Did my friend starve to death

I am sorry to hear you lost your friend.

What makes you think the cause of death wasn't vascular dementia? You said that she forgot to eat.

Condolences ExDancer 💐

My step-father had vascular dementia and one of if not the most difficult part was getting him to eat. He would refuse saying I will eat when I am hungry unfortunately he never ever felt hungry.

Sorry for the loss of your friend my dad had vascular dementia and in the last year he lost loads of weight he just had no appetite and eating and swallowing became harder due to the nature of the illness
Vascular dementia is terminal and feeding through a drip or other means would be unlikely to have any benefit to the patient. My dad died of pneumonia he had become very weak and did spend the last few days of his life in a care home. We could have had him admitted to hospital but this would have distressed him more he was happy in the care of the home he was in.
Sometimes you cannot prevent the inevitable.

Just to follow up on what others have said.

My DF died of dementia, a different form from your friend ExDancer. But that was the only thing on his Death Certificate. He didn't want to eat either. The last time I saw him alert, he had a square of chocolate with me, but I don't think he really wanted it, he just had it to please me.

One of the things that can happen to people with dementia is that they lose the ability to swallow; whether they forget how, or something more physical happens, I don't know. But towards the end for my dad, they couldn't even give him medication by mouth because he wasn't able to take it. He was very thin at the end, I could join my finger and thumb around his upper arm.

Condolences on the loss of your friend ExDancer, please don't worry about what happened.

I think many of us have had relatives or friends in a similar situation. It is very hard to have to watch them going through this but there really isn’t a solution. I tried all sorts of foods that I thought might be possible for them to eat, always had different things on hand just in case, but nothing worked.

Just to say, in regard to what the doctor said, they could not have legally discussed her illness or any form of treatment with you, a friend. They were probably just shutting the discussion down.

Weight loss through Vascular dementia is sadly common - it is a terminal condition and in the final stages people forget how to eat, chew, swallow and what food actually is.

In the end stages I think it can be a kindness to let people slip away when they are dying rather than trying to prolong life. My mother had vascular dementia and went from independent living, hiking, driving etc to being emaciated and bedridden in less than 18 months, In the final months we tried everything to get her to eat with special foods and bringing her favourite foods but none of it made any difference.

She didn't "forget" to eat - she just wasn't hungry.
She cooked meals because her husband expected her to (thats our generation and not for discussion here) but we'd watch her trying her best to chew and swallow. She tried so hard to eat it was agony seeing her.
She was a good cook too.
What do they do for these youngsters with anorexia? Do they just die?

Are you saying you think the death certificate was incorrect, OP?

ExDancer

She didn't "forget" to eat - she just wasn't hungry.
She cooked meals because her husband expected her to (thats our generation and not for discussion here) but we'd watch her trying her best to chew and swallow. She tried so hard to eat it was agony seeing her.
She was a good cook too.
What do they do for these youngsters with anorexia? Do they just die?

Some do die unfortunately with anorexia but they are totally different situations anorexia is reversible and you can recover from it as it is more a mental health problem than a physical one. Vascular dementia on the other hand is terminal and you cannot recover from it

ExDancer

She didn't "forget" to eat - she just wasn't hungry.
She cooked meals because her husband expected her to (thats our generation and not for discussion here) but we'd watch her trying her best to chew and swallow. She tried so hard to eat it was agony seeing her.
She was a good cook too.
What do they do for these youngsters with anorexia? Do they just die?

Anorexia is one of the most difficult mental illnesses to treat. My daughter used to help look after a young woman who had had severe anorexia for years - she'd had every treatment under the sun and yet every time it looked as if she might be making some progress, she would relapse. She eventually died. My own mum had dementia and also found it difficult to eat - she used to complain that she found it difficult to swallow, but tests showed there was no physical reason for this.

she said she never felt hungry and if it wasn't for her husband she'd never remember it was a mealtime.

Exdancer The above is a quote from your OP, which rather does suggest that she was forgetting to eat and what was happening was similar to most of the experiences mentioned in other peoples's posts.

When someone dear to us is ill, if we are not party to all their medical notes it is easy to think that someone is not being properly treated. When someone's body is beginning to close down as the result of the illness they have, in this case dementia and not eating, drugs and treatments will have no effect on how they respond to food, they have lost their physical capacity to eat and it will not return.

Old people c an suffer from anorexia. It’s not just the Young.

A lot of people who are progressing towards death cease to eat. It’s part of the dying process. Hard for others to watch, but natural in a strange sort of way.

We aren’t used to witnessing the process of death nowadays, and expect to see intervention.
This could explain it.
Or she could have expressed a wish for no intervention, before she lost the ability to give consent.
I think that it is hard to come to terms with watching your friend disappear from in front of you. I wonder if you might benefit from grief counselling ?

I've stated, quite clearly (in my living will) that I'm not to be tube fed if I have a terminal illness. I'll just have the painkillers, thanks. There would be absolutely no point.

So, yes, sometimes people are weakened by starvation (and maybe dehydration) towards the end, but it's no kindness to drag it out.

I watched a lady with dementia (on the ward my mother was in) retching, struggling and crying as a feeding tube was inserted - quite horrifying. A young relative took several days to die (because he was young) in agony -from bowel cancer - and there was no effective pain relief available. I'm far more worried about those things than starvation.

ExDancer why has it take you a year to wonder this ? Surely after the shock of her dieing you would have questioned then what she died from .

Agree Hetty58

I’ve seen people with dementia in my mother’s care home being - albeit with the best intentions - badgered and pestered to eat and drink when they clearly don’t want to. I have seen people crying and whimpering and repeatedly turning their heads away.

To me it’s horrible, being forced to eat when you don’t feel like it. IMO, while I know the staff meant well, this sort of treatment is verging on abuse.
By all means offer, but if someone quite obviously really doesn’t want it, can they not be allowed that choice?

My mother’s weight dropped a great deal during her many years of dementia - her appetite was a fraction of what it had been, but AFAIK that’s pretty normal.

When I suffered a severe bout of depression in my 30s - so severe my doctor sent a psychiatrist and his assistant round to my house in the evening (1970s) - I was starving myself.

Not wilfully, not intentionally. I had absolutely no appetite - the mechanism completely shut down. I also cooked - for my four year old son (single parent at that time), but the process of cooking was purely mechanical. My son' s father frequently came round to cook for me and would put a plate of food on the table, but it was like something alien sitting there, and I didn't know what to do with it. In a state of 'panic' he would try to coax me to eat, and then revulsion took over, and I too panicked because I put the food in my mouth and and knew that I couldn't swallow it.
The psychiatrist explained that the depression (it was later discovered to be caused by a particular drug) had completely wiped out the mechanism that causes hunger and the desire to eat. I was scheduled for electro-convulsive therapy - which I declined, but that's another story.
My point is - do you think your DF was suffering from depression? It can completely kill the appetite.
A terribly sad end nevertheless. Poor lady.

Cold

Weight loss through Vascular dementia is sadly common - it is a terminal condition and in the final stages people forget how to eat, chew, swallow and what food actually is.

In the end stages I think it can be a kindness to let people slip away when they are dying rather than trying to prolong life. My mother had vascular dementia and went from independent living, hiking, driving etc to being emaciated and bedridden in less than 18 months, In the final months we tried everything to get her to eat with special foods and bringing her favourite foods but none of it made any difference.

Thank you for saying what I wanted to say, but so much better.

I'm sure everyone here has experienced loss of appetite when ill with flu, or such.
When it's happened to me, I have wondered what could be done if the appetite simply didn't come back - if I continued to feel that eating is completely unnecessary and not something I want to do.
The thought of having to force myself to eat, in such a situation, is awful.

It could be that, as well as removing hunger, the dementia also hinders or prevents the digestion and other body processes, so that simply getting nutrients into a person would not help them.

I'd guess the doctor knew that help such as you suggested Ex-Dancer simply wouldn't work for your friend, for reasons she couldn't discuss with you.

A very different situation FarNorth. Many elderly make the conscious decision to not eat, as they have had enough. A good life, but no longer worth living. My wonderful mum did- she was totally dependent, had lost the use of her legs and was blind. She just hated it, and wanted out. Not eating was the simplest way, as she had lost all appetite and sense of taste and smell. She was however totally compos mentis. Very different with someone with dementia or Alzheimers however.

Totally agree Hetty 58- it is cruel and totally un-necessary- to force feed people who have no quality of life, clearly have had enough and just want to 'go'. This is NOT akin to depression- just coming to the decision that the time has come, for very good reasons, and that life for the sake of, is just not life.

Many elderly make the conscious decision to not eat, as they have had enough
I'm sure my MIL did that.
It could have been that she lived on her own and had family who took meals, a home help who would make a sandwich for her tea, we would fill her small freezer with ready meals whenever we went.
No signs of dementia at all, she was perfectly compos mentis at nearly 90.
She ate when she was staying with us and I think having company helped but refused leave her home for sheltered accommodation or a care home.

We have a friend with Alzheimer's and he is not sure when he's full so would just carry on eating if he could.

I'm sorry about your friend Ex-Dancer

I should have checked that before posting.
Hope it makes sense.

It could have been that she lived on her own although she had family nearby

Yes ex-dancer, I am very sorry about your friend. And it is indeed very hard to watch and feel unable to help.