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She has full blown dementia in assisted living. She is in the hospital now but will be released back to her assisted living care soon. she's going to rehab for 2 weeks first. She's had dementia for probably 6-7 years but she broke her hip twice 18 months and 2 years ago and has gone downhill fast since then. since the onset of the dementia her appetite has been poor. she's has been at an assisted living facility for 18 months and has been on ensure etc. she's hostile and nothing seems to soothe her. want to know what should be our next step, the dr. seems to think nature should take it's course. we don't know.

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Hi. I know what you mean here. This happened to my mom too. She just didn't want to eat anything anymore. But she did eat a tasty meal of corned beef and cabbage that I can recall then after that she refused food and drink. I thought she was channeling her own death but now I know it was the disease. As I look back I would agree with the doctor and let nature take it's course. And remember it's not YOU it's the disease. It's hard to face at least it was for me because we don't see things the way they do. I didn't understand this at the time but I do now so that is why I am replying to you to help you get through this. Take care and keep in touch with me again if you want. I need a friend too.
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My 94-year old mother has dementia. I've cared for her at home 8 years. She had no dietary restrictions and ate heartily, but she began chewing her food endlessly before swallowing even after I'd cut her food in tiny pieces and prepared soft textured food. After being hospitalized for a UTI and then released to a rehab center/nursing home, she was put on a pureed diet. Even then she ate very slowly. When I saw her strangling on water while sipping through a straw, she was diagnosed by a speech pathologist as having a swallowing disorder and a feeding tube (PEG) was recommended. A gastroenterologist concurred that she should have a PEG. She seems to be doing OK with the PEG. Later was hospitalized with pneumonia. I could tell from the doctor's tone of voice then that they did not did not expect her to make it. I told the doctor she might just surprise him. She beat pneumonia! The medical staff have all commented how physically strong she is for her age. I do not believe in a one-size fit all solution. You know your mother better than anyone. Yes, my mother is frail and has a PEG. My mother still responds to music. Her responses are weak but she'll hum along and smile. She says hello when I speak to her. She can tell you if she is in pain. There is life there, although not nearly the quality she once had. Even her weak responses to stimuli tell me that she is not ready to go. I hope and pray that I will know when my mother is ready. I know that's not the definitive answer you'd like. I just think despite what the professionals tell you that you must feel something deep within your bones -- your connective DNA, whispering to you whether your mother is ready to go or not. May God bless you and your family.
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The family has to make some decisions. If the family wants to force feed her, a tube can be placed by the doctor, but keeping tubes in, especially in Dementia patients, can be difficult. The question to ask, is that the way she would want to live? Remember, life and living are not necessarily the same and there are worse things in this world than death. You may want to see if she qualifies for Hospice services. Hospice is as much for the family as it is the individual and offers counseling and comfort.
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What I'm seeing from what you wrote is someone who is probably in pain from the falls and I guess surgeries and who has gone thru alot of changes and turmoil with going from AL, hospital. She has probably spent time in rehabs after the two hip incidences. And going to the rehab again soon will probably add more turmoil. I can see where she would be unhappy. Maybe give her time for her life to soothe out. Maybe just be gentle and supportive of her right now.

Don't know how old your mom is.
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Most doctors will tend to give up on patients with dementia because it is a terminal illness. There is not much you can do because this disease will just keep chipping away at your loved one. Be prepared, and know that there is nothing you can do, and let nature take its course. Ensure takes AWFUL and I wouldn't have an appetite after drinking it either. Try yogurt or pudding. At this point-in-time, let her eat anything she wants.
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My mother had dementia for 12 years and was at home for 12 years until her death. I moved in to her house and cared for her the last 8 years of her life. I have also worked in a Geriatric Longterm facility for 32 years. I spent 15 years on the units and 17 years in Research. I have seen your mother several times. We all know Dementia is a progressive disease that always leads to death. Your Mother has hard time, many bad thing has happened to her. Refusing to eat. Although people can live on Ensure. The doctor is trying to tell you your mother is letting go somewhere deep down. She has had enough of life. When the doctor says let nature take it course. He is correct, I hope you are not thinking of putting a feeding tube into your Mother. A person with Dementia it is cruel. You are just prolonging death and that is cruel. Families who do it, can't let there love one die. The medical definition is Failure to Thrive. The best think to do to for your Mother is to call Hospice and let her die with dignity. When the doctor says let nature take its course he is correct. Good luck.
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Force feeding is against the law in NH and hospitals and there is no dignity left when a family does this. I have seen the days of syringe feedings and the patient trying to push it back out the sides if their mouths. Life is about quality not quantity. I am a firm believer of no feeding tube it prolongs death. Dying from not eating and fluids is not a painful death.
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The doctor thinks, let nature take it course, because why, the fact she is not eating? From my own experience with my Mom, she lost her appetite and had no interest in food, what so ever. I imagine, not feeling well, and having pain, no one feels like eating. There are meds out there, that help increase appetite. My Mother, found out some how, and no thanks to her doctor, who should have suggested something to help her, heard of a medicine, that helps with the appetite. What a miracle, after she had taken it. My Mom started eating, and I mean...constantly. She began to put on weight and enjoyed eating...again. My Mom was VERY upset, that her Doctor did not perscribe or even mention, that there was medication, that helps someone eat. Maybe you can check into this. The med my Mom was taking was called (not sure of correct spelling, but am spelling it like it sounds) Megace.
For a doctor to give up, and say, let nature take its course, without trying some thing, SHAME on him! There is some kind of hope, and obviously, you will have to investigate for yourself, or maybe, get another doctor!!
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My mother-in-law had always had a very health appetite, and ate most things, as she did when she was in the earlier stages of Alzheimer's. When she had to go to a Dementia unit at a nursing home, after a couple of months, they had an increasingly harder time to get her to eat. My wife would feed her when she was there at meal time. They started putting her meals into a blender to make it easier for her to eat, but it wasn't very appetizing. She got to the point that she just refused to eat anything. My wife tried to feed her some foods she had always liked, like Jello, but she wouldn't taste any of it. About a week before she passed away, she locked her lips shut when my wife tried to coax her to eat just one bite of Mom's favorite food, ice cream. She hadn't known us for a long time, so the big surprise was that she addressed my wife by name. "I said No, Phyllis!" Shortly after that she went to bed and never got up. Not all Alzheimer's patients follow this pattern, thankfully. I've been told of some who, when not under constant care, just forget to eat., and others forget how to chew. Each case is different and each one is difficult to care for, because of the unpredictability.
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Been where you're at, with my mother with dementia. There are no easy answers with this issue and no "one size fits all" answer. You're in for a bumpy ride. In my experience with my mother, our family disagreed on how to respond to my mother's lack of eating, which added emotional stress to an already sad, confusing and stressful time. I would recommend you ask medical pros questions, evaluate options, pros & cons, and you and your family/mother's family talk about things. Ultimately you have to decide whether you're going to follow the doctor's opinions/suggestions or not.

I had a doctor tell me something that has stayed with me and may be of assistance to you. I'll share. "There is a difference between being alive, and living."

I wish you and your mother...peace.
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