Mom stopped eating, but seems like she is still fighting. Should I trust hospice or take her to the hospital?

Trust Hospice, they have been through this many times. I know it is hard to sit through this, but they know what they are doing. Once you are on Hospice, there are no more ER visits or 911 calls. You work with your nurses and tell them what you feel. They will help you.

My heart goes out to you. This is so very hard, I know. My mother had been in the hospital and I made arrangements there with the hospice nurses to bring her back to the nursing home with hospice on board. She had stopped eating as well. I don't know your mom's condition or circumstances; but if hospice is involved; she is receiving comfort care. This is where they come in and truly do know what they are doing. And what is best for your mom at this time.

I realize it is difficult to see her like this; but the not eating is usually a sign that her body just simply doesn't want to any longer; and there is a reason for this. This was happening with my mother while in the hospital and she did not want any more food. The medication the Hospice nurses give is in your mom's best interest and to make her the most comfortable. They are especially trained for this; and this way the patient is in the comfort of their own home or wherever they live instead of a hospital setting.

I found these nurses to be most understanding and helpful. Hugs to you across the miles.

Offer little sips or tastes of stuff she likes and she can take a bit, or even just enjoy the aroma or look at it if she wants. If you think they are overdoing the morphine, i.e., its real sedating with every dose, and she might not be in pain with a little less, you could ask them to give less of a dose, or maybe a little less often. To be brutally honest here, some hospices do take the approach of trying to get things over with, or that no pain/no anxiety is more important than being awake and interactive, rather than maximizing quality of the time you might have left; sometimes they may be more attached to their style or doing things or their philosophy than your preferences. But the alternative of going to the hospital if there is nothing realistically treatable would not likely be best either...might just be a long run for a short slide and no real benefit to anyone.

A good friend of mine just lost her mom in the wee hours this AM with hospice in attendance - it was peaceful and easy on her mom after some rough days and nights, but with all the family having chances to visit and talk and be there for each other, and its still sad but was probably absolutely the right thing done the right way.

Please trust Hospice. They do know exactly what they are doing. Not to sound clinical or morbid, but we know instinctively when it's time to go...but it takes a while for the message to be delivered to our body. It can take hours or days - it just depends on the situation. Complete lack of appetite and lack of thirst (and no interest in either one at all, if there's no other medical reason for it) are the first major indicators that the end is coming soon. Please don't think your mother will starve to death - she won't. Her body has too many other things going on right now, and simply no longer desires food at all - so she just won't eat.

As Pam mentioned, talk to the hospice nurses and ask them for more information. There are definite signs that passing is imminent, and they will help you through this difficult time.

Again, please don't think I'm being insensitive to your situation - I went through this myself with my father-in-law over 15 years ago, my grandmother about 10 years ago, and just last year, my own father. I keep saying I will never watch another human being die, because it's just so hard emotionally....but I must have the word "caregiver" tattooed on my forehead or something, because I keep ending up as the caregiver who takes the aging relatives into my home, or otherwise takes care of them - which means I'm usually there when the end comes.

Just be there for your mom. She knows you're there, whether she makes sense, acknowledges your presence - or not. Trust me, she knows, and it will be a comfort to her to know you're there with her.

I should add this:

When my dad passed away last year, we went to visit him in the afternoon, and he was very groggy, in a lot of pain, wanting to sleep all the time, not eating and not drinking. His blood pressure kept bottoming out, and he was very weak from all the infections he had. We met with his physician, who had a plan to move Dad to another hospital where dialysis could be done 24/7, and to get him more "nutritionally stable" because he had stopped eating/drinking. To our thoughts, this was a good plan, but in the back of our minds, we all knew it would probably be a futile effort, and that Dad probably would not be with us much longer. We went to Dad's room, got him to wake enough to understand us, and I asked him if he wanted to stay with us and fight this thing...or if he wanted to stop all the treatments, dialysis, and just let go. (Hardest thing I've ever done in my life, and it brings me to tears still to think about it.) He said at first he didn't know what to do...then he said "stay". I asked if he meant he wanted to stay with us and keep fighting (which meant following the doctor's plan of moving to another hospital, etc), and he nodded his head...then drifted back to sleep again. We informed the doctor and he said he'd start making the arrangments to move Dad to the other hospital and we went home.

1 hour later, we got a call that Dad was not responsive and we needed to return immediately. This was at 8:30pm. He passed away at 11:15pm.

So you see...even though our mind says "fight", sometimes our bodies are just ready to go. I don't know if your mom has an advanced directive, but I assume that since she is in hospice care now, you have all that covered already. I really do wish you the best, and I hope you and your mom can get through this in peace. There is no easy way to go through this kind of thing.

Thank you for sharing your experiences and great advise. I wish my sisters felt the same. They want to take her to the hospital, they are very selfish unfortunately

Forced nutrition puts added stain on a body that is ready to leave this earth and causes unecessary distress to the patient. Relieving the pain and anxiety for a patient is of the utmost importance for patients recieving hospice care so allow the nurses to do their job. Your loved one may become unresponsive but that was going to happen anyway. The important thing is for them to be at peace and not frightened. Gently reassure them that you are at their side and will help them and that those left behind will care for each other. If they are calling for a parent assure them that person is waiting for them on the other side. A visit from a religeous will also often be helpful and frequently brings calmness. Above all forgive them and give permission for them to go. Do not be afraid to question your hospice nurse, he/she may or may not be very experienced. So if you don't agree or don't want certain actions go ahead and ask questions. Hospice discourages taking a patient to hospital for life extending treatments but this is always an option for the family even though it may result in the patient being discharged from hospice. Hospice may themselves admit a patient to hospital when they are close to death if there is a reason why the patient should not or does not want to die at home. They may also take a patient to the ER in the case of an accident where wounds and fractures need to be treated. Hospice nurses do have a great deal of discretion and practices vary greatly from one hospice to another and often depend on the experience of the individual hospice nurse. Nurses like doctors are trained to help people get better so it is a very heartwrenching job to watch all your patients die and this results in a very high level of burnout for the nurses

Your post brought tears to my eyes. Especially the last two words. "Please help" Letting go is the hardest thing we will experience in this life. We are not created to live forever. We all hope we will live long "healthy" lives, but many of us don't. Trust hospice. They bring with them a wealth of experience and this should be taking much from your shoulders. If mom isn't eating, she isn't eating. Taking her to the hospital will be IV fluids and comfort. They won't force her to eat. From the information you gave us, it sounds like prolonging the goodbye. I don't know where you are, but you're getting a hug from central Illinois. Love her. Make her comfortable. And wait. She waited for you to come into this world. Wait with her as she leaves it. You can do this.

Thank you. Mom passed on peacefully Wednesday April 30th.

Oh Stephanie....please know you are in my thoughts and prayers as you go through this journey. I do hope our words and experience was of some help and consolation.

Much peace to you in the coming days.

Stephanie, so sorry for your loss . Hugs and prayers to you during this difficult time

Stephanie may you find peace in knowing you took care of Mom during her last days and she was able to die with the people she loved most. Please continue with hospice. Their grief conciling will help you through this difficult time

So, it was the right thing after all. God Bless you, and Mom!