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My mom has had dementia for three years she is now bedridden and is semi conscious she has to be fed and cared for in every way. Hospice thinks she's dying now the doctors has ordered to stop feeding her even though she eats without a feeding tube is this legal?

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i have no legal wisdom on this. the way our world is going, it may very well be legal with less and less importance being placed on the lives of the very old and the very young. however, legal or not, it sounds cruel. if your mom is still able to eat, and is interested in eating, she should be fed. that is my humane answer. i don't think laws or rules and regulations can be administered across the board. i think case by case is the best. God Bless you and your mom!
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I presume you know whether your mother has a directive in place as to no extreme measures such as feeding tubes etc.? and it maybe that her digestive system is shutting down and can no longer process the food she is being fed? I think this has less to do with legal issues and more to do with good communication with her doctor. I'd request a full description of her current condition and explanation of why this order has been issued.
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The law depends on your state, but I would strongly feel that he does not have that right as long as she is willing to take food orally. Usually when a person is in the final stages of life the body begins to shut down and the need for food disappears. Hence their appetite disappears. Your mom is still taking and eating food. She is not being force fed or tube fed. I would say then that her body is not readying itself for death. My opinion. But legally I think you can only withhold tube feeding...and then only if she has that in her living will, or the family requests it. Hospitals usually have a patient advocate. Does the hospice? You could contact the local hospital and ask what the law is as well. You or any family or friend in the mean time could go feed her until the issue is resolved so she doesn't starve in the meantime.
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hello,
If this was my mom, I would like logical reasons as to why they would stop feeding her when she is eating on her own. It took the NH many different ways to get her to eat. Mom lost 25 pounds when she was not eating. ( 125 down to 99.) It just the psychological set back she was having.
Although, when you know you are dying your body is shutting down eventually and hunger is not on your mind. But until then it's cruel to not bring them food if they can eat on there own.
Equinox
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Please sit down with the doctor and ask him to fully explain this process to you and why he made this decision. There are many nuances to the dying process and what happens to the human body of which we are completely unaware - and lovingly caring for a dying body is different than caring for an ill, yet recovering one.

I learned that the body, when dying, doesnt really need food. However, patients may ask to eat, thinking they are feeling hungry when possibly feeling discomfort in the abdominal area. Depending on the condition of Mom's body, feeding her, even small amounts, will prolong the time until the inevitable end of life. Also, the body does not process food well which raises the opportunity for constipation, possible impaction and the very unpleasant possibility of the nurses having to assist your Mom to have a bowel movement.

This is all so very foreign and difficult, I know. That is why I urge a full conversation with the doctor on exactly what he sees and what he is thinking. Also, if you have hospice nurses, they are wonderful at taking all the time you need to answer any question you have, however many times you need to ask it for reassurance that you are doing right by your Mother.

If, after you have all the information you can gather, you still choose to give Mom small amounts of food when she asks, I would feed her: again being sure there is no problem swallowing, which could lead to aspiration or medical complication of which you are not presently aware.

As for the "legality" of stopping food, only an attorney can answer for sure, but I would strongly believe the doctor is not going to order anything for which he would be criminally liable. His order may actually be an act of kindness if your Mother is truly near the end of her life. Having witnessed a prolonged, slow dying process with my own Mother, it was agonizing to watch her literally whither away until her body was simply unable to sustain life.

It is a devastatingly hard process for both the dying and the one who loves and watches. Good luck to you both. You have my very best wishes.
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The doctor must STATE the patient is dying in order for anything to be done, or not done. Are you mom's healthcare surrogate &/or Healthcare POA? The doctor can't ORDER anyone to stop feediing her. She EATS on her own????Then NO, ONLY you can agree to that or if mom CAN respond then she can.
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If this withholding is a matter of "convenience" for the staff, that would be inhuman. If your mother is able to feed herself, WHAT makes them think she is in her last days? Keeping her raised so she doesn't choke, even on liquid nourishment drinks, etc, should minimize the chance of aspiration, I think.

Yes, talk with the doctor for answers, but don't be afraid to challenge him & his assumptions, etc.

Please let us know what happens. You're in my thoughts and prayers.
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Also, there are stool softeners that can be administered. Miralax is one that worked quite well for my mother when she was bedridden. Before that, constipation was a constant problem, even while she took a lot of senna-type ex-lax. I wish we had known above Miralax through those years.
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One of the hardest parts of having a parent die is not understanding the reasoning behind the care (or lack thereof) being given. It is my understanding that after a short period without food, there is no longer any hunger - which is why people on hunger strikes can go so long. And if the bowels lack muscle tone to remove the eaten food, someone has to reach up and dis-impact the fecal material. This is humiliating in my opinion, and not part of a dignified life or death.

You need to ask her caregivers to sit you down and explain why things are being done/not done, and listen to their compassion. Try really hard to separate out your emotional attachment and really listen. It's hard, but they really are trying to make this a better experience than it could be.
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Knee-jerk reactions don't help. It's a complicated topic. I'm grateful that some responses here address that. An organization that pays a lot of very thoughtful attention to this topic from both the humanitarian and the legal side is called Compassion and Choices, You can talk to a counselor there about your question for free. Some people have a specific directive not to be fed by hand if they are that far gone with dementia -- my father chose it.
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trunner0 I am so sorry you are having to experience a dementia patient who will die because it is a terminal illness. Nothing you can do can stop this process. The doctor knows this and if hospice has been called in, then she has less than six months to live. My mother was in this same state and I went to her nursing home and fed her yogurt every day, but it still did not change the outcome. She died Jan. 30, 2002, not being able to speak, move or do anything for herself. Start letting go because she is in her final days. My prayers are with you!
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Does your mom have Hospice involved? If the tube feeding was making your mom sick or she was not able to digest the food they can stop the feeding...If your moms body is shutting down and she is getting close to passing sometimes its less discomfort for the patient to stop the feeding...your moms body may be shutting down and no longer able to process the food..thus the tube feeding is causing her more discomfort........there are some wonderful Hospice pamphlets explaining nutrition at the end of someones life...So sorry your going through all of this....Bless you and your family....
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Bless your heart ! ! I have seen this alot, in Nursing homes. I agree with other comments. ASK questions ! ! Not give up ! ! No one has right to end someone elses life. Doctors are not GOD ! !
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There is a difference between a decision not to install a feeding tube and the decision not to manually feed someone who is still capable of eating. I can't understand why they would want to deprive a person of food if they are capable of eating - that is not using "heroic measures" to keep someone alive. If this were my mother, I might not want to have a feeding tube, depending on what had been discussed when she was able to participate in that discussion or what I believe my mother's wishes would be, but I can't imagine not wanting her to be manually fed. Who has Medical Proxy for your mother? That is the person, not the doctor, who is legally in the position to make this decision.
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Having known two friends who chose to stop eating in order to die, and several who suffered from tubal infections, I would urge you to ask the doctor, whose patient is your loved one, this vital question.
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There's nothing "complicated" about this! With all due respect, her mom CAN eat without a feeding tube!!! I honestly thought most docs wanted to keep patients alive at all costs so this question really surpirsed me - & I don't shock easlily anymore...I stand by my answer - I'm a Certified Medical Assistant & Hospice volunteer - NOT that I know more than others - but maybe have a different perspective.
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Most definitely find out what is behind this decision. Professionals are not always right. There should be a logical reason behind this. If Mom is still eating, then let her eat. Starving to death is a horrible way to die. And in this case blatantly cruel, since she still has an appetite.

I hate how many in the medical community treat the elderly with such little respect. It's as if the elderly are no longer important to society and seem to have out lived their purpose. Don't these so called caring professionals realize that one day their own parents and themselves might end up in the same position?
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Donnacecilia, I agree with you! My own mom's in a nursing home & they treat her w/respect (sometimes :/ ) but not ME!!!They hate me - John, the DON, hates me - he as much as told me..But you got it right on target - I agree 100% & for me, that's rare ;)
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i think it is immoral, even if it might be legal. Get a new doctor!
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A few weeks ago, when I was posting on AC the usual stuff, I happened to mention mom's current "progress." Mom had dementia since I was age 23, about 23 yrs ago. She was bedridden for 13 years. Don't remember how long she was on stomach tube. She was completely in a vegetative state for years now. Anyway, a few weeks ago, I happened to mention mom's current status (coughing and then struggling to breathe, not taking her nutrient milk 3 times a day - now only 1/2 can 3 x daily, her poop is no longer solid but diarrhea-like as in watery, getting so skinny so fast that her skin is tight around her legs and her stomach sinking in.)

I was told by several posters that mom was close to the end. Although a part of me denied it, I called family members on island to come and verify if mom is really bad off. I figured I was too close to the situation to be objective of mom's health. sure enough, sil took one look at mom and her body, and told me that mom would not last the end of the week.

The thing is, we had difficulty after that getting hospice service because the doctor needed to see mom in order to get hospice. We, the family took one look at mom and decided she's too weak to take on the ambulance roundtrip. We did our best to get around this requirement - And Failed. So, I had to Google on dying processes, etc... We siblings were "winging" it on our own. (I am soooo angry with both hospice and the doctor. My doctor of a different insurance said that if mom was his patient he would make an exception to do housecalls. It's the quality of life of mom that was important. Hospice could have sent a nurse over to evaluate mom and then speak to mom's doc. Both hospice and doc refused to compromise. We even went to adult protective service for help in this. Mom died while going thru the red tape.)

Since we were winging it, we siblings decided to continue to feed mom. But we only fed her as long as the nutrient went down the tube. When it stopped moving, we stopped feeding her. And yes, the 1/2 can got down to 1/3 only. We continued to feed her, and she did continue to poop liquidy. Until she finally died in her sleep. And yes, even with the 1/3 can, mom continued to quickly get skinnier as the days go by.

In the end, I think it would not have mattered if mom had her nutrient drink or not. But, for us, to NOT feed her was like starving her. We fed what she can take in. In the end, with mom passing away, not one of us siblings were left with any guilt that we had "starved" her. But mom is different from your mom. My mom could not talk or tell us that she wants to eat. We just fed her 3x a day and only what her stomach would allow.

I think, as long as your mom can eat and still swallows the food, then feed her. I've read enough posts here that when their loved ones reaches this state, they still eat but less food. Eventually, they will refuse to open their mouth for the food. Then it's time for liquid. When she starts choking also on the liquid, and she has a DNR, then your only options are to ignore the DNR and insert the stomach tube or respect her wishes, and let her be. Her body will continue to shut down either way. Stomach tube will prolong her suffering (body slowing down). Or she can die naturally. Sigh.... HUGS!!! to you. Sincerely, Book
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As I sit here feeding my Mom who also in a similar state of health, I think "omg it takes me a couple of hours each meal, but I feel so good when she is full." I cannot for the life of me understand this Doctor. Did her blood tests reveal her kidneys or something werent fuctioning? If she is going to die, why not feed her, Or, does he want her to die from not feeding her? When a well known young girl years ago on TV, who had a shrine in her bedroom, was finally starved to death over a court battle they explained that hunger is extremely painful. If they are not going to feed her, I would assume she will go on morphine? My friend's Mom has been completly comatose other than eating for 4 years, she loves to eat and she will feed her as long as she will eat. 3 years is not long to have dementia, gee we are going on many years here. All I can say is no one could tell me that I was to stop feeding my Mother. Good Luck and please update us.
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my husbad died 2 weeksago hospice wa called and wonderful but i canot help but feel guilty because although.h did choke they stopped feedng him.

ma God frgive because i feel that ikilled hm
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Ohh, Gabbie, that is why I could not NOT feed mom. Even when I knew she was towards the end, I and my sisters kept feeding her. I already knew from reading on this site what hospice was involved. I was so torn about getting one. In the end, we didn't have an option - and did not have hospice. And I am sooo glad that we didn't. Because us siblings continued to do what we thought was right...even with mom dying. As long as that liquid nutrient went down her tube, we will feed her.

I'm soooo sorry that you are now feeling like you have killed him. (That too have entered my mind when debating about hospice.) I am soooo sorry. I wish I could give you some advice about God forgiving you. This will be only between you and Him. What's done is done. If you want forgiveness, maybe approach your priest or pastor and tell them what happened. Tell them how you're feeling now. I'm sure, if these are true Christians, that they will help you to seek forgiveness to yourself. Because Jesus did not die for our sins for nothing. HUGS!!! to you.
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As for MY mom, if/when that happens w/her, she's 94 now, so...I wouldn't insert a feeding tube - she told me she doesn't want that - just let her be, tube feeding does cause significant discomfort (it may actually cause patients pain!). You know, I've been answering quite a few questions, issues, etc., & it may LOOK like when mom's "time comes" I'll be calm, etc., NOT, I love her dearly!!!!! Tonight Richard & I saw her around 6 pm our usual Sat time, stayed maybe 15 min & she suddenly told us to leave because her roommate was returning to the room to eat her dinner - so she basically threw us out! Im tearing up just saying this...It makes me very, very sad to see mom like this - she's been there for me my entire life! But anyway, I do agree with you bookluvr.
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You say that Mom can feed herself, then say she has a feeding tube. Is she inserting the feeding tube herself?
If YOU had dementia, would you want to be kept alive in a vegetative state? Not me. No feeding tube or life extending meds for me if, God forbid, I couldn't be healed. Think about it. Corinne
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Let me just share my story with you so you will know that NOT all decisions made by doctors are good decisions. . About 6 weeks ago, my mom had an allergic reaction to Lisinopril (an ace inhibitor drug for high blood pressure) and her tongue got swollen so that she could not talk and could not swallow or eat for almost 4 days. When she was first admitted to the hospital, the doctor put her on an IV and because my brother and I make all her health care decisions, he told us that since she was 92 years old, we might want to consider letting her die by not feeding her. In other words, we should consider letting her starve to death. He did not initially give us any options like having a feeding tube until we asked some questions but . I immediately began asking other people about feeding tubes and was told by someone who runs a nursing home that inserting the tube is usually a very short procedure and could help and in some cases if the patient regains the ability to eat,the tube feeding could then be stopped. So essentially I had to ask around about my mom's options because it seemed that the doctor had given us limited information and wanted us to follow along with his decision. After finding out this additional info about the feeding tube, I got a hold of the doctor and told him that we were NOT going to let our mother starve to death and that he should immediately take the steps to have a feeding tube inserted. He looked surprised by my request so he immediately rushed to my mother's bedside and asked her twice if she wanted a feeding tube to which she told him through her swollen tongue, "yes, that would be nice" twice. He then got up and told us that as soon as the speech therapist could see her on Monday, he would then contact the gastro doctor to see whether my mom could have the procedure done. When Monday came, the speech therapist told us that my mom could not eat enough to nourish herself and that if we could get her to do some tongue exercises, she might be able to swallow so that is what we did for my mother all day Monday (encouraged her to exercise her tongue) and by Tuesday, lo and behold, she was able to swallow again and she began eating her pureed food again. So my message though my story is that not all decisions made by a doctor are the best decisions for the patient and that there is nothing wrong with you challenging a doctor's decisions. Hope this helps. Good luck.
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My mom passed away on May 4 at 6pm the reason the doctor stopped feeding because she was. Close to the end but didn't want us to know they stopped feeding the evening of the previous day around six she died 24 hours later
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My mom passed away on May 4 at 6pm the reason the doctor stopped feeding because she was. Close to the end but didn't want us to know they stopped feeding the evening of the previous day around six she died 24 hours later
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I would guess it first depend on what state she's in & the law, is Mom in a coma or in and out of consciousness? I took care of my younger Brother at home on hospice he had a feeding tube, he had gone into a coma the last 50 hours I still fed him just didn't want him to feel hungry I didn't feed him the morning on the day he passed away I felt guilty. So I think it depends if she's not on a feeding tube she could choke. Sit down with the doctor and have him tell you Why he feels this way.
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Ultimately, it is your decision what happens to your mother, unless she has a living will/care directive or can express her wishes. As others have said, you need to ask her doctor or representative why he has ordered no feeding. 1) Could be she has issues, like digestive organs shutting down, that he is responding to. He's trying to prevent further harm, unnecessary anxiety with her. 2) Are there other family members around? Could they have given the "no feed" directive, unbeknownst to you? (May sound odd, but it happened in my situation. I didn't find out about it until after my mother's death.) 3) It could also be a personal opinion that is influencing the doctor. (I've also experienced that one!) That could/should be over-ruled by your mother's/your wishes.

But, before you can act you have to find out the root of this doctor's decision. Don't settle for what you're told. Your mother and/or her family is in charge here. Ask questions and demand answers!!!
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