonging the inevitable. I would in no way take her to ER just to be poked and prodded. Last thing my Mom wanted in her final months was to be touched.
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My mom had dementia with her Parkinson’s disease. She barely ate a thing. She was so tiny and frail.

In fact long before she died, she would often say, “I eat a ‘little’ only because I know that I have to eat to survive. I am not hungry.”

Appetites can dramatically decrease for some individuals as they age. They can be suffering with anxiety and depression. Or problems with their teeth or swallowing. Their taste buds aren’t the same, upset stomachs and so on.

It’s true that some people eat more when depressed or anxious but others lose their appetite.

A person will not have an appetite near the end of their life. I wouldn’t force them to eat.

As far as wanting to die. My mom lived to be 95 and she would gladly have checked out of life much sooner. Who can blame someone for feeling this way when their quality of life has diminished so drastically?

Hospice was wonderful with my mom and our family. I wouldn’t hesitate to utilize their services.

Wishing you peace during your caregiving journey.
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Can any of us imagine having all those health conditions on top of each other, being constantly confused, and not being so very tired of it all? Of course she is, and it’s completely understandable. Please contact her doctor and relay what you’ve shared here. Hopefully the doctor will add a hospice service to give her and you peace in the coming days
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