Mom is refusing to eat and take her meds. If she dies can I be held liable for her death from starvation? - AgingCare.com

Mom is refusing to eat and take her meds. If she dies can I be held liable for her death from starvation?

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I've tried everything form Ensure, to pedialite, She refuse to go get medical attention, She has lost so much weight.I'm afraid she is starving herself to death. Her sisters say I can be charged with Murder or something for just letting her lay there and die. Ive tried everything. I do not have power of attorney and she is good mind when anybody ask her qestions. Help Please

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Jimmy,
This is a very hard situation, in so many ways! SO hard to watch someone you love, dwindling in front of you!
More information/evaluation is needed.

She can't do her own activities of daily living [ADL's]--or she wouldn't need a caregiver.
Refusing food is unhealthy, generally; losing significant weight in fairly short time [[??]], MIGHT indicate she's NOT thinking clearly…OR, she might be trying to act on her diagnoses, to prevent a long-drawn-out slow death.
Elders refusing to see a Doc, may be hiding something, or fear something.

---How long since she was seen by a Doc?
---What's her actual diagnosis?
---Might she be "show-timing", fooling people about her level of mental clarity?
---Might she have an infection or other conditions which could cause her to not want to eat, or to not want to live? [[infections, ills, zinc deficiency-very common in anorexia…etc.]]
---Age?
---Existing depression?
---Used many antibiotics [[which kill off the gut Flora, and THAT can cause loss of appetite-- those good Flora help stimulate appetites, provide nutrients that decrease depression, and help with digestion…]]

Caregivers exist --because someone needs help-- including maybe, with some decision-making---particularly when ill in ways that can cause poor decisions / choices.
---You can "entice", "offer", etc. nice ways of inducing her to eat something.
---You can try offering things that have nutritional content, that might be easier for her to consume--like that Juice Ensure.
---Ask/Observe if eating is too difficult / hard for her? Maybe a feeding tube could help.
---Mashed Meds in applesauce are still nasty [[eeww!]]--those might even be delivered via that tube--meaning she no longer needs to taste that nasty stuff.
===BUT ...if there's an infection she can't tell exists [[this happens a lot!]] --it's common to refuse medical help, & act-out in various ways, including starvation.

You can call your local Area Agency on Aging, to start the ball rolling--ask them how to get in-home evaluations done for an elder who refuses to see a Doc, and is starving herself.
Social Workers can come to the house to do an evaluation.
Their evaluation appointments usually takes about 2 hours.
You tell them her age, conditions, & that she refuses to eat anything [& for how long], that she has lost [how much pounds from her previous stated weight?], and that you are very concerned that she is deliberately starving herself to death, and you need advice & help with this issue.
They will ask you questions, ask her questions, evaluate situation.
When they ask -her- if she wants to move to her own apartment, or if she wants to go into some sort of assisted living, elders generally say 'no'.
BUT, you can say then, how much help she needs w/ her ADL's.
Make sure the Social Workers understand how much care is needed---how costly it might be to Medicaid if the elder lived on their own, or in a facility--sometimes, even Social Workers can have some faulty reasoning….they need hard facts.

They document things….so be specific…what, how often, when, how much, etc.--you can write up a page of what you have done, to give a copy to them. .
They create a file.
This helps protect YOU, --and-- the elder you care for.
How good their evaluation is, depends on how specific/factual your input is, and how much they can observe for themselves.
IF she is really good at "Show-timers", let them know that when you call them, so they can assess that too.

Sometimes, just going thru this evaluation, can convince an elder who is acting out [[IF that's what they are doing]], to start eating again--just to keep officials from coming to the house again.
BUT…if there is something warranting deeper evaluation, they can usually help get this done…Like:
If Hospice in home is needed, they can help get that set up.
IF she needs to be in a facility, they can get that ball rolling.
If in-home help is needed, even a few visits, they can help get that going.

Please keep us posted how things are going!
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I just realized that I have another blessing to count. My husband, just starting the dementia process, is a hypochondriac and loves to have people take care of him. I will probably never have to try to force him to seek medical attention, or force him to allow home health care. My father was more like your mother.

It's horrible when you want to help them and they won't let you.
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Sorry that you're going thru this. I went thru it with father in May. He absolutely refused to go see the doc even though he was coughing so hard and coughing up phlegm that was changing color until it was greenish brown and very thick. I knew he had pneumonia just from these signs and spent weeks trying to get him to the clinic. I also knew that because he was bedridden, if he died, I would be held responsible. Our current Attorney General's pet project is elderly abuse. I did not want to be one of his pet project..... Then, he got very confused and couldn't tell anymore if it was day, night, morning (it's always morning to him) and wanting to eat breakfast (even if he had his nutrient drink an hour ago), saw invisible people and didn't recognize me at all.

I did what you did. I had to beg 911 to come (they weren't going to come because he said that he will not let them in the house). And they did. They asked questions - he answered it correctly - and amidst of him telling them that he knows that they're trying to make him look crazy - they left without even touching him NOR did they write anything down on the chart they were carrying. NO Paper trail from that one.

I called APS - they heard out my story by phone - and then referred me to the elder care lawyer. I called them up and was told to come in for interview. I did. After that, the office manager told me that father has a right to decide if he wants to die. (mom just recently died a month ago - in April). She said that he needed grief counseling. So, I then went to the medical insurance to see if they provide home visits from the doctor. I was told very firmly that their doctors do not do home visits nor do they give diagnosis via phone. I have to bring my father to the clinic. They then proceeded to give me a phone number - to the APS! I was back where I started.

I had NO paper trails in all this. Everyone just kept passing me around. I think it's a great idea that you have these paper trails - even if it's your own. As for my father, because it was pneumonia, he finally told me to call 911 because he's tired of the pain and he can't breathe. His left lung was almost filled with fluid. At the hospital, his UTI got worse. He thought he was at home. I mentioned to the attending physician about his UTI and the doc was very abrupt with me - saying that he has more urgent situation to deal with (pneumonia). Father was released from the hospital without his UTI being treated. sigh.... Fortunately, Medicare provides options of home health care after hospitalization. I was able to convince the attending home nurse on his visit that dad had UTI. Father STILL refuses to go to the doc for anything. So, I'm hoping to learn from here what others input is on this situation. I have feeling I will be going thru it again....

I hope you find a way to encourage your mom to eat something.
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Jimmy, I'm so sorry about this. It does sound like she's going.

It might be easier if, at 4 AM, you moved into her room to sleep - on pillows on the floor, or in a lounge chair. It wouldn't be quality sleep, but you could just lie there and reassure her without having to get up. If she's in a big enough bed, it might even comfort her if you lie next to her. I think it would not be "improper," if you were both comfortable about it.

Try and see if that lets you sleep more. If not, try to nap during the day. God bless you.
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Jimmy I absolutely agree this is a time for action not wait and see. it is good that she ate something however little. Have you tried giving her Boost. It is a high protein drink and comes in strawberry, vanilla or chocolate. The chocolate tastes just like chocolate milk although it does not contain milk and is very easy to drink.
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Jimmy they will always say no to a question of do you want to go to the hospital. The real question is, "Should she be in the hospital?" If the answer is "YES" then you need to get her there.

When they are calling out for their "Momma" they can be dreaming but they are most likely hallucinating. My mother did this in September when she was hospitalized..... her medications were wrong and she was dehydrated. If you Mom does this when you leave the room, she may also be afraid to be alone. My father began sleeping in the living room because he was afraid to be in his bedroom, my mother now will sometimes make that comment as well.

I think you need to either take her in to see her doctor, call her doctor and explain everything that is going on or call a social worker or hospice to come and check on her. Do not just leave her in this condition.
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Thanks again for the comments and advice. Mom is allergic to Citris acid so NO kind of juice i can give her. The ensure i gave her was like a milk, and I even tried making a Milk shake out of it with some Ice cream. Didn't like it. Today has been rough since about 4 am she has been calling out for her mother and saying hurry. I can here this on the baby monitor. I go check on her and ask why she is callin out for Mama and she says she didnt know she was. But as long as I'm in there she mostly quite about the time I would go lay back down she would start again. I got her to eat a little of corn, peas, sweet potatoes, and potato salad but only a bit of each.She is saying ok Mama I ate now please come get me. Her Mom has been gone for over 40yrs.Trying my best to remain strong and be there. I asked her again if she would got to the Hospital and she refused. again Thank you all
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Maybe the pharmacist, the "tech" or hospice will have some ideas that you haven't yet tried. One thing I wanted to mention was that you said you tried to give her Ensure. Was that the milkshake type of Ensure? Did you know that they have a juice blend Ensure now that is thinner like a juice and yet it contains protein? Have you tried that? If you haven't, do you your mom would sip that if she just thought it was a liquid juice? It might give her some nourishment if she's willing to try it thinking it's only fruit juice.

Now that her sisters have been there to see her, and stayed such a short time for such a long trip, don't be surprised if they take some kind of action to obtain control of the situation legally and without informing you until you get notified by the court that there is a hearing scheduled. Long distance non-caregivers who gain guardianship for conservatorship will often make an arbitrary decision that patients are not being well cared for, take them out of their home and place them in a facility. It may be right or wrong, needed or not, but it often leaves the caregiver out in the cold with no place to live. I hope you have some plans in place for yourself about what you will do in this eventuality. I don't want to be negative or a wet blanket, I just don't want you to be in shock and unprepared should that come to pass.

Oh jimmy, we all know how hard this is on you as the person who provides the 24/7 maintenance. Watching a human being, especially a relative and more especially a child or parent, decline before your very eyes when you are helpless to change the outcome, is just one of the most stressful and horrific things that can happen. You have done the best you can and other than continuing to provide access to anything your mom WILL accept, you are pretty much powerless. Just I know that you can be proud of your behavior and that those of us who know what you're going through really appreciate you!
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Jimmy, if you want to you can call an ambulance regardless of your mother's wishes. She's 64 (i.e. young), diabetic, has been refusing medications and sustenance and is now hallucinating. I'd be surprised if she didn't have some raging infections as well.

Now, this is not a simple call for you, I do understand that.

1. If you're convinced that your mother set out on this route knowing it would lead to her death and intending it to do so, you can document document document as described, and you're in the clear.

2. But it might always be at the back of your mind that maybe something else started her off and she wasn't really making a rational decision - in which case you will always be sorry you did nothing.

I think if I were in your position I would call an ambulance. She will still have an opportunity to refuse help, and if she can convince the paramedics that she is of sound mind and making an active decision to refuse their help they will leave her be. The worst that can happen is that she's taken to ER, dragged back to life, gets sent home, blames you, and has to start it all again - in which case you get her to make an advance directive and sign it in front of witnesses.

Really hard for you, either way. But make your decision and act on it now.
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Thanks, Her Sisters did come Visit one sunday a couple weeks ago stayed maybe 30 mins after driving about an 1 hr and 1/2, They had to get back. After that is when they decided this. I have gotton letters from a Pharmist and a Tech which states me asking question on how to get her to eat and suggestions on what to eat. Trying to get Hospice to come in now cause she is seeing things and People that are not there.Thanks for the Hugs and Prayers.
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