I want Grandma out of her misery, but the rest of the family just want to keep her alive when none of us can make her happy. How do I cope?

Jeanne, very good question! If she goes to a NH I think I will feel worse, actually. I will worry more about her (and how she's being treated) and I will feel guilty about sending her there and not visiting her enough. Because, let's be honest, if she's on the other side of town, I will not be able to visit every day.

About hastening her death.... no, I wouldn't, but mostly because she hasn't asked me directly. If she did, and I was convinced she was in her right mind, who knows, I might consider it. All I am advocating for is letting her decide how much to eat and drink, nothing else. She's taking her meds so far, so that's good.

Cwillie, I am a bit of a calorie freak myself and she's about 120 lbs and eats a total of about 15-20 teaspoons food a day (~300 kcal) + one small Boost-like drink (300 kcal). I don't know who can survive on 600 kcal/day, but 18-year old dieting me certainly couldn't ;-) I don't mean to make fun, but basic math shows that, objectively, she should need more than that just to survive, so if she's eating less, she's losing weight, and that can kill you...at some point, I guess.

Let's be clear, I'm selfish as f*ck about most things in life, but I wouldn't want to live the way she does and I don't get the vibe she does either. I'm just not sure whether she needs more stimulation (PT, people tempting her every hour with different treats, visitors, TV & company - all things she claims she doesn't want), or more peace. Because I'm no good with the first part, certainly. I'm a complete hermit myself, I work from home, the Internet is my best friend, and all that goes with it.

I often help my mom with her meals in the nursing home, and I wonder how some of the people there manage on the little bit of food they eat, but they do! When you say "she isn't eating and drinking almost anything" what exactly does that mean? Have you tallied up the number of calories she gets in a typical day? Years ago when my mom's appetite disappeared our doctor pointed out that people doing nothing need fewer calories and told me to try to maintain 1000/day. This is easily attainable if you aren't worrying too much about a balanced diet, especially if she likes sweets. Consider that a tiny pat of butter contains 36 calories and sweetened drinks and juice also add up.

Well, if Bulgarian NHs are like US NHs were a generation ago (and some still are) then I agree it would be dreadful to wind up there. But things can change. I suggest you actually visit the one you would use (if you had to) and see if it still matches the stories you've heard. I'm not advocating this for GM's sake. She might not get any better care there, but at least you wouldn't have to provide it and you could get on with your life. That is pretty much what you want, right? Or at least what you are conflicted about.

The rest of the family wants GM to keep on as long as she can. And you? You can see how miserable she is, and you hope she can't hold on any longer. But do you want to do anything to hasten her death? Just what is the alternative to letting her keep on as long as she can? I personally can't condone doing anything to hasten her death, but I understand some people feel that is justified.

Thank you all for your thoughts, they are great! I am conflicted, that's for sure. Grandma certainly doesn't want to go anywhere, she just wants to be left alone to sleep all day. There are practically no good NH here in Bulgaria where I am and even the thought of bringing her there fills the whole family with dread. They will NOT do anything for her that we aren't already, at least at this point. They will NOT make her sit up, use a wheelchair, go to the bathroom on her own, etc. They will just leave her in a dirty bed to rot. Or at least those are the stories I hear from people who've been there.

Hospice isn't something we have here. We have a doctor on speed dial and the woman who takes care of her hygiene, but nobody does both around here.

My thinking is.... she isn't eating and drinking almost anything. How long can she really last? Isn't it better to let her stay at her home of 60 years? On the other hand, yes, it might be a long time, and no, I'm not happy about being stuck in this situation for the long run, but I've seen her deteriorate quite rapidly these past 2 months and I somehow keep thinking the end is not far. Mostly because she wants it and I cannot imagine that changing. She's a bigger hermit than me - she hasn't left the apartment for years. She has no friends, doesn't want visitors, and that's not new. I doubt she'll warm up to anyone at this age, especially since she cannot hear them.

If I ask my family, they will definitely consider a NH, I just don't think my grandma deserves to be in a Bulgarian NH :-/

I don't know about how hospice is where you are, but in the US it would a lot of sense to have an evaluation done. They may say she is not a suitable candidate for their services, but it doesn't hurt to try.

What has been a mutually good deal has turned out to be very one-sides. Not Grandma's fault, for sure! But circumstances have changed and it is OK to consider changing your situation.

This may be the time grandmother will benefit from being in a care center, probably a skilled nursing home. I don't know what they are like where you are, but it was certainly a wonderful experience for my mother. While she was bedbound they turned her frequently to avoid bedsores. They dealt with a catheter because she couldn't get up. She was never able to bear weight on her leg after her hip broke, but after a period of recovery (while she was on hospice care) the NH used equipment and two aides to get her into her wheelchair every day, used the same equipment to get her to the bathroom, or any time she needed to get up. She went to nearly every activity they offered, with an aide coming to wheel her to it. She liked eating with other folks her age. She loved that there were men around, and she wore her makeup and wanted her hair nice each day.

Would your grandmother do as well as my mother did in an NH? There is no way to know without trying. But she couldn't possibly do worse than what she is experiencing right now, could she? I really think the whole family ought to discuss what happens next. And care in a place that is set up for this may well be the best option.

Belle, where in Europe are you?

There is a poster here, JeanneGibbs, whose mom was in the same boat as your gma. Couldn't have the hip surgery, went on hospice, and with their care, she recovered and "graduated" from Hospice. She spent her time in a wheelchair, being sociable and going to activities in her Nursing Home. Jeanne says that her mom was never particularly sociable before this, so go figure!.

Hospice will at least get you good care and good pain relief. Please consider it!

You sound terribly conflicted about your needs vs. Grandma's needs. that's not unusual. As you say, Grandma has nothing terminal and could live in this dreadful condition for years. Are you willing to be her caregiver, going forward; caregiving for someone who is not invested in bettering their physical or mental condition can feel pointless and maddening.

Is it time to get Grandma into a good care facility, where you and other family members can visit, bring treats, spoil her but also get on with the business of living, i.e., dating, job hunting, and the like?

Things to think about. She will develop pneumonia, more than likely, from being bedbound. Are you going to treat it? She will develop bedsores; are you going to transport her to a carecenter for treatment of those? There comes a point, in my mind, where an elder needs both the kind of and scope of care that it is better looked after by professionals who surround her 24 hours a day.

Barb, she was considered too frail for a surgery, so she didn't have it. Her hip is starting to heal, but she's severely immobilised and can hardly move anything! She has absolutely no intention of doing PT (we've tried a couple of times and she screams at the top of her lungs to leave her alone, or better yet, just kill her already).

She's not terminally ill by any standard. She's eating and drinking very little, but the doc says her heart and lungs are fine. She just has no quality of life at all and is miserable. I've talked to her about antidepressants and she just cursed at me. The doc has never mentioned those either.

Things will only become worse for her, and I pray (not technically, I'm agnostic, but still) she dies soon, before the bed sores and losing her mind.

JoAnn, we have a woman coming every day to help with her hygiene. Hospice is not really popular where I'm from (Europe).

Cmagnum, I've been living with her for 6 years now. It used to be a good deal - she would keep to herself, I would do her shopping and cleaning and live rent-free. When she fell, it just made sense to stay. It's always been my intention to live with her until she dies.

Cwillie, we do offer her food regularly, and it's usually stuff she likes (sweet and soft). She still eats very little, even when it's social (I'm eating with her and talking to her). I don't force her, just offer her choices. But sometimes she gets angry that I keep offering. She thinks all I do is make her eat and drink. Which is true to a point, because she spends most of the time asleep and the rest of the time doesn't really want to talk. And she can't do anything else.

Any other thoughts? These are very helpful!

Food = love, that is unfortunately true and often very hard to overcome.
I vowed to never push my mom to eat, but then we never really reached a point where she went completely without eating. If she didn't want her meal she could usually be counted on to have a snack later, and she actually seemed to enjoy the drinks like boost or ensure so I was able to get some calories in her that way. Now that mom is in the nursing home I find myself cajoling her to eat, simply because I know that the soup won't be warmed up later if she gets hungry, and because she needs to be fed it is doubtful she gets anything - food or drink - outside of meal times. It's hard, and I feel like a hypocrite.

Give your grandmother permission to stand up for herself and refuse things she doesn't want. Tell your family that keeping meal time pleasant and stress free might actually make her more willing to eat. And point out that often people with a diminished appetite do better with tiny snacks of favourites throughout the day rather than traditional meals, so keep lots of appealing, calorie dense snacks available. Good Luck.

How did you get stuck with taking care of grandma at 30, when you should be having your own life? Is this something the rest of your family particularly your parents expected you to do? If so, then they don't sound all that helpful.

How do u cope. Do what u can and don't worry about the rest.

I agree, Hospice at this point might be good. She may be losing the will to live. She is 90! Breaking a hip is a bad thing for the elderly.

Belle; Define "let her go"? As you say, she's not dying. Are you all actively treating anything?

Was her hip surgically repaired? Did she go to rehab? Is her depression being treated?

Have you considered a Hospice evaluation?