Elderly Father Refuses to Eat or Drink

me and my mother have been look after my 80yo feather for a few years now. he had a couple of surgeries about 2 years ago and since then has eaten less and less and will constantly refuse food (he is EXTREMELY stubborn). we had to call an ambulance about a week ago because he had a fall and since then he has basically eaten nothing (he drinks alittle). he refuses any food or the meal supplement drinks that are prescribed to him, he also refuses his meds that he is on. he is extremely skinny, he just wants to stay home (no nursing home) and dosent want to move much anymore. we are all obviously very stressed out.
so my question is.
is there somone or some government entity that we are supposed to tell? he would refuse someone taking him away somewhere. but if something were to happen to him. would we get in trouble because we were supposed to alert somone of his condition (malnutrition) or how hes refusing to take his meds?

Comments

  • +4

    Hard situation, I would tell him that if he doesn't eat or drink you will be forced to put him in a home.. do you know any police / ambo's that could talk to him? Or any friends that can speak to him..

  • +11

    Sorry to hear
    Recently been through this with the Mother in law
    Apart from having him hospitalized not much you can do but make him comfy and prepare for his passing
    Dont mean to be blunt but if it has been going on that long it probably will not change

  • +2

    If he has decided he does not wish to eat or drink, why would you seek to force him?

    • +7

      Humans need water and food to stay alive, they are only looking out for their family, I'm sure you would do the same.

      • +2

        Your assumptions on how I would treat a family member who was refusing to eat and drink are incorrect.
        While I think it would be sensible to ensure the parent's behavior is known to their GP, I would not be transporting them to hospital to force feeding, or otherwise seeking to have them declared incompetent on the basis they were refusing nourishment.

        You might consider your own assumptions and how you would wish to be treated, and consider if they align with how you are suggesting treating somebody else.

        • +2

          Your assumptions on how I would treat a family member who was refusing to eat and drink are incorrect.
          While I think it would be sensible to ensure the parent's behavior is known to their GP, I would not be transporting them to hospital to force feeding, or otherwise seeking to have them declared incompetent on the basis they were refusing nourishment.

          I never assumed you would do any of the above, and I would not wish the same to be done to me if I were in a similar position as OP's father, but I also doubt you would just stand around and watch them die.

  • +9

    He is in the statistical range to pass away soon; there should be no assumption of anything unfair here on your part.

    Treat him with dignity, whatever that means to him.

  • +5

    Sorry to hear mate…

    You can’t force him. He’s probably made the decision that his time has come. You could try getting a friend to talk to him perhaps.

    The thing to do now is to get his affairs in order and make sure he has what he needs/wants.

    You don’t need to tell anyone (is that really a thing in other countries??)

    • +3

      Except if the authorities found he died of starvation or malnutrition, OP and his family could get the blame and be charged with something?

  • +6

    Sorry to hear this OP.
    This reminded me of my late grandpa who recently passed from terminal lung caner. He lost a lot of weight in his last 2 months or so, however had a strong will to live. He tried very hard to eat more, sometimes multiple little meals as he had difficulty swallowing. I think what kept him going was his will to see us graduate and attend our ceremonies. We took him out as much as he could in his final years, family trips, dinners etc and every day, he was given a reason to live for one more day. I remember him telling my mum that it felt like someone was constantly hammering on his lungs and even the strongest morphine could not ease the pain.

    OP, could you see if there's anything he would like to do and something that could possibly 'get him going'?

  • +6

    I worked in aged care for a while. Has he done an advance health directive (“Do not resuscitate”)?

    https://publications.qld.gov.au/dataset/power-of-attorney-an…

    If he is of sound mind there is nothing for you to do. You do not want him to be peg fed - trust me. Once someone has lost the will to live all you can do is keep them as comfortable and as happy as possible.

  • +4

    Speak to his GP regarding it, the assessment would look into whether he has capacity to make health, financial and accomodation decisions (a geriatrician referral would be of benefit). As others have said there isn't much we can do to force him to take medications/food; artificial feeding isn't sustainable for someone who doesn't want it.

    There are certain anti-depressants that are often utilised for people with low appetites that assist with weight gain. If these problems have been worked through with your GP and appropriate referrals there isn't much else you can do. Good luck

  • +5

    We went through a similar issue with my grandmother after she lost her husband at age 86. We had to start taking her in to Casualty as it was obvious she was allowing herself to become malnourished/ dehydrated. They would place her on an IV drip and give her Sustagen before discharging.
    She’s still not 100% but we’ve been pedantic about doing a big family lunch at home every Sunday, and a different Aunt will call in and take her out for lunch/coffee every few days during the week, which has improved her nutrition intake greatly.
    Good luck with your dad, it’s heartbreaking to see our loved ones growing old.

  • +2

    I'm sorry hear op :(.

    I don't know of any government entity, maybe talk to your GP.

    Does he have a mental illness, maybe phoning your community mental health could help, they can come out and visit.
    Maybe he's severely depressed but won't talk about it, beyond blue could help.

    I have a friend, both of his parents have psychosis, he wishes there was some entity that could help them but as they are adults and are partially functional there is nothing that can be done.

    I guess if your father doesn't have a mental illness and he truely believes it's his time, I'm sorry op I don't know any entity that could help :(.

    I hope there is someone who could help your father.

    • +1

      he truely believes it's his time

      it comes a time in one's life when they're just tired. it sounds like this is what he wants.

      • :(.

        My grandfather lived till he was 86.

  • +2

    Buy him some cannabis.

    • +1

      Don't understand the negs. It makes you happy and hungry. Sorted.

      Bikies will help, too. ;)

  • +1

    I don't have a solution but I'm sorry to hear about your situation. I hope you and your family can work through this together and find a viable solution!

  • +3

    Take him to a hospital. They will discuss with you and make the decision about feeding. If you are unable to take care of him by yourselves the government can provide help in the form of services at home. In extreme cases they could even recommend TACP which is nursing home like care at home but for a limited period of time.

  • +2

    Could he be in some kind of pain that he isn't telling you? Maybe it just hurts to eat.

    • +1

      Yes, my mum found it very painful to swallow during her cancer treatment and ended up in hospital with severe dehydration.

      • Yeah I was also thinking of my sister's father in law who hardly ate in his last few weeks with stomach cancer. Sorry to hear about your mum.

  • is he still sane & able to talk ?

    move to NT for euthanasia

  • Sad but understanable. When you are just waiting around for the grim reaper, when you feel like you have no more to give in life or nothing much to live for anymore, then it is a option to stop eating. My dad did this and it is mentioned on his death certificate.

  • Is euthanasia allowable in Victoria?Can someone here clarify this.

    • +2

      move to NT

  • -1

    This may be harsh but this is what I would do.

    Ask him if he wants to end it. Buy him ticket to Belgium where Euthanasia is legal.
    He gets to eat that chocolate and say good bye on his terms.

    All the best in this roller coaster situation…

    • +1

      NT is nearer

  • +5

    Treat your father like the adult he is. It is not uncommon for terminally ill people to decide they have had enough and simply stop eating and treatment. Spend quality time with him and keep him comfortable, he knows what he is doing and it is his choice to make. Reporting it to someone could put him back in hospital being force fed. Do you want to betray him like that?

  • +2

    This is why I want euthenasia as an option for myself. If living has become too much of a burden I don't want to have to starve myself to death, I want an option that allows me to do this quick and painlessly. I feel very sorry for everyone in this situation - it is horrendous. When my grandmother had a stroke she kept pulling out her feeding tube so the hosptial personnel tied her hands to the bed to stop her. My mother told them to release her and just make her comfortable. People have a right to autonomy over their own bodies.

    If I was the OP I would ask the father to talk to a doctor to see if there is an underlying issue that might be addressable or if the father has just had enough.

  • +7

    Talk to a GP - but ensure you have one that understands end of life issues and the legal issues in Qld - assuming yourblocation on your profile is correct.

    Just because a GP profile lists aged care interests it is no guarantee they are actually passionate about it and will be up to date in the appropriate issues - especially legal.

    I worked in palliative care education and research for years.

    There are a number of useful resources around end of life care and signs and symptoms of impending death that you should be aware of.

    Your father clearly has signs of issues that would be concerning him. It could be time to stop telling him what to do and forcing him go eat and drink.

    You need to be asking the right questions in the right way. I don’t know his diagnoses But assuming there is no dementia it is time to get the legal things in order (as long as he has the ability to make these decisions).

    Refusing to eat and drink is common in certain situations:
    1) terminal phase of life where the body begins to shut down and no longer requires food and water and can no longer process it either. Forcing it at this stage causes harm to the person.
    We had an Italian family in RBWH who were forcing food down the back of the throat of a dying man in a coma. This can cause death within hours if it goes down the airways and into the lungs - if not choking initially.
    2) someone who no longer wishes to live and feels as though they are no longer are in control of their life (eg Loss of independence and what is important to them).
    Not eating and drinking is the only way they see as within their power and they know what will happen.

    As long as mental capacity is in tact and mental health is not a causal factor then it is time to listen to them and verify this is indeed what is happening. Allow a honest dialogue from them outlining their wishes. Ensure that their wishes are either put into end of life legal documents (preferred by all health professionals) or record it to verify if is what HE wants. Additionally putting it onto paper and having it dated, signed by him and have 1 or 2 witness signatures. This is then a legal document though medical staff prefer the ridiculously long and convoluted Advance Health Directive (AHD). The AHD form is Very complicated thing to understand and complete and he may be too weak to do this.

    If he has one, make sure it is up to date with all aspects. There is a review page for changes, date and initials (or signature - can’t remember which).

    3) Aging process - as they age they eat less. What age this happens depends on their underlying health issues.
    4) an undiagnosed health issue may be causing a mechanical issue such as swallowing problems. There are also things that can go wrong to any part of the digestive tract which can impact intake. Also certain diseases lead to weight loss and loss of appetite. If he has nutritional supplements prescribed - my guess is there is already a known issue. Also check constipation is not the issue (is he on medications that cause that - especially opioids).

    Find out if the Gold Hospital is participating in the Advance Care Planning process as if they are, then they will help you to ask your Dad the right questions and negotiate thus thing. If joy see offered referral to the palliative care team, grab it as they are einserful and will help a lot / even in the home.

    You need to know some of these things from him:

    The most vital things apart from ascertaining if he is refusing as his way of controlling his life:

    At what point would he no longer wish to live? You really need to know this too so you can advocate for him. If this is his wish Then you must ensure no artificial hydration and nutrition inserted in a hospital setting (sometimes called tube feeding).

    It is about what things he would not want to live without being able to do. For my Dad it was if he was ever bed-ridden and unable to walk and do things for himself.

    Also ask why he is not taking his medication. perhaps he thinks they are making him sick or too hard to swallow - or simply no point to have them any more. It could well be time to have a decent doctor review and undergo a tabletectomy (joke teen - but the removal of tablets not considered essential items s a vital part of good medical care). A pharmacy review as well as they often find harmful interactions between drugs. I have known of aged hospital patients taken off all drugs as they were really ill. Then they could determine what were the actual problems and what were side effects of drug interactions.They got better very quickly and went home.

    Can you be held responsible for his malnutrition? No - Not if you are providing good care and offering food and medication. Don’t Force food. Offer small morsels he normally enjoys more often. It does not matter if it is fruit, yoghurt, custard, ice-cream. For my Dad it was ice cream, fruit and small tidbits of party food like cheese, gherkin, cabana, Cheerios, dip etc. with crackers or chips. ask him what he feels like.

    A nursing home having the same issue with a dementia resident was guided to stop forcing or putting any pressure on her and offer a small selection at each meal time - as this person could not say what they felt like. She began eating and put on weight.

  • +3

    I know I am late in answering this, but wanted to wish you the best. My dad passed away 3 yrs ago from lung cancer and he was mostly cared for at home, by my mother and myself. He wanted to spend as little time as possible in hospitals. His GP came to his home and discussed his condition and situation and what to expect with all the family. He then arranged for Blue Care Nurses to call in a couple of times a week to assist.
    Can your doctor arrange something similar? When they visit, they can offer your father his meds, food and drink, and if he doesn't wish to do so, they will take note. They will not force him and will treat him with respect, but at least a professional will witness his condition and will understand the situation. It will be good support for your mother as well, knowing that she and you are not solely responsible for his care and condition.
    I really tried to tempt my dad to eat, and found he would always welcome his favourite - a mango smoothie. He had a sweet tooth! No need to worry about the fat content at that time, he needed all the calories he could get so I was generous with the scoop of icecream. And I also sneaked some sustagen powder in there as well.

    • Absolutely … good advice. Witnesses are. A good idea as they can give care Tips too and provide equipment. That was why I suggested accepting plaliative Care. They can provide much more equipment. The education and resources and support they provide is wonderful. I am not sure if th3 Gold Coas5 has a home care outreach program. I side to have contacts within na$ 8nowl3dge of all the services in the state but I no longer do.

      If private, there is. Ahospice and they provide an outreach within the cmmunity too. Their medical support used to be GP’s whereas the public system I see palliative care specialists. .

      Yes, what they eat is irrelevant. My Dad was that ce-cream, fruit, and party food things like cheese, gherkins, dip etc.

      Boosting calories by using cream (eg n mashed potatoes or porridge) or adding whey protein concentrate is an excellent way to sneak. The prescribed supplementation stiff is awful. The Sustagen Dutch Cocoa is not a ba$ drink with milk.

  • Hospital doctor speaking. Discuss with your GP and get situation documented. Consider (ask GP for) referral to hospice who are often wonderful in these situations. Consider what makes your dad happiest. Best of luck.

  • +2

    It is a very hard time, EgoToSpare. My mother passed nearly three years ago and we felt we were very lucky that it was at Redlands Hospital. The patient liaison lady was fantastic and did a similar document to the AHCD with us that was a QHealth document. As soon as mum signed it and she had witnessed it, she made copies and made sure it was at the front of mum's file and also noted on QHealth records, just in case she was ever admitted to a different hospital.

    The AHCD is the most important thing you can get right now - but your dad's GP should sign off on it that he is competent to make the document. Talk to the GP and see what help you can get.

    The palliative care at Redlands was incredible - mum was given a room and we were told to bring whatever we wanted from home to make it 'her' room. There was no hospital 'machinery' in it - they gave pain meds but through the thigh and hidden so nothing looked clinical.

    Also - when a relative was at the end stage, she organised Karuna - they were incredible. They had volunteers that would be with her overnight so her mum could sleep. A Buddhist organisation, but with no preaching at all. All of the family developed an incredible respect for what they do. They have a palliative outreach team - not sure if they go as far as the Gold Coast (is this where your Dad is?), but worth checking in as they are Brisbane based and can tell you if there's a similar organisation in your area.

    Make sure you and your mum are taking care of yourselves as well - this is a very difficult time for all of you. Message me if I can assist further.

  • Go to your GP asap, explain the situation and request an ACAT assessment. It's highly likely the doctor will suggest this without you even asking. Your doctor may first refer you to a Geriatrician who may assess your Dad and request the ACAT assessment.

    ACAT:
    https://www.myagedcare.gov.au/eligibility-and-assessment/aca…

    An ACAT assessment is also a mandatory requirement should your Father's condition deteriorate and he needs to go into formal aged care, even respite temporary care.

    Does your Dad have any dementia? It seems based on the behaviour that there may be some.
    It's a difficult situation but your Dad may need to go into care if your family is unable to persuade him to eat/drink. It is also a massive stress on you and your Mum and it's unhealthy for you to be under stress for very long periods. I understand it's your Dad and it's so hard to not care for him yourself, but you have to think about both him and yourselves.

    You need professional assistance otherwise your Dad's life may be at risk. There is plenty of help out there. Your GP is always the best starting point.

    How do I know this? I've been through exactly the same situation not so long ago. Best of luck to you…

    • Sadly the standardsaged care funding are based on provid8mg nutrition to the point of causing stress at meal times. I know this from my own work but also with my Dad. Don’t get me started on the standard of Care! Communicaion etc.

      Palliative bed in a hospice or spevialist palliative care service is a better option for end of life - every time.

      Many services offer wonderful support at home. It is up to what the father’s preferences are.

      YES Acat Is useful should there b3. A need for respite should crater stress or illness mean it is needed. Additionally, there is. Arespit3 option that I sorivifpded every week for crater rest.

      OP - is your Dad a DVA gold card holder? If yes, then your options for respite and assistance are hugely increased as well as drivers to appointments etc., equipment and much more.

  • +2

    As others say - if he is mentally competent, then it's his choice.

    Have you had a frank conversation with him asking why he won't eat? Use the words "is it because you have decided the time has come to let go?"

    People appreciate others being straightforward when they are near death. Don't dance around the issue.

  • I'm very very sorry to hear this. Refusing food is a sign of the end. I'm not sure what you can do but hopefully some other comments here have helped you in your situation. You may just have to expect to worse and consider what you would want to happen if the roles were reversed.

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