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ohreally51 Asked January 2013

Should someone in Hospice be forced to eat or wear oxygen?

My 92 year old mother in law lives in LTC facility and is mentally in good shape. She has very slow growing tumors that do not obstruct her breathing, according to her doctor and seem to cause her no pain. She gets very frequent UTI's which seem to be the main culprits of most of her discomfort as well as, at times, mental clarity, which I have heard is not uncommon.
Due to several falls/breaks within the past four or five years, she has been wheelchair bound and she does have difficulty staying dry, which exacerbates the UTI issues. Also, not uncommon, her sense of smell and taste are not very sharp and the food where she lives is downright awful. She does seem at times to have a taste for sweets but often rejects some of her meals or parts of them because she just doesn't like what she is served.
My husband's only brother, who lives in the same town as she does, basically bullies her. He tries to jam food into her that she doesn't want and bullies her about wearing her oxygen, which she doesn't like to wear and feels isn't always necessary. Her oxygen percentages rarely fall below 92 or 93, not bad. She weighs about 138 and is 5'7" or so, so she isn't just skin and bones although she used to be much larger (170 +/-) several years ago, mostly from sitting around too much eating fattening and sweet stuff.
Anyway, my BIL can be really mean in the way he puts things to her, so she will wear the oxygen or eat things he brings in to her just to make him leave her alone. Last night she told us he brought her a huge sundae and made her eat it. She said after she ate it, she 'upchucked'. This stuff just disgusts me.
I am wondering why, when a person is prepared to die, not necessarily depressed at all but just old and infirm and 'ready', people seem to want to thrust things on them they don't want. I would like some input from others on this. I am wondering if I am off base. I see this bullying behavior with my BIL toward his mother as just a power play. He doesn't seem in any way to be in denial that she is going to pass away. He does seem to have huge control issues; in fact, he seems to harbor a grudge for what she, in his mind, did years ago that he did not like.
My MIL is a Christian woman who has accepted that she will 'go to a better place' and seems to be ready to leave this life. What is so bad if she is slightly oxygen deprived - if she is so uncomfortable wearing the oxygen thing - and is she is somewhat thin because she has no appetite? She is not dehydrated or in any way out of it.
Thoughts?

purplesushi Jan 2013
I suggest you have your MIL's doctor or even a case/social worker at the LTC facility talk to your BIL, that way you're not the "bad guy". Let them know what's going on & that your MIL is quite upset everytime he leaves. It sounds as if she is quite capable of deciding what is best for herself, and if that is the case then there isn't anything wrong with not forcing food & oxygen, etc. I think too many times our elderly are "forced" to hang on for years and years when they are ready to go, and it's not right.

jeannegibbs Jan 2013
I agree with you totally about not forcing food, oxygen, treatments, or anything else upon elders. Unfortunately I think you are also right that in this case it is the elder herself who needs to put a stop to it.

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ohreally51 Jan 2013
Thank you for you response, jeannegibbs. I was really asking for other opinions regarding whether 'making' someone at this stage in the game do things they'd rather not do (that might make more sense earlier in a person's life. I mean, I thought perhaps another perspective might help this to make any sense at all (I doubt it, but I am trying to get it and I just don't).
This guy is a bully and while he may say he loves his mother, I think there are people who just never really even get the meaning of the word! Compassion and respect in my view are key to that meaning.
Hospice is definitely involved. (My sisters are both nurses and one is a career hospice nurse. I know the definition of what they do. There is no mistake here). My BIL is also in the 'funeral business', meaning he sells almost everything but the casket to funeral homes. He has had the audacity to tell my husband that we don't understand all the stages of grief as he does because he is a 'professional'!!! He also talked my MIL into agreeing to embalmment and a viewing based on this argument when all her life she wanted direct cremation (already trumped her on the same thing when my FIL died four years ago). To avoid an argument, she decided 'maybe he's right'. All my husband and I wanted to do was honor her wishes. Now BIL has pitched a fit and told my husband that he better be prepared to do everything, because he isn't getting involved! He has badmouthed my husband and me to even my step kids and tells us updates after he tells them. I am so tired of all of this, but MIL won't disagree with him because then he 'freezes her out' and we live way out of town (1800 miles away). My husband has come to grips with the fact that as long as she only complains to us but then won't in any way stand up to him, our hands are tied. We have offered many times to move her near us, and she refused, but now she is just too frail.
I don't think she would want 'no food from the outside' nor should she be banned from having something occasionally she likes just because he pulls this stuff. Really, she's the one who has to say, sorry, no, I am full and stop eating whatever he is trying to force on her. The director of nursing has been, I am sure, pumped with lies regarding us. After all, he's the one coming in with sundaes for her! He paints her as 'confused' or 'out of it' when she attempts to say no to this stuff.
I guess I just think when I am 92 I want to be left the hell alone - if that's what I want at that point! - and if I want to eat like a bird or I am more comfortable struggling a bit for breath rather than have something in my nose, so be it! Just wanted to hear if anyone else feels the same way. These are not little children, they are our elders/parents.

jeannegibbs Jan 2013
Maybe your BIL really is acting in love and in the belief he is doing the right thing. Maybe he is a control freak and deliberately mean to his mother. In either case, he needs to be stopped.

Can your mother call in an aide when he brings her something as ask for her to dispose of the food? The easiest answer is for MIL just to leave the oxygen off and to refuse to eat the food. But obviously this isn't "easiest" for MIL -- she'd rather give in to the bully and throw up than to stand up to him. So someone should be an advocate for her. Can you talk to the Director of Nursing and ask for advice on how to prevent this bullying? Could they have a "no outside food for this resident" rule? Could they put a sign on the oxygen machine saying, "Use only as needed?" Would they have a talk with this visitor explaining he mother's needs?

It doesn't sound like your mother is on hospice care. If she is, then it is the hospice staff (social worker and/or nurse) you should be talking to about this.

It is kind and caring of you to try to stop this bullying. I hope you have success.

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