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My mom’s diagnosis was down-graded from ESLD and days-to-weeks to live to a stage 3 liver disease with more than 3 months to live. However, she still doesn’t eat much in day: less than 300 cal per day. She lies to doctors about how much she eats and how much she participates in her physical therapy exercises, does not want a liver transplant, smokes like a chimney. I’m wondering if some mental health or AA would be good for her. She did quit drinking 4 months ago. But I'm not sure how to approach it or if I should even try.

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Therapy is wise if you can find someone with special knowledge on geriatrics and giving up drinking...colngrats to her!!!
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The most you can do is an intervention with the help of a therapist or counselor. She is addicted to 2 substances. You can’t “talk” someone into quitting — especially a family member. You can’t care more about her health than she does. You can’t have her recovery for her. How old is she? Bless you for caring!
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You know the diagnosis is a guideline and all positive things she does for her health would help. Therapy can be very helpful.

I wonder if you have considered home health or hospice? They come with a lot of support for her and you. She would have a weekly nurse to check her vitals, her weight, fill her meds. Hospice would provide any medications she needs for her liver disease. Home health can order physical therapy to encourage her with the exercise. An aide could help her with baths.
My DH aunt is on hospice and is also getting Pt
Not all hospice offer the same support. You could call and interview a few over the phone to see if what they offer seems helpful to you.
They will tell you if she qualifies. Some home health agencies also have a hospice group.
You and she are doing great with the four months!
About whether you should try. Pick your moments. My mom had a psychiatrist visit her in ICU a few days before she died. I could tell that she truly enjoyed the visit. As Abbe said, finding the right therapist is key. Now during Covid, some therapist are treating patients over the phone or computer.
I also recommend the book, “Being Mortal, Medicine and What Matters in the End” by Atul Gawande.
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Three months to live? Can you tell me why she should not smoke if it gives her comfort. Can you tell me why she should do anything different than exactly what she WANTS to do at this point? Why do you want her to eat? To me eating means a few more days to look forward to dying, personally. Have you discussed with your Mom exactly what SHE WANTS for these remaining days of her life?
AA is a personal decision. Going to AA because someone else wants you to will be no good whatsoever. I would definitely suggest that YOU go to Al-Anon, though, as they are a great support to people who want the support. Wishing you great good luck, and Mom as well.
Has hospice been suggested?
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I guess I'm not understanding why if she only has a short time yet to live, would you want her to go to any type of therapy. Unless for some reason she asks for it of course, otherwise I would just let her live her life the way she wants to. Let her enjoy whatever time she might have left and just be there to love on her and support her.

Now when it's all said and done,(or sooner) you might want to go some Al-Anon meetings for yourself, like AlvaDeer suggested, so you can heal from the trauma of living with an alcoholic. They are a wonderful organization that can help you heal and put things into perspective. Best wishes.
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Homecare123 Dec 2020
I guess I am still really struggling to understand her life timeline and liver disease in general. Her MELD score is 20 (was 14 when she was doing “worse”) and I just don’t understand what an 80% chance of living at least 3 months means. Whether she eats or not could she live a lot longer? If so, should I work on addressing substance abuse in the past?
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Your mother has liver disease, is pretty much starving herself, lying to her doctors, smoking like a chimney and doesn't want a liver transplant. She's made her wishes known, so it's up to you to respect them, in my opinion. AA, at this point, is futile, since she's already given up drinking. Alcohol is not an issue, so AA is not an answer. It really doesn't sound like your mom is seeking 'an answer'.........she just wants to do as she wishes and if it were me, I'd let her. Whether she has 3 months to live or 3 years, she wants to live her remaining days on HER terms, you know?

Wishing you all the best; I know it's very hard to watch someone you love make decisions you don't agree with.
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Talk to your mom's GI doc and tell them the truth. Trust me, they won't be the least bit surprised. Doing liver panels (blood work) will show all this issues and mom can lie like a dog, but the blood doesn't lie.

IF she is smoking, drinking and basically non complaint, she will not even be considered for a liver transplant, so the 3 month 'left to live' sounds about right.

Get some help for yourself, b/c your mother is unlikely to change and is probably going to die, sooner rather than later.

(My SIL is a liver transplant doc in a large city hospital. I swear your mom's story could be the story of a patient lost 2 weeks ago. Woman wouldn't comply with ANYTHING and he told her on Thanksgiving he'd pulled strings and tried to get her well enough to possibly transplant and she screamed at him. Lovely lady (not).

I asked 'So what happened?" and he replied, 'well she died the next morning. We lose more than we save" He said a full 60% of his Liver patients are totally non compliant, so don't take your mom's behavior personally.

I am sorry she's choosing to be this way, but people have their rights to slowly kill themselves.
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