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My mom has never been one to shy away about subjects like death. She has a living will and has told us in no uncertain terms that she wants no extra measures taken to extend her life. It's all recorded, her AL knows this. She has not been happy with the measures the AL has taken to curb the pandemic. She used to take advantage of all they offered (lectures, art classes, etc). Now, she can't do that. We do weekly zoom calls which she enjoys. She had been looking forward to a major family celebration in September - but it got delayed a year. Her response was that she would not be alive to see it. We arranged an in-person window visit. We arranged to 'spring' her from AL for a smaller family get together in about a month - a compensation for the one that got delayed. She said she probably won't be alive in a month. She asked if we remembered where she wanted to be buried. She said she could no longer remember birthdays, etc, and wanted us to mail out the checks and cards, etc. She has vascular dementia and has noticeably gone downhill in the last few months, doing things like asking the same question 2-3 times during a phone conversation. It seems like she has given up and lost the will to live. She is 91. Is this depression talking? Or dementia? Any advice?

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It's neither depression nor dementia talking. She's 91 and she realizes it. She knows how she wants to die and makes sure you know her wishes. She is reassured in knowing you understand her and what she wants in her final days. Many elderly are afraid to discuss the issue, and although she may be a little premature in saying she won't be around next month, she's not afraid if that should happen. The repetitive question are a result of the advancement of the disease. I wouldn't be concerned about her anticipating her death, just promise her that her final wishes will be met.
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NYDaughterInLaw Sep 2020
Well said.
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It may be a favorite subject? It is, in fact, one of mine. As an old retired RN I look back now and know I was destined to be either that or an undertaker. I have always been quite "taken " with the grim reaper. Thus, if my mind fails more, I may "go there" more. My bro, 85, and me, 78, used to speak so often about death, and now he has gone and done it.
I think that Americans have quite a lot of fear of the subject, and of the "fact of life" itself. Basically it is birth, reproduction (or not) and death in the long view; those are the passages for all from fruitfly on through. For me it is a subject of interest to the extent I was once a member of the Thanatos Society, and have a book of Victorian Momento Mori. I am certain I have misspelled those.
In any case I wouldn't read a whole lot in it. It is charming she is ready to speak about it. Don't negate her concerns nor her wish to discuss a subject that makes you uncomfortable. She actually MAY be nearing a passage, or she feels she is, and would love to discuss it. Reassure her, let her know how you love her and all she has taught you of life.
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My Dad had heart disease. His father died of a stroke at 68 and a brother died at the age of 53 of CHF. So Dad always felt he was on borrowed time. So every holiday like TG and Christmas he would say "this my last Holiday".

Mom is 91. She realizes at this point that death gets closer. She has all day and everyday to think on it. Will she wake up tomorrow? Yes, she probably is depressed being quarantined to her room. Anyone would be. At this point, let her talk.
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My 93.5 mother constantly talks about wanting to die, and has been doing so for years now. She's on enough Wellbutrin to make an entire village giddy, takes CBD gummies to 'improve her mood', but loves drama SO much that she can't help herself from wanting me know how much she wants to die. But that she's petrified someone in her Memory Care ALF will get COVID19 and give it to her. You do the math. I personally find nothing 'charming' about the topic at all, but hey, that's just my take on things.

Let your mother talk about whatever she wants to talk about. It could be dementia, it could be depression, it could be drama, or it could be a little of each all mixed together to give YOU a stomach ache. I don't know. Some people have a feeling about when their time is approaching; I sincerely believe that. While others just like to cause their loved ones to feel anxious or worried FOR them. Speak to her doctor if you are concerned.

Good luck!
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RedVanAnnie Aug 2020
I think your answer is right on point.
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It’s probably a good idea to go through with her all the things she raises, and anything else that will be relevant when she dies. If she discusses it sensibly, then things are OK and you are both very fortunate – too many people refuse to consider it at all. If the conversation doesn’t go sensibly, then perhaps it is dementia or depression, and a conversation with the doctor might be a good idea.
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When my grandparents reached their 80's and 90's - yes all 4 of them - they were concerned that "end of life" issues were resolved. One grandmother was cared for by my mother with my sister and I doing respite. When we put gram to bed, she would bid us a lovely good night and say she hoped to see us in the morning - if she was still alive. She lived to be 98. We would always tell gram we loved her and looked forward to the next day.

Maybe your mom just needs to know that her "life issues" are cared for and that she is too.
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I would pay attention to her. My dad did much the same thing. He was genuinely tired of this life. You don’t have to have a reply, just listen and let her know you understand, if when you don’t
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In her universe, she is just facing her reality.
Your future lies along a different path.
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True. She might not be alive in a year for a family celebration. Or she might.

She probably lacks the energy to be cheerful and daily activities are becoming harder to manage. She knows she is nearing the end of life and expressing that verbally might be helping her cope.

With advanced age and decreased energy and engagement in the world, people often see the end could come any time. Some people go on for years thinking they are going to die soon so they want to make no long term plans.

That mindset gives rise to expressions like "Don't buy green bananas."
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Of course she's depressed. Her life has become little more than hiding from the dreaded Covid. They're trying to keep her alive so she can sit around and do nothing. Frankly, it doesn't make a lot of sense to me.

My mom's in the same situation -- in memory care, 91, and has vascular dementia. The lack of significant personal interaction during the past six months has definitely taken its toll on her. Her dementia is more severe than your mom's -- she doesn't know about Covid -- but I'm sure she thinks we've abandoned her. In my opinion, it's cruel to keep us from our loved ones, but the health department and the state has the facility's hands tied.

Reassure your mom that no one has abandoned her and that no family events are happening for anyone and you aren't excluding her. You may have to keep reminding her of it, but I have a feeling she may think she's being abandoned.
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