My mom at 93 has dementia. All her vital signs are good, however she is losing the desire to live. Can this lead to an earlier death?

As we age we lose the fear of dying that we had when we were young, especially if we are a person of faith. We begin to realize that life is on a continuum and dying is the natural end result of living. While we don't want to hasten our death the thought of being reunited with our loved ones who have gone before us is comforting and helps to alleviate the fear. Most elderly people aren't afraid of dying, they are afraid of how the people they leave behind will handle it, dying alone or in pain. Give her permission to go and tell her you will be ok until you meet again.

So imagine that you're in stage 7 dementia with moments of clarity and your family won't feed you or give you something to drink even though every time they give you something to drink you swallow, and every time they give you something to eat, you chew it and swallow.  You're helpless to sit up or even adjust your pillow or most importantly to vocalize your needs.  Your family decides that "it would [not be] bad to ...allow [you to waste away] more quickly" in what I imagine is a very uncomfortable way to die.  You could of course, be given morphine while you die of thirst or hunger even though your body has not yet indicated that it is ready to shut down.

Or out of love your family deprives you of your heart or blood pressure medicine hoping that you will pass from a heart attack or stroke more quickly.  Not receiving the medicine makes you feel physically uncomfortable and frightens you because you don't know what's causing your head and body to hurt or to feel strangely cold or hot or your heart to pound.  Or they deprive you of your seizure medicine, hoping that will expedite your release, and you begin to wake up time after time with your body in pain from contortions during a grand mal seizure.

The answer is that we simply cannot NOT provide comfort and sustenance until a human being is actively dying - e.g. an active refusal or inability to eat or drink without a feeding tube.  And even then, we will provide a different kind of comfort. This is the reality we all face and the realization that we quickly come to.  Failure to take care of a completely vulnerable human being who is not actively dying is just not in our makeup.

Mechanical intervention (e.g. feeding tubes) is a different matter altogether and I can only imagine the discomfort and horror it would cause someone to be hooked up to a feeding tube or ventilator indefinitely; that, quite frankly, seems like torture.  So that is where our family has decided to draw the line, and our mother's living will clearly states her wishes in this regard.  It is very helpful to know this long in advance, and pray that your loved one doesn't say something such as "Just take me out and shoot me, please" because you won't want to or be able to do that, even out of kindness. 

Bottom line: As much as you think "it might have been better if...." it's not a thought based in reality.  You did the right thing.  Best to you all in the decision making process of caring for your loved ones.  There's no easy way and it doesn't seem possible to skip even one painful step.

Yes, quite possibly. The will to live is a part of life itself. Maybe she should be seen by a medical professional.

I like the answer Target456 gave. When people begin to feel useless, they see no reason to go on. Understanding this is important. My mom wanted to die after my dad died, but she lived on, and eventually found some peace in not having so many responsibilities. If your mom's loved ones say they need her, it would be good to tell her how she is needed because she most likely doesn't know, as her roles in life have changed. For instance, we need my mom's sassy sense of humor to remind us to not take things so seriously, and her practical advice on many matters helps to ground us when we get too flighty with our ideas. But to argue with her feelings won't help. My mom hates to be told what to do, but it is often necessary, since she has dementia. What I learned to do eventually, and now what they do at the assisted living, is make sure she has some choices to make every day, even if those choices are just what color sweater to wear and what movie she'd like everyone to see. It seems your mom has no other health issues, so she will probably not die soon. My mom was not able to will herself dead, but my mother-in-law actually did just that after her husband died. She sat in a chair, wrote her husband a letter that she was coming to be with him, and died. It's all very mysterious and cannot always be predicted.

Of course there is a mind-body connection, however you can combat it by verbalizing empathy for her feelings of how difficult it is to live with all the changes (I.e., “it must be very hard to be experiencing and living with so many new and unfamiliar symptoms” or “you feel afraid imagining that things might still get worse.” A lot of family members feel compelled to say invalidating things like, “Oh Mom, I need you” or “there’s still a lot to live for” or other remarks that hint at a family member’s own denial or fear and don’t reflect or mirror the true difficulty all the changes have on the person declining. When you mirror and empathize, you are connecting in a more loving way that will hopefully help alleviate some of the distress vs add to it and hopefully that will enable her to have more quality of life, and less unhealthy distress, while she is still living. All of the above being said from my own years of experience as a hospice social worker and as a licensed counselor. Take care.

I agree MargaretKen I am convinced far too many Elderly People in Elder Care Facilities are being force fed with medications which are keeping them alive way past their natural time with out any quality of Life. My wish is to let me go when it's my time, why prolong the evinitable.

I think many people at a great age feel the same way. They are tired and just want to rest. The body makes it's own decision and forcing food, exercise and socialization on some one is not a kindness.

Sometimes I think people sense when their time is near. If she is ready to go, then I don't think there is a reason to prolong her life. I know it is hard on you and the rest of her family, but 93 is a good, long life, and it may be time to let her pass on peacefully. Nobody lives forever.

Our experience with MIL was that she had the same issues, also around 93. She wasn’t obviously depressed, she just said she had had a good life and was ready to go. It was difficult for the facility to get her to eat, and she had boosted liquids etc. She died quite suddenly at 97. Looking back, her body was closing down, and it was quite true that she was ready to go. Honestly, I can’t see that it would have been bad to have allowed it to happen more quickly.