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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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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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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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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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Hello: Have you tried giving her pureed food? My father had Alzheimer's and my mother somehow knew he didn't stop eating because he didn't want to eat. He couldn't chew and swallow regular food. We fed him pureed food and he ate. Unfortunately we fed him baby food since this happened 20 years ago and there were no other alternatives. My mother wasn't able to puree her own recipes. Most of those shakes are sugar laden and maybe your mother doesn't like sweets all the time. I hope she is well.
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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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I can say as a caregiver someone 87 yrs old, we sometimes think i dont want them to go. this can be selfish on our part. with what u have told me if it was my mother i would not force her to eat see the body has what we call a process, it will start. then u have drs come in and say do this and that, my dad passed last yr he had chf, alzheimers and many other slight problems he was 83. could not walk had a real good appetite then 1 week gone no food he wanted i told my mom. let dad be dad. he closed his eyes went to sleep and woke up in the arms of his savior. i thank God everyday we let my dads body be in the hands of his creator i pray it all works out for u and i give u love with the process
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We also have been there with Mom. After a long talk with the NH staff, they explained that when the end is near the body just does not need that much food and forcing it just fills up the stomach to the point that it comes up and they can aspirate the stuff. Dad was worried that Mom was starving , but not so at all, she eats what she wants when she wants and is offered often. She is in charge. Darn near the only thing she is in charge of after multiple strokes, surgeries and hospitalizations. So sad to see, but it is part of the process of life.
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I pray for you, and I agree with krusso, you either have Dementia or you don't! One of my great aunts (no Directives) had the peg tube, for a year when she started to reject it from both ends, then it had to be removed anyway, all that suffering for NOTHING! My Mom had a Living Will, Praise God, when the Dementia took over and she needed 24 hour care, I just really and truly Thank God I was able to take care of her at her home until she passed away this past July. I don't know what it is in us to want all these artificial means of continuing to just breath, almost knowing it is time to let our loved ones go when a quality of life is not going to happen. Prayer always helps me make the best choices, I hope you can do this before you have that tube inserted into your Mother. God Bless You, for being there for your Mother...
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Life is a voyage and not a destination...your mom is simply wanting to change to a better life,think about what you would want,your love for your mom will not die when she moves on,good luck
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My mother if 89. She has had two cancer surgeries, and three different major procedures on her back as her bones are so brittle. Every time she has something done she goes downhill and doesn't eat. However, she springs back. We bring in the therapist and get her up and moving. Her appetite comes back and she plugs on. There are always two schools of thought. Do nothing and let her go or fight back and have her for a little longer. You only have 1 Mother.
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It sounds like your Mother is ABLE to eat, chew, swallow, so I do not understand about the feeding tube. I would make her favorite comfort foods and give them to her all day. Can you get a physical therapist in to help her regain the strength of her muscles?
She got cdiff in the hospital? Too many anti-biotics for her weak little body:(
Can you get a nutrtionist and get her on PRO-biotics? Give her natural Greek yogurt and other acidophilus. I pray she can recover from this with a optimum push to get her intestines normal again, let's believe:)) xo
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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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Angelscare, I am so sorry to hear you are in the awful position of having to make this decision. It's one with no easy answers, and whatever you do, you will second guess yourself over and over. That said, please see if your mother has a medical directive or a living will that was made in earlier times and could give you some direction. Also, find a grief therapist or even a regular therapist for yourself so you have an advocate for you in this very stressful decision-making time. I hope your family and friends will surround you and your mother with compassion. Sometimes, no matter what we do, we are out of control. This is a profoundly important decision for you and your mother. Have you asked her if she wants one of these tubes? If so, what has she said? You may have to listen with your heart as well as your head.
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This is such a personal decision. For me, I would not allow a feeding tube. I think everyone is entitled to a good death. And, I don't think life support (which is what a feeding tube is) is appropriate for very elderly people with seriously compromised health to begin with. What you're experiencing with your mom doing so well up until her hospitalization is very common. So much so that we have an expression. "she was doing great...until she wasn't." That's the way it is with the elderly. With rare exceptions, they just can't bounce back the way younger people can. Try not to lay too much of this on your sister. It will only damage your relationship with her and truly, the end comes to us all one way or another. If she hadn't caught the flu from her, she could have caught it from someone else or come down with some other infection. Life is meant to be lived, right up to the end. We aren't meant to just be 'preserved'.
As others have mentioned, loss of appetite is normal at the end of life. And, feeding tubes have complications, especially for people who are already fragile. The cost of being able to feel like you did "all you could" can be very high for your mom.
No life is long enough and we never want to see a loved one leave us, but 87 years is a good, long life.
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I just experienced the same thing. My mom passed away 3-6-2013 at home. She developed a UTI, fell and never bounced back. I tried to force feed her and tried so very hard to "Preserve" her. She was ready to go. She loved her family, lived a wonderful life but she was ready. It is so hard to let got but it was also hard to see her failing and getting impatient with her when she refused to eat. I have regrets for yelling at her for not eating and I will live with these regrets the rest of my life. I miss her dearly and would give anything to have her back home with us so I could be more patient and loving to her. Let her go and be happy in her final days. I wish I had. I sometimes think my mom wanted to go because I was giving her a hard time about not eating. She was tired and ready to die. I wish I was kinder and more compasionent.
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Such a difficult decision. Does your mom have advanced directives? If so, is this what she would want? My dad, who used to LOVE to eat, gradually ate less and less a few months before he passed. I made his favorite foods and he would eat a little and say he just couldn't eat anymore. Hospice said it's all part of the body shutting down. Food doesn't move through as quickly so he didn't feel hunger. He would also say that things just didn't taste good. To have prolonged his life by putting in a feeding tube may have prolonged his life but not improved the quality of his life. I think that's what you should focus on. Is she happy living this way? I was lucky that my dad never said he didn't want to die or was afraid to die. He was very practical and accepted it as a part of life. He was more worried about suffering, lingering or being a burden on someone. I had to make decisions for him when he was no longer able, and as difficult as it was to know it would mean I would have to let him go, I honored his wishes. He passed peacefully, with his family all around him, in his own home, and that was the best gift I could give him. Peace to you ~ Kuli
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This is a very difficult decision and I'm sorry your family is having to go through this. Your mom's experience sounds very much like what happened to my mom; she passed away in February after two months in and out of the hospital and nursing/rehab facilities. She, too, had been doing well and was fairly self-sufficient until she got a urinary tract infection, spent a week in the hospital on IV antibiotics and that week with no activity just flattened her. She just never bounced back from that, and it was just more of the same for two months until she finally got pneumonia and that's what took her. I did not have the feeding tube decision for her, but the last few days she stopped eating and one of the nurses gently and kindly alerted me that likely her body was just shutting down and she would probably not last much longer. It never got to the point where I had to make a decision about a feeding tube for her. However, my dad had a feeding tube put in before he died about ten years ago; it was in for several months but he was utterly miserable. He rallied a bit and I wanted it out but they would not take it out until I threatened to get an attorney. He lingered for several years in a nursing home but was at least able to eat. Now here is the kicker: in that nursing home, next door to him, was a old man who was completely comatose and had been for several years--the only thing keeping him alive was a feeding tube. He just laid there day after day with his mouth open--not moving. Sadly, he had a very devoted wife and family; they would visit often and just sit there by this, let's face it, shell of their former husband/father. I felt so sorry for this man and often wondered if he might actually have been conscious "in there," and how dreadful that would have been if so. It was bad enough if he was "just" comatose. I vowed then and there that I was absolutely done with feeding tubes if anyone ever suggested that again. May God be with you as you wrestle with this decision; everyone's circumstances are a little different and it's very had to know what to do. I'm not sure there's even a right answer here.
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I hear the problems of the feeding tube, the infections bringing rapid decline, and wonder if a feeding tube would solve anything.

Someone suggested an appetite enhancer - that might bridge the gap, if indeed she can recover as haggismom's mum did. Shakes, favourite foods etc. are a good idea.

Often I think the procedures used near end of life do more to prolong the dying process rather than prolonging life with any quality.

All that being said you have to live with your decision, and it is a very difficult one. I know you want to do what is best for her.

((((((((hugs))))))) and prayers
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We're here for you, but don't let this opportunity to bond with your sister get away. As someone who has said goodbye to many love ones, my biggest regret is that we family members spent a LOT of time stressing about healthcare, but little time discussing heart care. Join with your sister in loving on your mom. You'll then be better prepared to let her go.
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A feeding tube is not going to "artificially" keep her alive! When it is her time, she will go. STARVING is a HORRIBLE way to die!! They say one of the most painful. You are just supplying her with what she needs to go comfortably. We did the same for my grandma. Some family got mad?? So we asked her. "Grandma, since you can't eat on your own, would you rather have a tube.... or go hungry?" She said she wanted the tube! She wanted to live as long as she was able! Having been a nurse in a nursing home, trust me. All the people I have talked to that had them were HAPPY to have it. It really is no big deal to put in... and the benefits are great! When it is her time, she will go.

I did see one lady who had one (her choice) and family decided they were done waiting for her to die (couldn't wait to get their hands on her MASSIVE amounts of money...) Anyway, we tried to feed her the best we could after it came out, but she just wasn't able to take in enough to sustain her! SHE WANTED TO LIVE. I watched this woman STARVE to DEATH. It was one of the most horrible things I have ever experienced. I will never forget the look on her face when she passed. It looked like something out of a horror movie, an inaudible scream. I will never forget. I felt like I failed her, her family killed her for money. It was a slow agonizing death. I wouldn't wish that on my worst enemy. Sorry if this is graphic, but people need to know the reality of what they are saying.

A feeding tube is NOT an artificial "life support" thing like a respirator or something! It is just providing the basic means that we are all entitled to. Food, water, air. Leave the rest to God.
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Personally, I would not have it inserted. In my opinion, it's along the lines of being on a ventilator - once that process has begun, I believe you would need a court order to reverse it if you change your mind. The tube will remove any control your mother has over food - once inserted I don't believe you can eat "real food" until it is removed - consider that part of the decision carefully and ask your mother what SHE wants. If she is content with the amount she is eating, let it be.
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Angels - I'm assuming the PEG line has been put in since your post days ago.
How is it going? Is she able to process foods and what is her calorie count at?

The next couple of weeks will tell if she was just at a low point and has rebounded. I'd personally be concerned more about recurrent C-Diff. If she gets another C-Diff and still has feeding issues, then realistically you should have her evaluated for hospice care whether at your home or in a facility. The concept & acceptance of hospice may not be easy for you but is a very good option for many. I get a vibe that you are looking to blame your sister for mom's situation as you said sis "exposed her to the flu...two days later I had to put her in the hospital....this was Feb 20th". The flu was very bad this late winter, she could have gotten it from going to the store or church or even from you carrying the germ but not having the flu. At 87, she likely has a compromised immune system anyway with or without annual flu shot & the 5 year pneumonia shot. Your sister did not cause this.

Hospice is not automatic either, they have to be evaluated by both the hospice MD and the facility (the NH) medical director in agreement on it's benefit. My mom had 3 TIA's back to back while in her NH #1 and was evaluated for hospice and not accepted and she was 94 at the time.

The situation that Lori describes with a person living for years & years ONLY because of the feeding tube does happen and there is just no real quality of life in that situation. I would not want that for my family or myself. That's my personal choice. You have to try to balance out your personal feeling with what is viewed in general by health care providers & other family as the best option for your mom.
It's not easy, best of luck.
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Pooh with all the mind reading. It sounds as if something might be going on; a uti, another or not completely treated c-diff. IMO i would also try the peg tube and continue to monitor and explore what is medically wrong with your mom. If she can talk of course, do some loving interviewin about what hurts or "doesn't feel good."
How can anyone way this is the way for her body to shut down? No one can say for sure it is shutting down so try the things you need to try and see what response occurs.

Pulling out the tube. There are ways to get that tube under clothing so that the patient does not have access it; ways I have read about in the past. True, if she is in a mere hospital gown her little hands might pull it out but don't let her little hands get ahold of it; stretch pants that go waist high as I recall helped.

I would do many things before I were to assume it is mom's way of telling us she is dying...rule out all that you can medically. Once she is nourished and hydrated you will have a better picture of what is going on. Colon impact? Kidney or gall bladder stones? Depression (can affect desire to eat as can medications).

Please use the peg tube, keep it well covered and keep us posted. thank you
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Yes, you did the correct thing by ordering a feeding tube. Do not worry about the consequences. She will eventually die, and it will be from other known causes, not de-hydration or starvation. The answer to your Q is yes.
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Input never hurts, but wouldn't it be best to consult a geriatric specialist for something so serious as this?! Discussing attitudes and behaviors here is one thing, but medical advice is imperative.
I withdraw my first post because I don't have the right answer. Good Luck:) xo
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You did right.
She wants to live, that is the key.
Despite her medical history, she can
Enjoy life.

"if they don't give up neither do we".

Did anyone mention a ng feeding
Tube using a kangaroo pump ?

While not as pretty, do not require surgery.

I wish you luck.
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My mom made this decision on her own. We had the peg tube inserted the day before Thanksgiving. It is not an easy thing to live with. Mom can not swallow anything. Not even a drop of water as her throat has shut down. She enjoys watching her great grandchildren growing up. She is very strong. She takes 3 isosource a day thru her peg. She feeds herself most of the time. Mom has endured and still is enduring a lot of pain, but this was her decision. Like your Mom she has several different health problems. If your Mom has the will to live she can live a full life on a peg tube. BUT it is far from an easy life. I wish you good luck. If you have any problems, please let me know. I may be able to give you some tips thru experience. What ever decision you have made, know that it is the right one for Mom and you and don't give up. The end of life can be harsh, don't ever let it get you down. There is always a way if there is a will.
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How heartbreaking is this? And I mean for you. I know it is so hard to see someone we love struggle so. If she agrees with you, then I would do the tube. But I know my grandmother stopped eating, and she had made it clear that she wanted no extraordinary measures taken. So she passed on. My 80 year old Mom has Alzheimer's. but both she and my Dad (deceased) have always said they don't want extraordinary measures either. It is going to be hard (she made me the Health & Financial POA), but I will do what she wants, even though I know it break my heart.
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Yes, and you are doing the right thing with the tube. That long on antibiotics ruin her stomach flora and she needs acidophilus (good bacteria) to combat what the antibiotics destroyed. It is in liquid or pill form, but get the kind you have to refrigerate. Have you every tasted Boost or Ensure? It tastes like chalk. Skim milk will give her the most calcium and sweeten it with honey if that is more tasty, while the honey combats bacteria. Keep encouraging soups and if she can chew, eat avocados which are the most perfect food, mashed up broccoli, etc. I have a NutriBullet blender which makes vegetables and fruit into a liquid. That way she will have great nutrition and she can drink it off and on. Just keep encouraging. Mashed potatoes, squash, etc. Keep trying to get her to walk too. Best wishes.
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