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My 82 year old mother-in-law has always taken care of herself but now she is dependent on outside care. She has congestive heart failure, renal failure, diabetes, just started dialysis and learned last week she must have a toe amputated. She says she doesn't want to live this way and would rather stop dialysis and die.

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CB, I went through this with a friend. She was diabetic and on dialysis. Her circulation was poor and her extremities were being lost. She, of course, did not qualify for a kidney transplant. She held on for her family, but with the dialysis and hospitalizations, she had no life at all. She kept going for her family. They amputated one leg and wanted to amputate the other. She said enough and stopped the dialysis. I don't think there was a person who didn't understand. My friend was a wonderful lady and I am glad that her suffering ended. We still miss her.

Seeing what she went through, I think it is sometimes the most merciful thing to do to stop the dialysis. I would stand behind your MIL in the decision she makes. She may change her mind day to day, because death is frightening. She will know when she is ready to move on to the other side. I am so sad that your family is going through this. I know how hard it is.
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I feel your MIL is a wise woman, and should be given love and support in her decision. Contact hospice and enjoy the time left. It won't be long. Army/retired said it best Death with dignity and quality of life intact.
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Tell them you love them, make sure there is a healthcare directive in place and respect their wishes. I had to honor my mother's wishes about an end of life decision I had to make on her behalf. It was difficult choice, but without guilt. It was what she wanted, dying with dignity and quality of life still intact.
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This is a very tough one. I think a lot of us have watched our loved ones decline to the point where they are merely existing, waiting for the inevitable end. I have read many posts wondering what the point of life prolonging medical intervention is if it can not bring quality of life also. If you MIL is of sound mind, has had time to be treated for depression and time to become accustomed to her new limitations then I think you should support her decision.
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