In end-stage vascular dementia, how long without eating or drinking before death?

Viv, this might be the time when you 'give her permission to go'. You tell her that everyone is safe and can cope, and you all want her to be in peace. So many people seem to have had that experience at the end.

Hello,
My mom just recently passed away from Dementia. She couldn't swallow anymore and she had already said she didn't want needles and machines and things at the end of her life so I couldn't do feeding tubes or intravenous nutrition. she lasted two weeks in a hospice with no food and just mouth swabs and a little oxygen because I didn't want her to struggle to breathe. They kept her pain free an comfortable but it was extremely sad to watch her wither away like that. I wish you and your family all the best.

My mom went 11 days.

My mother-in -law lasted about week but she was not taking anything by mouth. She had an bad episode on Sunday (very agitated). Went to a hospice home on Monday to adjust meds. Another episode Monday night had to be sedated from then on out became pretty much non responsive. She rallied on that Saturday would at least smile at visitors and passed away on Monday. So a little over 7 days.

Please let hospice evalute her. If a person gets better they can always go off of hospice. The hospice staff is experienced and can handle this and all the questions you have at this time. I don't know what I would have done without hospice for my mom in the last 7 months of her life. Medicare pays for hospice.

My sister had vascular dementia caused from three strokes. She didn't eat in her last days. She died within two weeks of not eating. My brother-in-law would try to feed her. Seems she forgot how to chew. He would have to dig the food out of the side of her mouth. She only weighed 67 lbs. at the time of her death.

We called Hospice in about 4 days before she passed. She was in a nursing home. I lived out-of-town when I got there I asked the hospice nurse if we could take her home to die. The next day the ambulance transferred her to her home about 3:40 pm. & by 7:40 pm she had passed away. Of course, they had loaded her with pain meds & xanax before she left the nursing home. She was already in a semi-coma when I arrived. By the time they took her from the nursing home she was in a coma. They provided liquid morphine & xanax. She was struggling to breath, the hospice nurse said we could give her the morphine to try to help her breathing. It didn't work. I played Elvis Presley's gospel song Take My Hand, Precious Lord. As soon as she heard it playing her breathing slowed & she just slipped away. It was truly amazing to see her pass so peaceful. I played the song later & saw the song lasted 3 minutes & a few seconds.

I urge you to bring Hospice in the sooner the better. They are wonderful support not only for the patient but for the family. We used them for my Mother too. We were able to keep her in our home until such time as she passed.

I understand that you are in the UK (United Kingdom) and that you have already signed a DNACPR (Do Not Attempt Cardiopulmonary Resuscitation) Order. Check with your GP (General Practitioner) as well as any medical doctor who visits the care home where your mother now lives, but my understanding is that there is no reason for the care home to require your mother to go to a hospital. It is usual in these situations to seek to alleviate pain, especially with morphine. Whether to permit intravenous injections is perhaps a little more open to interpretation, but your wishes should be paramount in this situation.

I too am involved in a similar situation with my wife who had vascular dementia for two years, and now Alzheimer's for the past eight years. She is still at home with me, but we have a "Hospice at Home" service who are extremely helpful. I suggest, as have others, that you should seek advice from the hospice and make sure that the care home and its health personnel are aware of that advice. In the UK (and perhaps elsewhere) you need to push back at times against well-meaning but unhelpful advice. You know best; and you know your mother best; and you need to make that clear at times to others. Even if your mother does not go to the hospice they may be able to stop others interfering and to guide your mother to a peaceful experience of dying with dignity.

As others have said, each person is unique; and you do not know how long your mother will live. You might find that the hospice can help you to get National Health Service (NHS) Continuing Health Care, which means that the NHS pays all caring costs of the care home.

With my prayers for both you and your mother and your family at this difficult time.

Hope this is still relevant for you. As others have said, Hospice is an amazing organization. My father passed in February of 2014 at 92. He was able to pass in his own bed. Even though he wasn’t eating or drinking, and wasn’t coherent, he still heard me when we told him that we loved him and it was ok to go. We assured him we would take care of Mom. As much as it hurt, I was there for his last breath. They helped us get through everything before, during, and after.

Please contact hospice. Once she is admitted to hospice the nursing home cannot call 911 or send her to the hospital. They will provide comfort care and personal care and are really wonderful at their expertise.

My Husband went 4 days without eating or drinking.
Please do not have them hospitalize your Mom.
Please do not do a feeding tube.
And I would also discourage IV fluids. Her body probably can not process fluids at this time and it would cause more problems.
Just hold your Mom's hand, tell her you love her and that you will be alright and give her permission to go.....

Not sure if I'm too late but I wanted to put in my two cents as I just went through this with my mom who passed away on Tuesday (10/30). She didn't have diabetes but she has had numerous UTI's, two resulted in sepsis and almost killed her. The last serious one was this past January and she was released on hospice. She rallied very well and ended up staying with us for 8 more months although on a steady decline. For the longest time she was still eating fairly well but almost over night she just decided to stop eating, stop drinking and not really respond. It took her only 5 days of this to finally pass peacefully but my mom was extremely frail and she had been losing weight. I loved her and we were always close but to be honest in the last few months I prayed God would call her home as she could not longer hold herself up or do much of anything else. I'm sorry you are going through this but as others have said, let her know you love her and that its okay for her to go, that you will be okay. I said that to my mom a dozen times and I believe they decide when they want to leave us. If its not too late to call hospice do it right away, they were a God send in all of this! God bless you and her!

They still need your permission as POA to send her to the hospital. I hope by now with all the encouragement here, you have requested hospice so she may go peacefully. You know in your heart she is ready.

I believe it was 6 days for my father without eating and drinking...but that had him on Morphine on his last days to keep him comfortable...but upon it wearing off, he would have seizures. He died 6 days later.

In my 30 years experience I can say this honestly everybody is different. My suggestion is to get a hold of hospice care. They will let her be comfortable and hopefully not suffer let her go with Grace and dignity. Good luck to you both.

I don't want to alarm you, but with her age, being a diabetic, not eatting & have very little fluid that her organs should be shutting down one by one. I think the nurses & you are right that she is ready to go.
Unfortunately, the process is different for everyone. I have seen people live long past what would be expected in the some what same condition, I also seen people with less health issue, but others up there in years and stop eatting and drinking go pretty fast.
Like Cwillie stated " it depends on her condition before she decided to stop eatting".

I know this isn't very helpful. I would tell her that "I love you, and you were a good mom, and you can go, it will be ok".

I have found that some people need permission or need to know that their LO will be ok for them to leave this world.
Just my thought.

I am truly sorry that you are going through this.
May God be with you and your mom.

Thank you all. Yes, the procedures here are different I think. If Mom has a heart attack I've got a 'Do Not Resuscitate' order on her, but with a diabetic coma, because it is treatable, they would have to call an ambulance and the paramedics will probably take her to hospital, which we absolutely don't want. I did ask why they couldn't just left her drift off, but unless it happens overnight when they don't disturb the residents, they have to make the call if they suspect it. I am hoping she will go peacefully if she is going to go......
We have been warned before that she is in the final end stage but she rallied round. She has never ever been this bad before, so, even though she doesn't get many lucid moments, I think she's had enough now.

This afternoon the nurse told me that she is still refusing everything they try to tempt her with and that she is quickly becoming more frail.
Time will tell I suppose.
Thank you all for answering me
xx

The diabetes complicates things, as well as how well nourished she has been up to this point and any other comorbidities. I would think after six days without food and minimal fluids she hasn't got long, perhaps instead of trying to encourage her to fight it is time to talk to staff about letting her go and asking what that means. And why ever would she be hospitalized if she lapses into a coma, even though procedures might be different in the UK I'm sure there is a protocol dealing with end of life - hasn't she any kind of advanced directive? Can you not make this choice as her POA?

I'm surprised that her doctor hasn't suggested Hospice. I'd immediately ask for a consult. They are very helpful with the things you seem to need.

They gave me a booklet called Gone From My Sight. It's a short explanation of things to look for as your LO nears the end. I'd ask for that and for their support.

Is she sleeping a lot?

Get Hospice involved as soon as possible.

Would you be able to request a hospice evaluation?
Are you able to discuss with your mother's doctor what the options are?
Does your mother have any lucid periods when she might be able to express her wishes, or at least give some indication of what help she wants?

I'm very sorry you're facing this.