Aged mother in law

I have to assume you are stressed and not thinking clearly.

You have placed her in a care home so you have delegated the duty of care to them. They cannot stop feeding her. Only a doctor could authorise that and only as an imminent end of life matter.

Even if you had medical power of Attorney you could not authorise the Care home to abandon its duty of care.

The only way you could stop her being fed is to assume her care for yourselves. Then if you did not feed her you would be open to prosecution.

Do you really expect the care home to stop feeding her?

Lathyrus3

I have to assume you are stressed and not thinking clearly.

You have placed her in a care home so you have delegated the duty of care to them. They cannot stop feeding her. Only a doctor could authorise that and only as an imminent end of life matter.

Even if you had medical power of Attorney you could not authorise the Care home to abandon its duty of care.

The only way you could stop her being fed is to assume her care for yourselves. Then if you did not feed her you would be open to prosecution.

Do you really expect the care home to stop feeding her?

Exactly this.. I am a carer in a high dementia care home

Lathyrus3
Obviously I don't want them to stop feeding her, that would be equally cruel but why not food and drink that she likes? It's the constant "force feeding" of supplements which she doesn't like that I object to.

My mother was in the position you describe when her father neared 100, justanovice.

My grandfather's care was 'delegated' to a care home as he needed hoists and 24 hour care - he was blind and deaf by the end, and unable to walk or get out of bed.

He wanted to stop eating, as he had no power to end things any other way - any options were out of his hands as he was too weak to do anything such as overdose on drugs.

My mother was asked to sign to say that she was aware that he was refusing to eat, and that she withdrew consent for the home to feed him against his will. This would have been tantamount to her consenting to allowing him to die.

Of course there is a dilemma here. Who should take responsibility? The nurses, or family? I fully understand why neither party was willing to do so.

By rights, my grandfather should have had agency to decide for himself, IMO, and I sincerely hope that the recent vote on assisted dying will spare people these awful decisions in future.

That's not much help, but I am sending virtual support to the OP. It's a horrible position to be in

doodldog
It's certainly my worst nightmare, and having known my MIL for over 50years I'm fairly certain that it's hers too.

It is horrendous and you have my sympathy, do you know which GP sees her? The one who attended to my mother, whilst a different matter, agreed no more antibiotics for my mothers continuous chest infections.

This must be very distressing for you but she is your MIL not your mum.

I think these things are best dealth with my immediate family.

It would be equally distressing to know people in similar situations are not being fed at all.

I too totally empathise.

My MiL is also in residential care, she’s 90, with very advanced vascular, mobility issues, incontinent. She’s extremely well looked after, but given she was a very active and independent we know she’d hate this (non) life.

I totally empathise too. Unfortunately life can be very cruel. My Mum, diagnosed with vascular dementia and Alzheimer’s, also spent her final years in two care homes, specialised but not always of the same caring standard. Luckily the second was the better one IMO.
She was a wonderful, kind, caring and private individual who would have hated all the indignity etc, had she been aware. Hopefully she wasn’t. It’s horrible for everyone whether the individual or the family. However, we weren’t in the position to be able to care for her at home, so the professionals were.
Should I press “post”? Ten years later, I still feel I should have done better

Keepingquiet Possibly the "demarcation" lines in families differ but in our very small one I am just as responsible for the care of my MIL as my husband and I certainly wouldn't leave him to deal with it alone.

When DM was taken into hospital with pneumonia. We were told not to give her anything to eat or drink .

She was crying for water. We found some sponges to wet her mouth and gave her water. How could we deny a dying person their dying wish.

Yes she vomited. So what!

My DSis and I, & our DC took turns to sit vigil beside her all night. She died the
following morning.

I feel for you justanovice.
Remember don't be afraid to question Authority.

I am puzzled by this. When my grandmother was in care many years ago, the care home told my parents that they thought she was approaching death because she had stopped eating and was refusing to eat, which I suspect meant no more than turning her head away and refusing to open her mouth

I do not understand how anyone can be forced to eat unless they are fed through a peg or on a drip. In fact refusing or not wanting to eat is one of the signs that someone in her situation has started the process of dieing. www.nhs.uk/conditions/end-of-life-care/your-wellbeing/changes-in-the-last-hours-and-days/.

Presumably Care staff are offering her food and she is refusing to eat. As to the food itself. If what they are offering her is food she dislikes, then it is perfectly pointless. You could try talking to the home about at least offering her something she would enjoy.

I believe from what I’ve seen and heard that some homes do withhold food and drink from very elderly frail people who are close to death.

There used to be an initiative called The Liverpool Pathway but I understand this was supposed to have been banned some years ago.

A friend’s Mum was nearly 100 and barely alive. It wasn’t until after she died that she realised she had not seen any water or other drinks on her Mother’s bedside whenever she visited. She strongly suspects that the staff did not provide any in her last few days.

As death approaches most bodily functions shut down, particularly digestive processes. Food and even water cannot be processed but remain in the body, or as in Granmarettos experience are vomited out by the body rejecting them at an early stage.

Food enters the stomach but often cannot leave and the stomach becomes swollen and painful or enters the digestive tract and causes swelling there.

Water cannot be processed by the kidney to make urine and remains in the body, often in the lungs, which makes breathing difficult and causes what was once known as the “death rattle” a form of pneumonia. At this stage keeping the mouth moist and comfortable is important.

It is human instinct to want to nurture those we love but often good intentions lead to additional distress.

This is not to say that the OPs mother in law s imminently dying but just to point out that what seems to be withholding of care may not be that at all.

So sorry that you are going through this. My mam was thankfully not forced to have anything and died aged 99. It’s bloody horrible getting old. Sending you love and hugs and try and stay strong. 🤗❤️

Eventually when people have had enough of living they stop eating. Its natures way of winding things down.
They should be offered sips of water and kept comfortable with mouth cares.
It shows how important it is for us all to do an end of life directive so our wishes are clear.

She may possibly still enjoy an ice lolly, or ice cream.

She should be offered whatever she wants, and I would absolutely insist on that.

If she refuses the things she likes, which are easy, then it could be said that she is declining to eat.

What supplements?

I realise that's the sensible thing to say farmgran but if you have never been around death and have no idea what will suit you when the time comes, you have to rely on medical advice.

Everyone is different and their wishes change. My DM was ready to go but 5 years earlier she was having an operation and was really scared she would die.

No-one mentioned death in the hospital. I asked the consultant what would happen to mum. He said they have geriatric wards. Well that would have been the last thing she wanted. Perhaps she heard him and decided it was time to go in the admissions room.

I understand how you feel. It's nu use forcefeeding a person who gets sadder by the day. At the care home they probably do what they are used to, but more effort should go in adding more calories the the food your MIL likes. An example : you can dilute milkpowder in full-fat milk to use for making milkbased desserts or certain sauces. I think it would be better to add a few happy days to her life than a few months of sadness and frustration.

This is a truly horrible situation - so sorry OP that you are experiencing this. My mum broke a hip and in hospital developed pneumonia. It was decided to give her antibiotics which might work and they did. However, she was not allowed to have anything by mouth and suffered from that. She was fed by tube for a while which was absolutely cruel - she pulled it out a few times. Eventually she recovered enough to come out of hospital and go to a care home, where she spent 6 months in bed, on oxygen, hardly eating and eventually died. A slow agonising time for her and my father. I find it difficult to come to terms with the fact that there was nothing I could do to help except visit her most days and feel so guilty.

We faced a similar situation with my Dad who died back in 2001. He was at home but very unwell, in his mid 80s but with some long standing health issues. He had stopped eating and drank very little, his wonderful GP had promised that she would arrange care if it became necessary. He was very weak and my sister and I had to get him to the toilet and he couldn't stand and it was very distressing for everyone, most of all him.
After talking to him we agreed to ask for that help from the GP and that afternoon an ambulance took him to a respite room in a local care home. There was talk of fitting a feeding tube but I was very opposed to that as I could see he was failing and he really had 'had enough' and I understood that once fitted it would prove difficult to have it removed. He was in that care home for 3 days and one of my sisters or I were with him the whole time, often all 3 of us. It was awful and painful to watch him but we do know that he went very peacefully and some time later we acknowledged we were actually privileged to have had that time and to be with him at the end.
It doesn't offer any help for your situation justanovice but hope you can all stay strong and advocate for your MIL. Now in my 70s myself I really dread growing older knowing all it may bring.

I have witnessed this sort of thing in my mother’s (dementia) care home.

I dare say it is all done with the best of intentions, but I was very clear to the CH staff (once my mother was past a certain stage) that there was to be no badgering and pestering to eat or drink, if she no longer wanted to.

The staff agreed with me, and in the end it was never an issue.
IMO you would be perfectly entitled to make such feelings/wishes - re ‘striving to keep alive’ - known to the staff.

From all I’ve ever read or heard, staff often seem to think that relatives will want their family member kept going for as long as possible, regardless of quality of life.

Which may well not be the case, which is why IMO it’s necessary to discuss it with the staff.

Lathyrus3

As death approaches most bodily functions shut down, particularly digestive processes. Food and even water cannot be processed but remain in the body, or as in Granmarettos experience are vomited out by the body rejecting them at an early stage.

Food enters the stomach but often cannot leave and the stomach becomes swollen and painful or enters the digestive tract and causes swelling there.

Water cannot be processed by the kidney to make urine and remains in the body, often in the lungs, which makes breathing difficult and causes what was once known as the “death rattle” a form of pneumonia. At this stage keeping the mouth moist and comfortable is important.

It is human instinct to want to nurture those we love but often good intentions lead to additional distress.

This is not to say that the OPs mother in law s imminently dying but just to point out that what seems to be withholding of care may not be that at all.

Thank you so much for posting this. I wish these facts were more widely understood and explained to families