Is it abuse for a Guardian to allow a dementia patient to starve without intervening?

Don't let's start judging people as good or bad on the basis of a couple of quotes. It's a complicated question. It is an ethical end-of-life choice, but it's not clear whether the person in question might also just be trying very hard to get some attention. Either way, it is -- or would become -- a Hospice situation because ultimately it's hard to starve to death and not painless. Does the person have advanced directives or is she too demented to have them? Get some elder advocacy going so that YOU are not alone with your concerns.

I don't think that honoring her wishes is abuse at all. My mom lived a good 91 years of life. She was diagnosed with progressive Dementia (Lewy Body Dementia) the last 6 months with mom was a roller coaster ride. I was moms caregiver and with the last stage of her dementia the brain shut off the abilities to swallow. It was a struggle for her to swallow even water. At that point the hospice nurse came and the last 2 weeks we would offer her food or water..and she would turn it away. They have a brain disconnect that makes it so they have no appetite or thirst for anything. Mom had horrible gag reflexes whenever she would try to drink. It was so hard to watch. I am sure when you see that the time is near. It's better to let them choose not to eat than to try and struggle with it. The hospice will keep her comfortable with the breathing and anxiousness of the whole dying process. And believe me, it's a big relief to have them there. I hope you understand and respect her wishes. And if she has an advance directive, the only thing you can do is keep her comfortable. God Bless the caregivers for their jobs are the hardest...watching their loved ones suffer. ((hug))

I complete agree with Rackem. My dad with dementia may have a bad day and say he wants to die, but he will forget about it later in the day or by the next day. Make sure food is available, but otherwise I would let it go. I personally wouldn't try to force feed a person who says they don't want to eat and then follows through with that. If wanting to die is a claim she stands by day after day, let her be. She's probably suffering and has enough of her faculties to understand she's different and will never be the same person she used to be.

I think its abuse! The sound of your cousin's attitude in the words she says are of apathy towards your aunt. there may be ways to convince your aunt to eat, but it doesn't sound as though your cousin is even trying. i know nothing of the legalities of it, but from a human love and respect perspective, your cousin sounds pretty awful to me.

My grandmother had dementia, and in the end, she refused food and water. The doctor informed us that he had seen this with many patients. It is the last thing that have control over. However, my grandmother was very far along in her dementia. I don't think it sounds like your aunt is in that phase yet. And even if she were, the appropriate setting would be a hospice situation, where she can be made as comfortable as possible. It sounds like your cousin needs to take your aunt to see her doctor to make some adjustments in her care.

My mom has been suffering from dementia for quite awhile. Throughout the years, she has threatened to do alot of "insane" stuff. Does your aunt live with your cousin? Is it her parent? If she lives seperate, does a caregiver live with her? If your aunt lives with a caregiver and the caregiver prepares meals, I would bet that your aunt would eventually eat. It is not that easy to just stop eating when someone is preparing meals. My sister and I were threatened with a lot of stuff, one of the "plusses" of dementia is that they forget and are easily distracted, but it takes effort. If you cousin doesn't provide nourishment, as guardian, I think would be considered abuse. Why did she seek guardianship? The only reason she was appointed guardian was because the court felt that your aunt couldn't make decisions for herself. If a 5 year old refused to eat, would you quit trying to pursuade her to eat? Another angle is does your aunt have a living will that she created when she was mentally healthy? What were her wishes?

Some good answers above. I have always thought that refusing to eat is the last control I might have over myself should I wish to leave this Earth. I don't blame her at all for chosing this path. Does she live alone? If she lives with someone who is her caregiver, I'm wondering if it would be wisdome for them to keep a written log showing that she is regularly offered food, but refuses.

This is a tough call and there is no black and white answer. This is a personal decision. If you notify the court, yes they can force her into eating by putting a feeding tube in her. But on the other hand what does your aunt want?

Perhaps you aunt does not want to face the phases she is going to go through and she has a right to make that decision as well.

I do not believe this is a legal situation, but a family decision. I am sorry but this is personal and if you involve legal counsel everyone of you will lose your rights and the courts will take over.

I will just say this my father had severe brain damage after a heart attack, we had to decide if he was going onto a feeding tube or if we were going to do what they call comfort care, which is basically starving the body. As a family we discussed it and made our decision. In turn, I gave the order to the doctor.

So I am sorry having been down a similar path, I disagree with taking the legal step, you need to discuss it. Your aunt and her family need to discuss it and make a decision that you can live with. This is a moral and ethics situation, not a legal situation.

I agree with prsimon- the "mild dementia" has me concerned. I do know with Alzheimer's , at the very end stages, stopping eating is common- my Grandma did this and on my last visit to her I tried so hard to get her to eat but she refused-I came close to forcing the food in her but stopped ,as hard as it was , and realized that the visit with her would be my last. I then just sat with her and made peace with the situation. She seemed calmer than she had been for months then and , at the end of our visit, as I left her room she blew me kisses- she used to do that from her porch step every time we pulled out of her driveway after a visit before the Alzheimer's robbed her of her memory. It was the last thing I saw her do. But she was at the very end stages of Alzheimer's. I fear your Aunt's decision is based more on depression then a natural progression of a disease. I think she needs to be looked at by a psychologist or psychiatrist.

I am not judging you, your cousin or your aunt, unless the person is brain dead and being kept alive artificially, as in Terri Schiavo's case, I do not think anyone has a right, to starve themselves to death or let someone let them starve themselves to death, but let us suppose, someone is that depressed, about their diagnosis,it would seem to me, that a proper doctor should be called in, to offer alternative choices in care.

As far as the court is concerned, the guardian, is suppose to help the person, (not go along with some idea, of a mild dementia patient?) usually a guardian gets appointed when the person is declared disabled....and the guardian eventually has to answer to the court...how does she plan on getting away with it? Your cousin, is assisting someone in suicide, it is only suicide if self-inflicted, other wise it is a homicide.

If this is a for real situation, your duty is to report her... this is done by making an emergency order to the court, or reporting her to senior abuse, etc. you could ask the question of the senior abuse hotline, if someone is allowing their mother to starve because the mother wants to starve or...is allowing someone to starve senior abuse or die by starving is something, that a guardian should be allowing their ward to do and from there, the decision would be in their (Senior Abuse Hotline's) hands.