New Here -I am very impressed with the thoughtful replies and valuable information I find here. I understand a fair amount since I did a graduate degree in clinical psychology and then another in neurophysiology. But, I am in no way equipped or prepared to deal with my wife of 48-years who has been diagnosed with rapid onset dementia and Major Depressive Disorder.
Late May this year 66-year old wife fell and suffered several fractures. In mid-June she fractured her spine. She was prescribed many opioids, muscle relaxants, anti-depressants, anti-nausea meds. Early July had kyphoplasty surgery to repair spine. She suffered several adverse side effects due to drug interactions and her hypersensitivity to opioids. She has suffered three prior life threating head traumas with two near death episodes. She has also suffered seven fractures resulting in seven major surgeries in the last eight years.
Prior to the fall she was brilliant, athletic, highly educated women who was providing full care to me after my total knee replacement. She did all the shopping, house keeping, driving, appointment management. I had seen no signs of mental decline, forgetfulness, or any indicator of dementia.
By late July she was a zombie with severe cognitive disabilities, total loss of person, time, or place. She is now very confused, refuses to talk, won't eat or drink and refuses all medication. Her weight has dropped from 93-pounds (42 kg) to 65 pounds (29 kg) with a height of 65-inches (1.6m). She is a former body builder and elite long distance runner.
August Brain MR I(w/wo contrast)I and EEG studies found no organic problems.
She OD'd on Hydrocodone (Norco) in early September and barley survived with four doses of Narcan and a Narcan drip while in Intensive Care for 48 hours. She received 10-days of in patient psychiatric therapy after her OD but now refuses all treatment of any kind.
She is lucid at times and is very clear that she understands the consequences of not eating or drinking. Hospice Care (end of life care) had provided home care at times and has said death was imminent on two occasions. But, each time she regains her mental capacity, starts eating and drinking and saying she does not want to die. That lasts for a week or so but then she goes back to no food or liquid.
We have discussed her end of life wishes and she is adamant she wants no extraordinary life saving, or prolonging, efforts. She is also morally opposed to suicide. My brother, sister, niece, and her cousin have all killed themselves in the last two-years and she was very expressive with her disapproval. She says she does not want to kill herself but at times does say she is too tired to continue.
But - I wonder why does she start eating and drinking when she is close to death? Does she really want to die?
She asks for food but when I prepare her favorite things she hands them back and says "you need it - we don't have enough for both of us" or "I want to share with you so eat this". We are now and have always been very well off financially and our pantry is always over stocked with all her favorite foods. I show her the pantry and refrigerator contents but she tells me that is not real. At other times she refuses to talk for days at a time and just stares at the food.
I am at a loss as to how to care for her - she seems to understand the consequences of not eating but I am also convinced most of the not eating is due to confusion and her thinking we can't afford food.
Here in the states - there is almost no family support for these problems - I can place her in a "memory care" facility or hire a care giver to help at home but I can't seem to find any way to get her medical care, and am not sure if it would help. She is under the care of a neurologist and psychiatrist but both say she is uncooperative and there is nothing they can due to help.
Her advanced medical directives prevent me or hospice staff from taking any steps to prolong life so I have no idea how to move on from here. It seems all I can do is sit and wait for her inevitable death.
Late May this year 66-year old wife fell and suffered several fractures. In mid-June she fractured her spine. She was prescribed many opioids, muscle relaxants, anti-depressants, anti-nausea meds. Early July had kyphoplasty surgery to repair spine. She suffered several adverse side effects due to drug interactions and her hypersensitivity to opioids. She has suffered three prior life threating head traumas with two near death episodes. She has also suffered seven fractures resulting in seven major surgeries in the last eight years.
Prior to the fall she was brilliant, athletic, highly educated women who was providing full care to me after my total knee replacement. She did all the shopping, house keeping, driving, appointment management. I had seen no signs of mental decline, forgetfulness, or any indicator of dementia.
By late July she was a zombie with severe cognitive disabilities, total loss of person, time, or place. She is now very confused, refuses to talk, won't eat or drink and refuses all medication. Her weight has dropped from 93-pounds (42 kg) to 65 pounds (29 kg) with a height of 65-inches (1.6m). She is a former body builder and elite long distance runner.
August Brain MR I(w/wo contrast)I and EEG studies found no organic problems.
She OD'd on Hydrocodone (Norco) in early September and barley survived with four doses of Narcan and a Narcan drip while in Intensive Care for 48 hours. She received 10-days of in patient psychiatric therapy after her OD but now refuses all treatment of any kind.
She is lucid at times and is very clear that she understands the consequences of not eating or drinking. Hospice Care (end of life care) had provided home care at times and has said death was imminent on two occasions. But, each time she regains her mental capacity, starts eating and drinking and saying she does not want to die. That lasts for a week or so but then she goes back to no food or liquid.
We have discussed her end of life wishes and she is adamant she wants no extraordinary life saving, or prolonging, efforts. She is also morally opposed to suicide. My brother, sister, niece, and her cousin have all killed themselves in the last two-years and she was very expressive with her disapproval. She says she does not want to kill herself but at times does say she is too tired to continue.
But - I wonder why does she start eating and drinking when she is close to death? Does she really want to die?
She asks for food but when I prepare her favorite things she hands them back and says "you need it - we don't have enough for both of us" or "I want to share with you so eat this". We are now and have always been very well off financially and our pantry is always over stocked with all her favorite foods. I show her the pantry and refrigerator contents but she tells me that is not real. At other times she refuses to talk for days at a time and just stares at the food.
I am at a loss as to how to care for her - she seems to understand the consequences of not eating but I am also convinced most of the not eating is due to confusion and her thinking we can't afford food.
Here in the states - there is almost no family support for these problems - I can place her in a "memory care" facility or hire a care giver to help at home but I can't seem to find any way to get her medical care, and am not sure if it would help. She is under the care of a neurologist and psychiatrist but both say she is uncooperative and there is nothing they can due to help.
Her advanced medical directives prevent me or hospice staff from taking any steps to prolong life so I have no idea how to move on from here. It seems all I can do is sit and wait for her inevitable death.
