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My 94 year old MIL recently came to live with us after fracturing her hip. She had surgery and rehab. Until recently she actually lived on her own. She's been doing fine - going to the bathroom on her own, I helped her shower just last night, and she's been sitting in the living room with us watching TV and joining in conversation.


She eats little to begin with, but I've noticed yesterday and today so far she seems weaker and has refused food, although she had some tea. (My husband is currently out of town so I am with her while I work from home.)


My question is should I, for lack of a better word, "allow" her to refuse food? I'm not sure how I could force her to eat, but should I try to spoon feed her? I have some really good soup that I think she would like, but when I ask her if she's hungry she almost gets angry and tells me no. She hasn't eaten since lunch yesterday. Currently, it is after 10:00 a.m. the next day. And she went to bed at 7:30 last night and so far has only gotten up to go to the bathroom. (My office is also the guest room that she is in so I am sitting with her.)


To be honest, I have a weird feeling inside. I wouldn't have been surprised to see that she had passed overnight. This is all new to me, any advice would be appreciated.

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No, at 94 I would think we have still at least the choice whether we eat or do not eat. And I would never hospitalize nor put in feeding tubes. So my question now is what understanding is there with MIL and with family as to what her end of life wishes are. Firstly, you would be utterly amazed at how little it takes to keep one alive at a certain point. Those who purposely stop eating in order to pass with hospice support and doctor's knowledge, if taking minimal sips to hydrate, can live well over a month.
You surely should OFFER anything you know she loves, perhaps easy to take puree, high protein puddings, and etc. You surely may think now to contact the MD and discuss palliative care and Hospice support if you wish.
But no, I would NEVER under any circumstances, force anyone to eat, against their own will. And at minimum, you could be looking at choking food into the lung and death due to aspiration pneumonia.
It is time to have discussions about end of life with your MIL, your family, her doctor.
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PenelopePitstop Jan 2022
Thank you. Other than sleeping a lot and not eating much, she's doing ok (considering). I see no reason to put her in the hospital, nor would we ever dream of putting a tube in her. I do kind of feel like she is in hospice at our house. :(
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Definitely do not force or try to force your MIL to eat; it's her prerogative, after all! A person can live for quite a long time without food; it's water the body needs to survive, in reality. I wouldn't threaten her with PEG tubes or trips to the hospital either, what for? I always look at it as how would I like to be treated?

Your MIL doesn't have to be looking & acting half dead in order to actually BE approaching the end of her life, in reality. Death is not a linear thing; in other words, she'll have lucid moments where she's spry and active, while there will be other moments where she's exhausted, lethargic and refusing to get out of bed. The fact that she's refusing food almost entirely is a sign that her body is getting ready to transition, even though that may take months to actually happen.

Hospice accepts patients they feel have 6 months or less to live. Get MILs doctor to write a referral to hospice and then she will be evaluated by the hospice team. If she needs comfort meds, they will be dispersed; if not, they won't be. Hospice does not 'kill' people; they provide extra support, supplies and services to them as they approach the end of their lives. They help YOU, too, as you try to navigate a difficult part of this journey. If your MIL needs a hospital bed, oxygen, adult briefs, etc, hospice will supply them at no cost as their services are paid for entirely by Medicare. Also, your MIL will be spared the pain & suffering of going back & forth to the hospital for unnecessary poking, prodding, testing and life extending measures that only prolong pain & suffering. My 95 y/o mother has been on hospice since 12/21 and I can't tell you how wonderful their services have been in this short time already.

Wishing you the best of luck during a difficult time.
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As hard as this is--don't push food. Liquids, yes, as much as they want, which may be a very small amount.

As the body shuts down, it's actually painful to eat. My dad quit eating after he was vomiting back up everything he ate. Liquids, he could keep down. But I'm talking popsicles and fruit ices. Not much nutrition.

I'd be talking to a dr about EOL expectations. If she is in pain or discomfort, there are drugs used in Hospice that make the passage of all this so much more calm and peaceful.
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As a retired nutrition clinical staff member {27 yrs in Geriatrics} I would try offering home made milkshakes {add skim milk powder for extra protein and fruit like bananas}, Ensure if affordable, puddings, cream soups with added skim milk powder for protein, custard and any food she really likes. Yes..A decreased food intake will cause weakness. I would assess how much pain she is in. Pain can cause a decrease in intake. Her MD needs to know she is eating poorly. Also watch her weight loss…a 5% weight loss in 30 days is a sign that needs reporting to her doctor. You can not force someone to eat. Aging people begin to decrease their intake. Some people do not bounce back after a hip fracture..good luck..
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Refusing food is the first sign that she may be transitioning. I think a hospice nurse should come and see/talk to her. And you separately. Might want to call your husband home. Maybe she will respond in his presence. Or maybe she is waiting for his return. She is at an age that even you can ask her why she won’t eat.
Both my sister and I (separately) asked her if she was afraid of dying and to me she “no, not anymore” which spoke volumes. Both sis and I believe there is an afterlife. My sis told her to come back and give us a sign, she did. Same day we were all (my niece too) visited by a small wild bird.. Brothers aren’t believer so she let them alone. When she left me, still in her house she flew directly into a wall. Turned and looked at me and flew away (still learning to fly)
Dont force her. She needs calm and love and reassurance right now
love and light
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Absolutely no force feeding.

You might consider getting a referral to her doctor for hospice care, because I'd say she might be heading toward death.
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PenelopePitstop Jan 2022
I read that not eating is one of the early signs. She was very lethargic this morning, but has since pepped up a bit. Still not eating, but asked me for a glass of water and now she's busy talking on the phone so I don't think she's that close (although this morning I might have said the opposite). Sorry, I'm not trying to joke or make light of the situation, but it's the truth!
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Agree with Patience's answer. I was very sad/upset when our mother started refusing food middle of October-I went to visit her and nobody could get her to eat-nurses, I, my brother. She passed in early December....It is very likely this is the beginning of the transition and you are wise to recognize it. It is a sad and sometimes frustrating time but hopefully you will have some nice moments with her during this time which can comfort you later (true for me).
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It is normal as people age and become weaker and ill, their appetites go way down. This is the body's way of saying to prepare for what is coming. Don't force her and make her miserable or sicker - let her decide what her body wants and needs. Be at peace - it is part of the 'process'.
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My mom will say she’s not hungry but then eat if I just put some food near her & don’t say much about it.
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Tell her if she won't eat, then she'll end up in the hospital and no one will have choices anymore.
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PenelopePitstop Jan 2022
Actually, when she was in the hospital she wasn't eating much there either and they didn't do anything like tube her. She's also very picky and they tried everything and even brought her those Ensure drinks, which of course she hated. But no, even there, they didn't force her. My husband said she was "playing games" and told her if she didn't eat, she wouldn't be allowed to come home, so she finally started eating! But now she's home and starting that again.
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