Expert: Mary Gordon - 3/3/2009

Question
My mom is in the late stages of AD and is 78 and not in the best of health; however she can still swallow.  The problem is she has given up on eating and drinking and hasn't had anything substantial to eat or drink for the last couple of weeks.  She is on hospice but I am getting various answers to how long she has.  She is not in the best of health and has been taken off all her other medications, such as her hypothryoid replacemant hormone and baby aspirin.  She will also occassionally drink a little bit of the health shakes.  Does anyone have any opinion on the health shakes and if they are sustaining her life?  Does anyone have any experience with this type of dying process and how long it might take?

Thanks!

Answer
Hi Teresa

This is the really brutal part - for you, not her. The waiting is so hard, when you know there is only one possible outcome. The final phase was similar for my mother in law. She took in less and less food and drink, no matter how she was coaxed, and finally stopped entirely over a period of a couple of weeks. She wouldn't react at all if a spoon or cup was put to her lips, or would bat your hand away. She got weaker and weaker, slept more and more, and finally lapsed into a coma and passed away. She did not seem to be suffering - and she did not seem to feel hunger or thirst. She was very peaceful, and she passed with my husband (her only child) at her side. It took about 6 weeks in total. She was close to the same age as your mother.

Our culture really has trouble with just sitting by and letting death come. We think we should be doing something, and its hard to stop all the thoughts racing around in our heads, and just sit still and really be there fully present in the moment for our loved one.

If your mother in law is frail and thin to begin with, and has concurrent health issues to complicate things, the end will not be long. She will not be taking in enough to support life - the few calories she takes in from the shakes won't prolong things. Not drinking is actually more of an issue than not eating, since the kidneys will shut down and she'll go into a final spiral. My best guess would be 2-5 weeks. It seems like forever when you are living it I know.

My thoughts are with you. I know this is very hard to watch, but I really believe this is much, much harder on you and others who love her than it is on her. She is like a silvery balloon floating away, just tied to her body by the most slender of threads. Soon she will be free, and at peace. The merciful part is that I'm sure she is past all worry or fears or regrets. It won't be long now.

Hang in there. This is really a sacred time, if you can see it that way. You have your chance to hold her hand, and whisper in her ear how much you love her, and that it's okay to let go. Even if you aren't sure if she knows you are there, YOU know you are there. You will look back at this and know you did the right things and be at peace with it in your heart. The tide is going out, and her little boat is going to set sail.

Thinking of you

Mary G.