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I need some advice. My mother is 87 years old...has some dementia at times...has had quad-drouple bypass....stents...and a pace maker. Up until Feb 20th...she could do everything for herself...eat anything she wanted....didn't have any problems at all. (She lives with me). My sister exposed her to the flu...two days later I had to put her in the hospital....this was Feb 20th. While in the hospital...she developed C Diff. She has been on antibiotics since...couldn't get over it until this last week. During this time...she lost her appetite...nothing tasted good to her anymore. She has lost about 15 to 20 lbs in the past 2 1/2 months. She can't walk or even stand up any more...she is so weak. If she eats 2 spoons of food a day the last couple of weeks...that's a lot. She is literally starving to death. I feel if I can get some nutrition into her...she will overcome this. I've tried ensure...boost...she won't drink them. I have made arrangements to have a peg tube inserted this coming Monday. Am I doing the right thing? I feel it is the only chance she has. She says she doesn't want to die....I've begged her to eat and her reply is that she is eating...but she's not. Has anyone else experienced this with their parent?

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I feel not. Let her go in peace forcing food is not peace. This is your Mothers Journey not yours. She's 87 years old . What life really lies ahead for her other than more suffering. Does she not have a living will. I would never want to be force fed nor my Daddy (who himself was a Doctor) or My Husband also a Doctor. This is just my opinion. If you must then give her Ensure. Mix the Ensure with ice cream . Without it nobody would drink its. its awful. My Mummy takes it but we Doctor it up and she thinks its a milk shake just for her. Now that she's in a group home , we still make it for her there and she loves it. But she would not drink it just plain right from the can. Good Luck on whatever your path shall be. But remember 87 is a nice Life . Why let her suffer , when need not be.
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In your place, I wouldn't put her through the PEG. My mother went onto a PEG when diagnosed with throat cancer at age 67. At the time, there was no reason for us to think that it was anything but temporary, as many throat cancer patients can't swallow during treatment but can recover the ability later. I have seen firsthand how wrong we were. The process of recovering use of atrophied throat muscles is a painful and difficult one at best, and I can't imagine that anyone who is 87 would ever recover the ability to eat by mouth again. Are you realistic about that? Your "she will overcome this" makes me wonder whether you think that the PEG is a temporary measure to get her past her current weakness. Chances are, she'll have a PEG the rest of her life. She'll pull it out multiple times (my mother did, and she did not have dementia), and if you don't catch it immediately when she pulls it out, it means another invasive surgery to insert a new one at a new site each time.

Finally, if she's reaching a point where her system just isn't processing nutrition, a PEG won't be of use. You can pump Jevity or TwoCal into her stomach all you want, but if her system won't use it, it just goes back up into her throat and will aspirate her. That's my mother's status now, so I can tell you that a PEG doesn't necessarily feed you when you can't eat by mouth.

I'm not saying any of these things to scare you, just to make you realize that a PEG isn't the answer to everything. I know you're just thinking you don't want your mother to die, but I recommend that you do some research and make sure it's what is best for her.
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My mother will celebrate her 100th birthday this Sunday - she will enjoy a day at churchill Downs walk to the winners circle to present a trophy to the winner of a race named in her honor - 42 of her children/grandchildren/friends will be with her to celebrate - two years ago she wouldn't eat, she thought she did but she had lost her ability to taste anything but sweets, she had lost 16 pounds and on a 120 lb 5'3" frame that's a lot, couldn't walk and didn't make sense when she spoke - we didn't anticipate that she would last another 2 weeks. According to all of her tests she was physically well, blood pressure well controlled and for all accounts seemed to want to live - she simply would not eat. When seeking help I was told too many times to recount "she is 98 you know" . . . "this is her body telling her it's time to go to a better place" . . . "this is just a natural part of the end of life" . . . all of the standard "it's time to let nature take its course" rhetoric. Like you, I believed that perhaps it was not simply a reflection of "let her go" -I felt that if I could just get nutriients in her there was an opportunity for a 100th birthday. My solution was to prepare a loaded shake which provided protein/fat/charbs/vitamins/minerals and lots of caleries. She was taking her prescriptions so even though she initially refused the liquid diet it seemed that maybe there was potential - my solution - I told her that this drink was prescribed by her Doctor (she like so many of her generation instinctively follow their Doctor's advice without question) . It wasn't a quick process and can take hours for her to consume - she is now taking (only because I did the research and requested it - again the reluctance of professionals to consider that perhaps there is another solution to a peaceful natural etc. etc.) an appetite enhancer which has improved her eating in general and greatly improved the amount of time devoted to the process. My mother is not going to live forever - maybe not much longer, she still on occassion says things that don't make sense, she can be ornary and contentious (an understatement) but she will enjoy the company at her birthday and there was no reason two years ago to deny any of us that celebration. Do what you believe in your heart is the right thing even if it seems to fly in the face of the many well meaning "let her go in peace" advocates. What ever the solution it isn't going to be problem free - shakes, feeding tubes or starvation - there are inherent issues no matter what - but in my opinion if she wants to live there is hope and at any age that's what keeps us all going. Gotta go now and get my Mom up so she can enjoy a day at the "club" - she is the second oldest participant at the senior citizens day care center and she loves it!
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You did the right thing with the tube in my opinion. These would be my criteria:
1. She WANTS to live. 2. She has the potential for some quality of life.
My poor little mom also got into trouble after a procedure at the hospital last week. The staff was going to insert a tube but she went downhill. My mom did not want to live anyway (blind, going deaf, terrible arthritis, she could not even sit up anymore and could just barely hold a cup to her mouth). Mom had nearly zero quality of life. Finally, her symptoms suggested her organs were shutting down.
To me, if you mom wants to still go for it and there is some hope, I would do the same and put in the tube. Best of luck, V55
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Thank you to all who responded to my question. I went ahead and had the peg tube inserted on Monday...May 20th. It was going to be an out-patient procedure....but before they did it...her heart Dr. had her pacemaker checked. Just prior to her getting sick....she had been scheduled for a check up...he wanted to change the battery by the end of March...but he choose to put that off until she got over the C Diff. Turns out...the pacemaker needed to be changed. I agreed to let them keep her overnight and so she had the peg tube procedure done at 8:30 am and the pacemaker procedure done at 6:00 pm. I took her home at 10:00 am the next morning. I didn't tell her she was getting the peg tube prior....but the next day at home I explained it to her.....she was fine with my decision. I know it's only been a couple of days....but there is a big difference in her already. Before I took her to the hospital...she was barely responding to anything.....already she is totally alert...laughing....talking on the phone....and even asking for food....(she ate an orange....a pancake....and some M&M's and a cookie throughout the day!!!). The feeding tube is easy to use...(I am doing it myself...not by machine)....and she watches and totally accepts it. Right now...I feel I made the right decision...only time will tell.

I want to explain about my sister....some responces seemed to think that I'm blaming her for my Mom getting sick....I'm not. First of all...there are three sisters involved....the one I spoke about is the youngest...ten years younger then me (I am the oldest)....and she has always been my Mom's favorite....and believe me...this has never been a problem for me. When my Mom's last husband died (she has out lived 4 husbands!!!)...she sold her home and went to live with that sister....who was then her POA and Healthcare Surrogate....and my sister spent all her money. After the money was gone....she had no use for my Mom. One morning...3 years ago...she came to me crying about how badly she was being treated...I took her into my home. Prior to this...I hadn't seen or spoken to my Mom for 6 years....because my sister would not allow my Mom to....she controls everyone's life around her. My Mom changed her POA...etc to my name. I never put any restrictions on who my mom could see or talk to...everyone was welcome at my home. It took 1 1/2 years before that sister came to see her....my other sisters were there all the time....Mom even spent nights at their homes. For Mom's birthday this year...in January....I gave her a big surprise party....the "controling" sister wasn't talking to one of my other sisters at that time....and said she would walk out of the party if that sister came...so my other sister stayed away because she knew how upset my Mom would be if her favorite daughter left. First time I had to 911 my Mom....I called all my sisters to come to the ER....I didn't know if Mom was going to make it....again my sister would not allow my other sister to come....so again...she stayed away so my mother wouldn't be upset. The last two weeks...twice that she was supposed to come visit my Mom...she didn't show up....my Mom was so upset. The previous two times that she did come...she kept telling my Mom it was time for her to die. She also just recently found out her own sugar level was up...so she takes medication like a million other people do...but she's telling my Mom that she's very sick and may die before her....and if she does...she'll wait in heaven for her to get there. I had to give my Mom medicine for anxiety after she left because she was so upset. I had had enough...and told her to stay away. All of a sudden...she makes up with my other sister....and convinces both of them not to visit my Mom unless I allow her too (this was the day before Mother's Day)....so none of my sisters showed up for Mother's Day. I feel I have enough stress dealing with what I'm going through with my Mom...I don't need anymore....so right now...I don't want any of them in my home. Somehow my sister found out that my Mom was in the hospital Monday night....I was at the nurse's station...walked back into my Mom's room....and she was on the phone....my sister had called her...telling her I wouldn't allow her to visit her anymore. She doesn't care about how much she upsets my Mom....telling her this after she just went through two procedures. I hung up the phone...she kept calling back...this was 10:00 pm. My Mom told the nurse her kids were aggravating her...so I unplugged the phone.

I had asked her and my other sisters for some financial help with my Mom when she got sick...none of them would give me a penny. I told them that she may end up in a nursing home if they didn't help....I couldn't do it all myself...24/7....this one in particular...who had spent all of my Mom's money...said she didn't care if she ended up on the street...she wasn't giving a penny....so I do it all myself. Medicare only pays 80%....I have to pay the rest...Mom doesn't have any insurance...she used to....but I guess the payments weren't made and it got cancelled prior to coming to live with me. I pay for her meds....depends....chucks...everything she needs...she does get SS...but that doesn't cover hardly anything.

Right now....I'm worrying about my Mom....and I think it's better if I keep them away until she recoups....and I don't need the added stress of dealing with them. I may be wrong....but that's what I'm doing.

Again...thanks to all who replied....I will update if there are any changes.
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UPDATE...I did have the feeding tube inserted on May 20th...and while she was in the hospital they inserted a new pacemaker. Apparently the old one was bad. Mom only stayed in the hospital overnight. After she came home...she was a different person...I fed her through the peg tube...and she ate three meals a day. The doctor couldn't believe the change in her!!!! This lasted for three weeks...and she started to decline again...and eventually stopped eating again. For the next month she became bed bound....eating nothing. She became impacted and I had to remove it digitally. I cooked all her favorite foods...lamb chops...smelts...pot cheese and noodles...etc...she would take one bite and leave the rest. I made sure she didn't become dehydrated...and I continued to feed her through the peg tube. Everyday I put her favorite music on for her to listen to...her favorite movies to watch...I watched Wuthering Heights and Maytime about ten times each in two weeks!!!! We watched home videos of her and my dad...her Birthday party I gave her in January and I took photos of her and videos everyday. I had potted Gardenia bushes...her favorite flower...outside the glass slinging doors of her room for her to see and every day I would cut a flower and put it on her hospital table next to her bed. On the morning of July 23rd...I went into her room....and I knew something was wrong....she was trying to sit up. She said "help me". I knew immediately the time had come. I cleared the mucus from her mouth...told her to lie down and relax...I was with her and I wouldn't leave. I was holding her...I told her I loved her...and she said I love you too. Those were the last words she ever spoke...she passed immediately after she said them. She passed

I feel I did everything I possibly could for her...I'm glad I decided to put the peg tube in...because I'll never have to wonder if she would have lived longer if I had or feel guilty thinking she passed be caused I didn't. I know the answer. Thanks to everyone who responded to me...and I hope my story can help someone else.
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This is something that you have to decide for your self. My mother passed in 1990. She had Alz which started in 1975. She stopped eating in 1985. My sister was her court appointed caretaker. She had a feeding tube inserted and it kept her existing until 1991. She did not know any one before the tube was put in place. I seen my mother exist for six years and die in a fetal position. The choice is yoyrs to make. My wife has Alz. & we agreed while she still knew what was going on. We will not have a feeding tube inserted and make her suffer just so we can say we did every thing we could do. Will be praying for you.
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This is a VERY emotionally difficult decision to make - been there - not w/feeding tube but w/Daddy - he BOTH wished he could walk AND wished he was dead - he told me "I wish I was dead" a couple of times on the phone - But, that's why I can't answer this question Angelscare - OK, the simple answer is is Yes, you're doing the right thing by authorizing a feeding tube because she SAID she doesn't want to die - did she actually SAY that to you? I don't think there's such a thing as "some dementia" - either have maybe MILD dementia or you don't have dementia. What you should probably do is ASK her if she WANTS a feeding tube inserted - it's a surgical procedure that requires a lot more than you might think. But do ask your mom & hopefully she'll understand what a feeding tube IS & will be able to express her wishes to you. Bless you...
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As a healthcare professional , in my opinion, a Peg tube would be the last resort and for me, no thank you. It is generally not a short term fix but in most cases there for life. I would do anything possible for nutrition before I would do that. C-diff is a daunting condition and can result in lowered appetite and usually weight loss. This should pass in time. Your mom does not sound like she has stopped eating out of a will to die. Monitor her weight loss and try any alternative. Change eating locations, play quiet music, have someone eating with her while encouraging her. If you can hold off the peg tube insertion I would take that route and consult someone who can help you make another choice. Is it possible that your mom's PC would recommend her for a short-term rehab stay where she would get the assistance she needs to get back on track. Best of Luck. Most of all remember that this is your mom's life and don't let personal emotions take over.
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I believe her body is telling her what to do, she is making a subconscious decision.
I personally, and stress, this is my personal view, believe there is little point fighting this.
You have the guilt with whichever decision you make, did I do the right thing. What is the use of her being unhappy, and you watching this with all the pain this brings.
In a just world we would help our parents and understand they had lived a full life to the age your Mum is.
In a childish way, I figure it like this, we have to make way for the next generation, awful as it sounds.
God give you strength in these awful times, and remember Mum as a vibrant young woman rather than what you see now.
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