Dear Barbara, My mother-in-law is 93 years old and was recently admitted to the hospital. Her blood pressure is extremely high, and the doctor is keeping her in the hospital to treat the blood pressure. Her other symptoms are paranoia and agitation. She refuses to eat, and spits out her food, liquids, and medication. She has refused anymore blood work and tests. Every time they try to draw blood, she cries or screams that the technicians are hurting her (even if they haven't even touched her). I wonder if she is beginning the dying process. I have encouraged my husband to speak to her doctor about the possibility that this might be the case, and if so, is she eligible for hospice care. The doctors have done multiple tests with no abnormal findings, with the exception of the high blood pressure.

How can I convince my husband to ask his mother's doctor the question that he dreads asking? It kills me to hear about the army of doctors coming through to try and diagnose a 93 year old woman, who clearly does not want to be treated.

The very fact that your mother-in-law is 93 says she is dying gradually. How long it will take is another question. Obviously if she continues to not eat or take the medications the process will move more quickly. She is not in labor (weeks with different signs) but if she continues to not eat she probably won't be here next year at this time.

How to get your husband to see this? I'm not sure. Research has shown that Americans spend the most in medical care during the last year of life. That statement tells me we treat from emotions not reality. "I don't want mom to die no matter how old she is" vs. "Everyone dies and it is now her time". You might talk with your husband about how distressing it is for mom to be in the hospital with strangers and being forced to have procedures instead of being in an environment with those she knows and a routine she is familiar with.

A hospice referral is a win win. If she out lives the hospice certification requirements she and your family have had 6 months of guidance and support AND she has been treated with gentleness and respect for her wishes. If she indeed dies while on hospice she and your family have had support and guidance during that time as well. There is nothing to lose by being on hospice at this time.

Why make your mother’s remaining time be unhappy and with more discontent than is already there due to age and illness? Being old is hard work. Our thinking processes aren't as sharp, our memory is diminishing, our personality changing, our independence curtailed and then our children can't come to terms with the fact that death comes to all.

My blessings are with you, your husband and your mother-in-law during this challenging time. My hope is that your husband can put aside his own feelings of loss and uncertainty and give his mother the gift she so clearly wants--to be left alone medically and to let life take its natural course.

Something more about... Refusing Treatment at Age 93

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