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I just found out yesterday. To further complicate she developed dementia and will not speak. Hasn't said a word in 2 days. I have in home hospice care since yesterday. The nurse said just let her rest. I am certain my Mom doesn't want to be with us in this life anymore. I know her extremely well. My sister should have been here 2 days ago. Her train was cancelled due to weather. She wants artificial feeding tube. I actually want what I believe Mom wants. I love her more than life.

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The only thing I would add is that even with a feeding tube in place the body still may refuse to process the nutrition. All artificial feeding does at the end of life is put extra strain on organs that are doing their own end of life work.
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Midkid58, I like your flower. My mother's passing was also calm and sweet, but did I ever let it all hang out in my TV room in front of my niece! Not so much that my mother had died, but I missed her. I'd always go to a mall with her every Saturday, we'd pick out cool outfits to wear to Atlantic City that Sunday. My mother would choose a blue outfit where I would choose a red outfit. My sister has relocated to upstate Pennsylvania, and I will be joining her there soon so I have a couple of new mall buddies. I know I ought to keep on topic, but I just wanted to let you know how I felt about my mother's passing. When I let it all hang out, I let it all hang out!
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I support you in what your mum wants. It is not unusual for a sibling who has not been in the scene as much as you have to want extraordinary measures taken as they really do not grasp their LO's condition and are in a degree of denial. Don't make that your problem. What does her doctor say? Sometimes it is better coming from a professional. Maybe the nurse can explain things to her. I do hope that your sister has been able to make it. Our answers may be irrelevant by now. Do update us if you can ((((((hugs)))))
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I'm with the hospice nurse 100 percent about letting nature take its course in a situation like this!
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My mother was diagnosed with metastatic lung cancer seven years ago. She laid in bed a lot, would not get up, would not eat, that sort of thing. My sister and I had her in the hospital for awhile; we thought the best thing to do in this type of case is to just let nature take its course. My mother's cancer had spread to her liver and bones. About a month after being diagnosed, my mother went very quickly and very peacefully; she did not suffer. Should something like that happen to me, I am going to request to go with dignity, too; very peacefully and quickly; I did not want my mother to suffer, and I sure as heck do not want to suffer.
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So sorry you are going through this. The not eating...does your mother have a advanced directive that states she doesn't want a feeding tube? You can tell your sister that she didn't want one and let mom be the "bad guy"...in the sense that she wouldn't want her life extended by a few days with a feeding tube.
When daddy stopped eating and drinking, he only lasted a few days. All he "ate" was liquid morphine, as much as he could swallow. His passing was calm and sweet. not rife with hysteria and tears. Feeding tubes are miserable...make your sister aware (if you can) that this is not about her.
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She would probably pull the feeding tube out asap. (My husband did that when they tried to prevent aspiration pneumonia shortly before he passed.) Ice chips might be soothing.
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vstefans, excellent answer! In my dad's case, it was dysphasia from late onset Parkinson's and a life threatening aspiration pneumonia following his broken hip. He was in no pain, participating in PT, no dementia at that time, and most important HE wanted to live. Every situation is different for sure!
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A feeding tube would not even be guaranteed to keep her alive longer. In the setting of advanced dementia (NOT in all cases - feeding tubes are very appropriate for many acute situations, or other situations such as brainstem stroke or bulbar CP or ALS that cause dysphagia without necessarily having progressive loss of other brain and bodily functions), hand feeding orally as tolerated/as desired is usually better for quality and quantity of life. I know sister feels bad and wants and needs to feel she has had "everything" done but a feeding tube will more likely make a tough situation worse.
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When I faced the feeding tube decision, I googled the ethics of whether to put in a feeding tube. I also discussed it with the gastroenterologist who places feeding tubes, or pegs as he called them. Your hospice provider can also guide you. I armed myself with the facts and got lots of expert advice. Please take care of yourself and let us know.
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I'm so sorry you're going through this. I don't have any experience that would help in your situation but it seems to me that at 92, and with inoperable cancer as well as dementia, your mother's quality of life is very poor. A feeding tube will probably not improve it, although it might keep her alive a little longer. Is your sister worried she won't have a chance to say goodbye, or won't have a chance to see for herself that your mother has truly reached the end? I agree with what Babalou said - let your sister see for herself and talk to the doctor or hospice nurse herself so she is comfortable that it's time to let nature take its course. Please keep us posted - we're thinking of you.
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With the dementia, also comes with problems. My bedridden mom tried several times to pull out the feeding tube and even her trache.... With the liver cancer, depending on what stage she's in, she will have to deal with the severe onset of pain. Do Not cancel hospice care. They will be able to provide the pain treatment so that your mom doesn't have to suffer. I'd research other people's journey with liver cancer because knowledge Is power. It will help you stand firm and not second guess yourself when sis is passionate about the feeding tube and extending mom's life.
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Let your mom come and see mom for herself, let her speak to the doctors herself before you start the discussion. Right now, she's in emergency mode. Let her come down off the "riding in with her Superwoman cape" mode. Don't turn it into an automatic adversarial situation. Wishing you well.
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I'm very sorry for this terrible news. You have enough to cope with without people meddling.

It sounds as if your sister is clinging to the 'where there's life there's hope' theory. But hope of what? Prolonging your mother's life through heroic measures such as a feeding tube would be… it doesn't bear thinking about.

Focus on keeping your mother comfortable and reassured. I hope your sister does get there - she must be frantic to have had her travel disrupted in that way - but meanwhile if she calls and tries to insist on futile invasive treatment perhaps you could ask either the hospice nurse or your mother's doctor to have a gentle conversation with her.

Look after yourself, too, don't forget. Thinking of you.
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I hope you have medical power of attorney. If so you can make the decision about her care, feeding tube etc. The directives of the person with POA must be followed. Hopefully you can resolve this peacefully with your sister. A feeding tube can extend her life a long, long time. If able to speak and reason, most people would choose not to have a feeding tube and extend life.
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Agree with the others, Yes, feeding tubes come with their own set of complications that your sister may not be away of. It sounds like it s your mum's time. Honour what you know about your mum. Keep her comfortable. Maybe hospice or some other professional can talk to your sister about what is and is not recommended for your mum and why. As Eyerish says - look after yourself as well. Your mum knows you love her. Do come back and let us know how things go. (((((((((hugs))))))))))
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You must be devastated about your mom's recent diagnosis. It probably hasn't even sunk in yet. I'm glad you're here and I'm glad you posted about your mom.

You made a great choice in enlisting the help of hospice. As for the feeding tube that your sister wants I'm pretty sure you'd have to take your mom off of hospice if you opted for a feeding tube as a feeding tube in not in keeping with the tenets of hospice. Your sister might benefit from learning more about what hospice does and doesn't do.

I would imagine that the hospice coordinators explained everything to you. Discussed with you your mom's inability to eat and drink. If you're still questioning things call your hospice. They will be more than happy to talk to you about it.

Since you asked, "What should I do?" I'll just share with you what I would do. If it were me and my mom I would not force feed her food or drink. She's no longer speaking and I would imagine that her body is going through the process of shutting down. The euphemism hospice uses is "transitioning". It's OK to do nothing. If you think she's in pain give her pain meds. If she becomes agitated give her anti-anxiety meds. Treat her symptoms so she's comfortable. Then be there for her as much as you can. As much as you're physically able but don't wear yourself down. You're going through a process as much as your mom is right now. You too need rest. Make sure you eat. And be your mom's advocate. Educate your sister. Have hospice talk to her if necessary. Putting a feeding tube into the stomach of a 92 year old woman with an inoperable liver mass who also has dementia is pretty radical and aggressive. And even if you chose to take that route you might be hard pressed to find a Dr. who would do it.

What your sister is feeling is natural. It's natural for us to want to give our loved ones food and water but what their body is going through is natural too. You know your mom better than anyone and you know what she'd want. It's now your job to make sure your mom gets what she wants.

I hope you check back in with us and let us know how you're doing.
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This must be so difficult to handle alone. It's good you have support from Hospice. I looked into issues like feeding tubes, when my loved one got dementia. Upon my reading, I learned a lot of things that really opened my eyes. Feeding tubes come with their own set of problems.

I take it that you are the Healthcare POA. I would study the information and then come to a decision that you believe is what your mom would want.

Here's a link for a brochure written by a doctor regarding dementia patients who are in their final stage. There are other links on this site for further information. Take care.

http://avoidablecare.org/wp-content/uploads/2012/04/Sharpe-Handbook-A-Caregivers-Guide-to-Advance-Dementia.pdf
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i hope you don't listen to your selfish sister. I use the word selfish because she is only thinking of her own feelings. Not mom's Liver cancer and a feeding tube. Lord help us.

God bless you. And bless mom that her journey is peaceful and quick. Do not do this.
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Consider keeping your Mom comfortable and letting nature run its course. Your sister can fly if it is important to her. It sounds like you are following your instinct and that is something you should not ignore. Hang in there.
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