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I struggled with this when my mother no longer had any appetite or motivation to feed herself, since she eas solely in my care it would have been simple to withhold food and hasten her end.
Instead I made the decision that as long as she opened her mouth when I offered food I would continue to feed her and I know in my heart it was the right choice, if she had ever actually refused to open up and eat l would have honoured that.
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I cared for my mom in my home. She didn't talk for about a year before she passed. We fed her soft foods by hand and offered drinks, water, coffee(mixed with ensure) and ensure. We had decided early on no feeding tube, but I could not just not offer her food. Personal choice. She ate less and less. Then swallowing started being a challenge. Finally she just couldn't eat or drink. She went 8 days without food or water and finally took her last breath in April. I stayed with her those final days and was lucky to be holding her hand when she passed... Something I promised her. It was very peaceful. I also knew and know where she would be going. I know the Lord welcomed her with opening arms. I did not want any regrets or guilt so whether it was morally the right thing, I can't say, but at least I know I did what I could and helped her as she left this world. I think we each can only do what we feel is best for our loved one. As long as that is what is in your heart as you make the decisions, then it is morally right.
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If she is not fed, does she seem to look for food? Does she indicate she is thirsty- ever? If my loved one seemed to want to eat, I would continue to feed her.

My sister died of a brain tumor. She became unable to communicate with us in any way. Towards the end of her life she just did not want to eat anymore, so we let her stop eating. Then it became difficult to swallow and although she did not seem uncomfortable, the family tried to continue to give her liquids. Eventually, we settled for swabbing her mouth and using eye drops. We just wanted her to be comfortable.

In nature, animals that are dying do not eat or drink. I don't think they are in distress. I think the body knows what it needs to do. Have you consulted a palliative care group? They could probably help you with your decisions.
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being able to tolerate food and fluids by mouth even if puréed or thickened is not the same as artificially extending life

is mom awake and willingly accepting nutrition but non-verbal?

my 95 year old mom has been immobile for 1 1/2 years and uses both purée and finely chopped soft food and is hand fed most of the time

I’ve seen many late stage dementia patients refuse food at the end and some families opt for feeding tubes which artificially extends life - is this where your mom is?
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I'm sorry you're in this dilemma, Tnekver62. After being my mom's live-in caregiver till she died in April, I changed my advance directive (living will) to specifically state if I'm in final stages of Alzheimers and dementia to stop all artificial means of keeping me alive, including nutrition and hydration. I mean it! I would hope someone would implement it.

I'd show the living will to and speak with your mother's nursing home DON (Director of Nursing) and her doctor if she's to the point she mentioned in her directive. They can give you advice. Although you're a minister yourself, you need to talk with another minister or counselor to help guide and support you too.

Even though it's her wish and I know it would be a kindness to let her go, I can't imagine the impact on you. I can't imagine how traumatic it would be to actually implement it. It would be hard, but I'd do it.

As for morality, what's better FOR HER: implement her instructions and let her go or make her continue this way, possibly for years? Best wishes to you.
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Could you clarify what you mean by unresponsive, please?

When people refer to "artificial" feeding, they are usually talking about PEG feeding or tube feeding, which issues tend to arise when the swallowing reflex is impaired. They are not talking about a demented person being assisted to eat puréed food.

I can imagine how emotionally draining it must be to witness your mother's state for four years; and you now have the loss of your father to mourn too. Has anything else changed in your mother's condition?
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