She was recently in hospital for impacted bowel after refusing to take laxatives for Diverticulitis, also has Aortic Stenosis and was released with a DNR, how can I deal with this as she finds everything so stressful, she also has Vascular Dementia. She is 87 I am 80 we live together with my son [50s] he is our main caregiver.
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Is your sister in horrific pain that cannot be managed with medication? Is she bedridden? Is she unable to dress, feed, or wash herself independently? Can she still wipe her own ass? Is she still able to speak, read, and go outside if she chooses to?
These are things to think about before helping a person end their life.
It sounds to me like your sister refused to do anything to help herself before the dementia. Like taking the laxatives the doctor prescribed so she got an impacted bowel. DId she always refuse mental health medication too? This is how my mother is. She won't allow anything that can actually help her. She'd rather get hysterical every five minutes, turn everything into a crisis, and wallow in her own misery rather than agree to anything that may help her. From what you say in your profile, your sister sounds a lot like this.
I went from being my mother's scapegoat that all the ills of the world was blamed on to being her caregiver. I'm done and walking away. She will be someone else's problem now. You and your son should do the same. Neither of you deserve to live with someone like your sister. I can imagine what your lives must be like. Day in and day out living in constant crisis with your sister asking you to help her take her life.
No way. Put her in a care facility. I think it's absolutely disgusting and the most selfish act anyone can commit is making their family swear oaths that they will never place them in care. They'd rather that family they claim to "love" so much give up everything and become slaves to their needs. I have never made such a promise and I never will nor would I expect anyone to make it to me. No one should ask the impossible of anyone.
Start looking into placement for your sister. You say your son is in his 50's. How many years is he supposed to sacrifice?
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Donutlover, you don't say whereabouts in the UK you are, but if it's England then you want to dig your way through the NHS website and/or your local authority website until you come across your multidisciplinary community teams. There you will find a special trouble-shooting squad called Bladder & Bowel. Your GP can refer you to them, and frankly given your sister's? friend's? dementia, incontinence, chronic disease and recent acute admission combined he probably already should have thought of this, but it sounds like he didn't and I can imagine you wouldn't fancy tackling him again. You may have to, but let's cross that bridge if we come to it.
Note: there may be a wait. These people are much in demand and thin on the ground, but it is worth some patience. If she can't get out to appointments they will come to her, bringing advice, explanations, reassurance and options - including free supplies delivered to the house if it's clinically justified.
You and your son are each of you entitled to a carer's assessment. This will come from Adult Social Services, who will ask you about the impact looking after the person has on your lives, and see what support might be available for you.
When exactly was she discharged from hospital? And what exactly does it say on her "Respect" form (they're purple, it's the one that says she's not for CPR). There should be quite a lot of possible support for her - it all depends on circumstances and on how things are organized where you live, but the services will *be* there, somewhere...
Anyway, I'm very relieved that you aren't thinking of how you can help her end her life! Your question as it appears was a bit alarming :)
Your promises to your sister were also made without knowing what the future would bring. Your sister may be happier and better cared for in a good facility. If she could have foreseen this future, that might be what she would have wanted herself. Sometimes the ‘golden promise’ can be a leg shackle as bad for both parties as an unhappy marriage.
It sounds more like anxiety is the problem that is setting off all the other problems. This could be helped with medication.
I don't know the laws where you are, but unless it is a doctor who oversees this process, do not do anything to hasten her death. Choosing a DNR is one thing. Asking someone to help you kill them is another.
As mentioned already, your sister does not have the cognition to request assisted suicide, so the best thing I think you can do is ensure she has some anti-anxiety medications. Get her to her doctor and be sure to give him all your concerns in writing before the appointment, so he knows what's going on before your sister's in the room.
You promised that, and I understand wanting to keep a promise. But the situation has changed, and now it is your son who is the primary caregiver, for both of you. I'm sure he didn't promise to never place her in a facility, and even if he did, it would be unrealistic to keep that promise forever. People get to the point where their needs exceed what their family members are capable of handling. It's simply not fair to your son to expect him to honor an unrealistic promise made a long time ago. Dementia can unfortunately escalate to some very unmanageable behaviors. I know of a woman with dementia who has taken to flinging her own fecal matter around when she doesn't get her way. She's in memory care, and the absolute saints who work there are able to deal with it. But I bring this up to show you what kind of behavior your son could be in for if you try to hold him to this old promise. Especially for a person whose condition is partially the result of some bad choices she made earlier in life. We all make some bad choices. I certainly have. But I wouldn't expect others to sacrifice their remaining good years because of those bad choices.
As for what to say to your sister when she's asking you to end her life, I see a couple of options. You could frankly tell her that there is no legal way for you to do that, and you are not comfortable doing something that could get you thrown in jail for the rest of your life (in reality, I doubt anybody would put an 80-year-old in jail, but who knows). The point is, you have a very valid reason for telling her "no."
But she has dementia, so another option is to keep telling her something that will satisfy her for now, and hope she forgets the whole business in time. You could say that you're doing research into it. You could say you've been in touch with a doctor in Canada who makes house calls to accomplish that. Say you're on his waiting list. And then keep saying it. "I just spoke to that Canadian doctor last night. He says he'll come as soon as there's an opening, but it might be a couple of months yet." She'll forget these conversations.
I'm sorry you're going through this. I'm sorry for your son, too. This can't be easy on him. Please, if he's asking you to do a certain thing like find a memory care facility for your sister, please listen to him and put his needs above hers. His quality of life matters too.
I have heard of demented old people that plotted to kill and ended up in prison for the criminally insane.
So it does happen, as it should.
"Yes the POA is for my sister, we live in UK and euthanasia is not really the answer I was looking for, sorry I was not clear I need to know how to distract her as she does not nor ever has listened to anything I say. She used to drink a lot and they seem to think this partially caused some of her problems."
At 87 her mental/cognitive state can be from any one of a variety of origins, so it really doesn't help anyone to try to analyze it at this point.
Empathize with her when she complains. Acknowledge that "aging is hard but we'll do everything we can to help make it better for you".
Do what AlvaDeer suggested. Meds for her anxiety/mood will help if she is prescribed the right ones in the right dosage. I wish you peace in your hearts on this journey.
There is no way currently, with your Sister's evidence of depression and her dementia, to avail yourselves of any such help as Dignitas or Pegasos in Switzerland. The process for documentation and mental evaluations is long and onerous, and the expenses are between 10,000 and 30,000 even for those able to tolerate the air travel. That would be even if you were in agreement and mentally well enough to make these decisions. Your sister has currently no disease that is incurable or that will certainly end her life in a six month period, so help in the USA even in states that allow right to die by law isn't possible.
Discuss with neuro-psyc any medications that may make life more tolerable for your poor sister.
As to the impacted bowel, a fleet oil enema will almost always work for evacuation of hard stool. It's messy so have lots of pads for the bed and adult incontinent wear handy. The oil will ooze out for some few days. Don't mistake the regular fleets enema and make certain it is the oil retention enema. Then see if sister will tolerate daily citrucel (not metamucil which ferments differently in the bowel and often causes gas and discomfort in the bowel) to keep stool moving daily. A stool softener such as colace may help.
I am so sorry for all you are both going through. I wish there was more help in our country for those who are well and tired, exhausted and finished with life, and who cannot go to their peace. My father, who had had a great life, was well into his 90s and able to discuss how exhausted he was, and how ready for peace. Those younger cannot understand these feelings until they get there, and often elder patients of mine while I was an RN would discuss how over it they were, and how they could not discuss these things with their families, who could not hear it.