My mother, who has moderate dementia has, since the beginning of Lent, decided that she needs to Fast/Abstain EVERY day. She grew up Catholic, and has expanded these "rules" to mean that she eats:
-a small breakfast
-ONLY fish and vegetables for lunch and dinner
-no snacks
-no liquids between meals
Again, this is every day.
She is in a Memory Care facility that offers beautiful snacks, a varied menu, and the ability to reject all offerings and have the chef make something completely different.
My mother has lost 10 pounds since the beginning of Lent.
I have printed out the "rules" for Lent. They are not this strict, according to her church. Plus, she is too old to be required to participate.
She, of course, will not listen to any attempts to get her consume more than this. Not from the care staff, the doctor, family, or the chaplain. She also says that she will not change this once Easter is over.
Mom is now dizzy and unsteady on her feet. She is now down to 106 pounds at 5'7.
I see possible falls in the future. She has ZERO padding on her body, and I am concerned about broken bones, or a broken hip.
Dementia has been one surprise after another. I don't want to go into the unknown world of hospitals/rehab/nursing home without SOME kind of plan.
My mother has been wanting to die for some time now. I'm thinking that her refusal to eat a regular diet is from wanting to end her life. She is on anti-depressants and is under the treatment of a geriatric psychiatrist. I do not want to prolong her life unnecessarily.
If she were to end up in the hospital after a fall, how do I make sure that the hospital does not do anything that would be life-extending, but provides her with comfort, only? She is under palliative care from Hospice, but they are not going to be with her 24/7.
I have Medical and Financial POA.
Any advice?
Thank you.
Lea, thanks for the hospice/hospital explanation. That’s exactly what I’m looking for-help formulating a future plan!
I don’t think that having a priest or a nun or a deacon would help change her mind about her “Lenten Obligations”. Mom can’t remember 5 minutes ago. So, she would not remember them trying to explain things to her. She was not even that strict a Catholic for the past 30 years or so. Yep. It doesn’t even make sense.
You or anyone else probably won’t be able to convince her.
So if she falls and breaks a bone, you'll deal with that crisis when it happens. I assume she has a DNR in place, but if she's taken to the hospital for a broken bone, hospice takes a back seat to necessary medical care. In fact, even hospice sends their patients to the hospital for broken bones to be set or repaired, normally. What can be refused is rehab and PT. She can choose to go back to MC afterward and forego further medical intervention. If she becomes bedridden as a result of a fall, then it's time for permanent placement in a SNF.
Unfortunately, you need backup plans for everything with stubborn mothers like we have. We had to take away my mother's "slippery" pants after 69 falls, the last one on Friday out of her wheelchair bc she found ANOTHER pair of slippery pants in the back of her closet. Today at the window visit, I found her wearing ANOTHER pair of slippery pants with a large hole in the leg she fished out of the donation bag! She spilled coffee on herself at lunch, went back to her room, found them, and changed herself! She knows these pants lead her to fall out of her wc, but she insists on wearing them. The CG went in there and cleaned out her closet today, making sure there were no more pairs hiding out! 🤐
Wishing you the best of luck coming up with Plan B C and D for your mothers next levels of care.
Have you had the staff dietician look at how much she is eating each day?
I would not argue with her about this. Arguing with people (age 2 and up) only engenders digging in of heals.
Have you considered a hospice evaluation?
Maybe, since she's already undergoing palliative care with Hospice, speak to them about your concerns if she ends up in the hospital...I'm sure they will be able to guide you on what to tell the hospital personnel so that mom gets comfort care only.
You are right, the fasting stipulations are not this strict.
Besides that, seniors aren’t even required to fast, nor is anyone of any age who has a medical situation that fasting would harm.
I think it is great that you have printed out the fasting rules.
Some people go overboard and your mom is in that category.
I would suggest having a nun, priest or deacon speak with her about what fasting means in the Catholic Church.
Best wishes to you and your family.
If she goes into a hospital, then she'll be taken off hospice care because that's one of the rules of hospice -- you aren't going to the hospital any longer. If I were you, I'd talk to the hospice folks and ask about how to arrange for comfort care at her nursing home. She might need to be bumped up to full hospice care, not palliative care.