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My Mom is tired and I can see she is not wanting further emergency intervention. What can I say to help her let go?

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I was helping to care for someone in home hospice. She was ready to go- everyone had said their goodbyes. It still took weeks and weeks. People go when they go. You can't (legally) hurry them along. What we did was concentrate on being. We called it Plan BE. Just be there. Do everything you can for her comfort, emotional and physical. If she says things that are uncomfortable to hear- listen. Don't bat the comments away. Hear them. Sit with the comments in silence. Let her say what she needs to say. Teepa Snow suggests saying "I know it's hard. I hate this for you."
Good luck to you. It's hard.
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Your profile says your mom is 88 and resides in independent living - is that correct? What exactly do you mean by helping her let go ... generally someone who is living on their own is nowhere near death, but they may feel as though their best years are behind them and the future isn't worth living... some people spend years - decades - predicting their imminent deaths and wondering why god doesn't take them. I would look for ways improve her quality of life for whatever time she has left after reassuring her that you will continue to be her advocate whatever the future may be.
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oldfletch Aug 2018
Very wish advice there!!! I am there, Now, and your advice has given ole me the,strenght & courage to look for thing BETTER than just sitting in my recliner, watching TV and, maybe sometimes, play around with my laptop!!! I thank you for your, very wise advice here and God Bless You
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What cwillie says is true. We have no control over when we pass. Some people pass too soon and it’s not fair. Some people pass too young and that’s not fair either.

If you have a religious leader, now may be the time to call upon them. It’s very difficult for you to know what to say to your mother and how to say it.

Is Mom still in Independent Living or is she now in Hospice? If she is still in IL, reassure her that when she is ready to pass, no heroic measure will be taken and her wishes will be respected. Same as if she’s in hospice and the hospice nurse can help with this. However, if she is still in IL and seems to be dwelling on this, I would ask the social worker at the facility if a therapist could come to speak with her.
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oldfletch Aug 2018
Some very good advice there, my friend! !!!!
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All I can say is give her as much love and giving support as you can. She maybe not be able to make a rationale decision let alone what she is saying. There is physical pain and mental pain. Also consider if she is on medications that can effect the way she is thinking, doing, and saying.The levy is put on your shoulders now given conditions you observe. Given with what you observe; try to write down and talk to her doctor and explain her condition and the doctor may give you advice of things you will encounter down the road to where she is not suffering and you are doing the best you and giving you support.
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I took my mom (88 yrs old) in to ER via EMS with what I thought was dehydration. She was diagnosed with final stages of Leukemia. Didn’t even know she had cancer. My mom always had a fight in her to live, so I would never discuss transitioning with her. Always was WITH her and engaged her. However, after I took her in, and doctors told us that she had weeks, I could see a difference in her. She stayed asleep, but I knew she could hear. I asked all of my siblings to come and see her so that she could hear their voices. I still did not discuss transitioning, but we all took shifts and would sit next to her bed round the clock for a week with soft music playing, rubbing her hands and arms. I DID say to her “we are all okay, and I will always make sure that we are all okay.” The next day, she was transferred to hospice and passed before the next day. Of course, I had been given a time frame for her by doctors of her final stages. However, it was still so very hard as no one knew she was even ill. I do agree that no one knows the exact day/time of our transition; however, there were personal things/concerns that I knew of my mother, and I wanted to always keep her comfortable and at ease...even until the end. My prayers are that you receive the right words, at the right times, to comfort your loved one and ease your burden of care.
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Artlady61,
If mom is not eligible for hospice, it can be frustrating for her and family. Years ago, I experienced this with my mom, who at the time was in ICU for 6 months. She did not have a medical POA or a medical directive, so her surgeon called the shots. So first advice is to secure those directives. She needs to provide this information in clear terms to others.

But your comment ("I see that she is not wanting...") that she has not verbally stated that she wants to be noted DNR or even assisted death. Her tiredness may be more depression than a decision that has been considered for all consequences that her death would entail.

I sense that you too are tired of watching mom suffer. I am now a counselor for the grieved and dying so my suggestion is this: seek counseling for yourself. The emotional pain can be overwhelming and cloud your judgement. DON'T say anything. Instead ASK mom to talk to a professional about her wishes and then put them in writing.
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I have read your short post carefully and do not see any mention of her being in assisted living, so I am now wondering where she is living and if she is functioning in life? If she is still able to get about and take care of her basic needs it would seem that she is not ready to pass. Somebody suggested that she may be depressed and as I am very familiar with this condition, I would like to say that I have been suicidal on many occasions. This is a very normal situation with depression. If that is the case she most certainly needs medical intervention and maybe a counselor also. If she belongs to a church perhaps a member could come out to keep her company.

You have said so little I am left to guess as to your mom's situation. However, if she is in hospital or in a nursing home the situation will be quite different. I am an RN and can assure you that when people are ready to pass they stop eating and drinking. There comes a time when it is not advised to push them to eat or drink because that is not helpful. When they have made this decision it is their way of communicating their mind is made up even if they are not able to express this in words.

If this is the case the best support you can give is to be reassuring that she is safe and you will understand if she wants to let go. You, and your family, can really help her by being there in short shifts and being very quiet. Having a lot of people around the bed, fussing with unnecessary care and talking among themselves is very confusing for people and does not make their passing easy.

One thing to be aware of is that people have an uncanny knack of passing when they are alone or with a nurse. So many times I remember the family leaving the room and then the patient giving up. This is not a bad thing. The patient has decided that that is the way they want to go. It may be that they care if the family is hurt or they just may wish this to be a private moment. We shall never know the answer. But, on the other hand, you can't be around all the time and will need to take breaks so if you must go for something to eat and find that she has passed do not be too upset because this may be the way your mom wanted it.

Letting loved ones go is never easy for anybody, but unfortunately dying is just another part of life.. We all have to accept that in the end.

Best wishes to you.
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You can tell her you love her and thank her for all she has done for you and that you appreciate it so much. You can tell her that you do not want her
to suffer and give her your permission to go when she is ready. Ask her if
there is anything you can do for her. Pray with her and lead her to accept
Jesus' open loving arms. (You will need a box of Kleenex). Be at peace my child and then you can pass that peace to her. If you have siblings, they need to do the same. This will be a very meaningful moment for her. When I did this with my mom, she decided to stay on for a long time but she knows
she is free to go when she chooses. God bless you through this journey.
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Why does everyone always assume that the sick or dying need to hear about Jesus - this is not a Christian forum.
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Landscapelover Aug 2018
Cwillie,

The first thing that I learned in grief counseling was that I would receive hundreds of comments from people that would probably not all seem appropriate. What I’ve realized is that all of the words of encouragement/advice (and I’m still receiving them) were meant to help me. Everyone’s experience is different in difficult journeys. But, I’ve come to this site in search of help after my mom was diagnosed with Alz until her transition this past Jan. (17 years), and I will forever be grateful for all of the advice/comments here.
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you call Hospice.
you stop taking her to the E.R. and you tell her you understand she has to leave you.
you apologize for any of your shortcomings and tell her you tried to do your best for her.
you allow her to stop her medications.
and hopefully, you tell her you love her.
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Artlady 61....
My heart is with you. It is very tough to watch your mother slowly pass from this world....I'm still grieving over my dear, sweet mom. I was her caregiver, and at the end, when she was very weak and only wanted drops of water dripped into her mouth, I set up my station, not to leave her side.
I sincerely hope you and her are saved by Christ. This is the most important decision of any person's life and death. Eternity awaits each and every one of us, but it's up to us to decide which way to go. I say to choose Jesus Christ....which is to receive eternal life with Him in an unknown, geographical location called Heaven. Yes, I said geographical, because it is. By not choosing Christ, we send ourselves to a place apart from God, called Hell.
Choose life! Choose Christ! And live forever with Him.
May God be with you and your precious mother.
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You say nothing about Moms health problems, just a decline. I know 88 yr olds with more energy then me.

It sounds like Mom is depressed and maybe a med would help. Next is Hospice. Problem here is her being in independent living. With Hospice, someone has to be with them 24/7. Nurses only come every few days. Aides the same.

When my MIL had a UTI we pretty much knew she would not be living alone at the age of 91. Once she was told that she would be going to another state for rehab and not going "home" she literally willed herself to die. Dr. called it failure to thrive. She went into the hospital early Feb and passed Feb 28th. She was used to getting her way and died the way she wanted.
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First of all, I'm so glad she has you!
This is a tough one. I can not answer this without knowing your mom's condition. Is she able to speak? Does she have written requests of her end life? So many factors surround the direction this situation should go.
I do wish the best for you and your mom.
Please update us On her condition / illness?
Hugs to you both,
Linda
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Artlady61
No one has an expiration date tattooed on them at birth. So a date is out of the question, you can joke about that to your Mom if she has a good sense of humor.
Somehow I gather she is in Assisted living. (several other posters have mentioned this but I do not see it in your profile.)
There are a few things that I have a question about.
1. What is your Mom's condition? Is she in good health for her age? or is she ill with one or more conditions that she will not recover from?
If she is in good health, is she depressed?, frustrated?, angry? is it something that can be discussed with her doctor and possibly medication may help.?
If she is ill is any one of her illnesses considered "Life ending" and is she no longer being treated? If so she would qualify for Hospice.
If she is in Assisted Living you can consult with them what Hospice Group comes to the facility, if there is more than one you can interview each one.
There is no requirement that someone has to be "with" her 24/7 .
She will have a Nurse that comes 1 time a week, she will have a CNA that will come a few times a week. (If the CNA bathes her she will not be bathed by the facility staff if they are doing that now) She will also have a Social Worker, Chaplain and volunteers at her disposal if she wishes to have them visit. And if she wants any "therapy" like Art, Music Reiki (sort of like massage) she can have them come in. The Social Worker is there for you as well as your Mom.
When my Husband was on Hospice the staff from JourneyCare was amazing and I would not have been able to do what I did if it weren't for them. I got supplies, education. equipment and support.
But if your Mom is "ready" as you say she says she is she needs to know you will be alright as well as any other family members that she may be worried about. And if she is still saying she is ready just tell her that maybe something is yet to be finished.
Best wishes to both of you.
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Usually diet Deprestion lack of activilty find some one to do activities and take her to doctor sometimes people need a little help antidepresents ..but not to much ..Never over medacate ..a client they just get worse..from charlina go have fun every day ..find some one with passion for life ..
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More questions would need to be answered before I could respond such as:
Your mother's physical health
Your mother's mental health
Is she on psychiatric medications?
Does she have a DNR order in place?
Does she have a DPOA in place and who is her agent?
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Art lady you have to come back and give more information as several have asked. This is much too vague a question to give sound advice. What’s her ailment. Where is she living now? She was 88 when you joined back in 2015 so is she 92 now? Help us out so we can help you.
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Thanks everyone for your input. This has been a rough week My Mom has a blood clot in leg and declined being admitted to the hospital She also wants to let her Dr of 13 years go.I am going to have her checked for a UTI this week and begin assistance this week at the Independent living facility. My brothers think I should let her make her own medical decisions but I don’t feel she is able to make clear decisions. At 91 she has high blood pressure pacemaker,stents,Stage 3 -4 kidney failure with bouts of dehydration and UTIs Hoping for a better week
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By googling I found https://www.deathwithdignity.org/ and thru them I learnt that Euthanasia is accepted so far in 5 states.
Euthanasia is the best and the most humane way to die where the patient is in control of her/his decision and families should understand and accept that decision to make that short moment, even though sad, the warmest, most respectul and dignified I believe now it is, than the INHUMANE of choosing the "palliative "way of hospices, hospital or other places where they use the killing cocktail of morphine and ativan and furosemide drying the "victim" completely inside and being unable to speak giving them a slow death that will last almost 2 weeks!!
Unhappily, I learnt too late about all this. Today, I can say that I do know HOW I want to die and it will be faster and peacefully, and of course, if I can find somebody that will hold my hand ( it will be around 5 min only to go into coma) it will be as going to sleep surrounded by those that DO love me and have accepted my last wishes.
Had I known this, I would have taken my mother to one of the closest states, Vermont. I never liked the way my siblings took this matter in their own hands and gave the code red to the hospice to the shortest and horrendous death of their menu for my dear mother. I was her caregiver and whenever I wanted to stop the cocktail of death and mentioned that I wanted to take my mother back to my place the hospice would tell me "It is 3 to 1", " You are the minority, your siblings win".
You can also read:
https://www.theguardian.com/commentisfree/2017/may/01/dying-at-home-terminally-ill-hospital
and please, do your own research to find maybe even more interesting articles and blogs.
http://hospice-uncovered.blogspot.com/2010/01/hospice-and-what-they-will-not-tell-you.html
Many thanks to this webpage that has pelped me so much in my times of despair and now, grieving.
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Artlady61, There are no magic words, but letting her know you love her, that you will be okay, and if needed, there is nothing to forgive. No magic. Just an I’m here and it will be alright.
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While your question and information provided is somewhat vague, often words are not as helpful/necessary as touch and visual cues (compassionate eyes and smiles), holding her hand, light loving touches on forehead, face / hair-head, telling her how much you love and appreciate her. Does she qualify for Hospice? I was with my client, with a hospice nurse, when my client died. Right before she died, Hospice nurse said, 'let your body do what it wants, its okay.' While your mom isn't there, supporting her to relax and let her body do what it needs to do may help her relax into the present moment. Perhaps have relaxing music on (if she can hear) to support her to relax - and get out of her head - and let the music flow through her. gena
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You might get a doctor see if he or she will approve a hospice consult. Your mom easily has enough things to qualify, But it does need to be 6 months or less. My mother died of a brain tumor and we had hospice for her. It was a Godsend. Do your brothers have medical power of attorney? If not, then they can’t make final decisions but just share opinions. I hope you have it. If your mom has any dementia then she won’t be allowed to make decisions. Hopefully she has an Advanced Directive that expresses her wishes. She has a right to die how she wants.
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Early in my interactions with this forum, I asked about what types of preventive health care would be appropriate for someone with Alzheimer's. Someone suggested that we make "Will it be easier or harder to care for her?" the priority. Another suggested "if you wouldn't treat the issue, don't screen for it."

I think you said your mom has a blood clot. A blood clot can cause a stroke and a stroke might make it more difficult to care for her. I read and embraced the message of "Being Mortal" by Atul Gawande. But I think I would have a blood clot treated. I think she's still making her own decisions? You might run the idea by her that treating the blood clot might help her avoid additional disability.

Death really isn't the worst thing that can happen to you.
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