Husband giving up again

Tell us a bit about yourself here.
Hi I have just found this forum and wishing I had sooner.

My husband has advanced COPD and a variety of other ailments including depression and anxiety. He is recently returned home from a 7 week hospital admission. He has an appointment at Papworth next week to discuss surgery he needs badly. Sadly I am worried we wont make it there.

Over last few days he has completely given up - refusing food and water or any other drinks. He refusing to get out of bed, except to use commode, and is extremelly lethargic. He has medication for depression and anxiety since GP visited yesterday. I am at my witd end so any suggestions on how to help him wouldnt go amiss !
I don't think t's unexpected that he is 'feeling his illness' at the moment, having had nearly two months in hospital. It can take a while to 'adjust' back to home life, and if coming home has reminded him painfully of 'happier times when he was not so ill' that might be making his mood even more down??

I'm glad he's on anti-depressants etc, but I wonder whether the meds he had in hospital have now changed, and that MIGHT be affecting his moods more, and maybe his dosage etc should be checked out for 'home life'??

Did he, for example, have a lot of painkillers in hospital, eg morphine, because 'coming off them' might be contributing to a mood dip??

Will the surgery at Papworth likely result in an improvement in his overall health, or is it designed to stop further decline? That, too, is likely to be depressing him. I think one of the things that chronically ill folk deplore is that they just get 'fed up' of being 'always ill and never better'. Once he was a fit young man - now he is no longer that. It's a kind of 'mourning' perhaps for the person he once was, that he can never fully be again??

In terms of food and drink, I think that the former is NOT so critical, but the latter definitely is! If he becomes dehydrated that leads to all sorts of further complications, and I would tell the GP right now, and keep that closely monitored so the doctor knows just what he is ingesting/drinking, and what not.

It would be nice to think that at some point 'normal hunger cues' will take over, but they can be masked by depression and illness.

Do you think that 'the more you fuss' the less 'cooperative' he is becoming?

I know you are worried- very understandably - but sometimes when others are visibly anxious over you, you become even more anxious yourself??
thanks Jennie,

Meds are same as in hospital, as they had to permanently increase/change them. He had been on them for 6 weeks prior to coming home. The op would be an improvement, but based on current condition it is unlikely to go ahead. We will know for sure when go to Papworth on Thursday, IF we get there! He hasnt got up for a week now and is refusing to go.

I have been using the tough love routine for a few days now, but so far it isnt working. The carers have tried to get him to wash/drink and have so far failed too. The doctors dont seem to be concerned yet! Our daughter in law (mental health nurse) came yesterday and had 'words', she told him in no uncertain terms, that if he doesnt drink he will end up in hospital again. His response - 'So what!'
Just an idea, have you tried giving him lollies and ice creams?
This might sound drastic, but I wonder if you should take the opposite approach? Instead of trying to get him to focus on staying alive with the best quality of life that he can achieve, especially if the operation is doable after all (do you think he was psychologically counting on it, and is now disappointed and frustrated it's unlikely, and that has made him 'sink like a stone'??), what would be the result if you basically said the following:

(I'm not saying use these words!)

'OK, so you are turning your face to the wall, and now are 'waiting for death'. Well, if that's s then there is a lot to sort out. I've drawn up a list and so far it covers - finances, life assurance, what to do with the house once it's gone, do you mind me remarrying, what do you want done with your stuff, shall I just give it to charity, do you have anything special, eg golf clubs/watch that you would like me to give to our children, or a good friend, to remember you by, oh, and what kind of funeral would you like, or don't you care, in which case I'll choose, and do you want burial/cremation etc etc, because if you don't express your preferences I'll choose for myself'

The idea is twofold - to hopefully 'shock' him into thinking' Hey, I don't want to go yet!' and also it does actually mean you might get answers you would need anyway, in that event.....
Rhona wrote:
Sun Aug 12, 2018 1:54 pm
Just an idea, have you tried giving him lollies and ice creams?
Yes I have Rhona.
Thanks Jennie

We have had a similar conversation a few times, so know most of the answers. However, it is always instigated by him. I will try your approach and see what happens.

You are of course spot on with his Psychological perception, it is understanding WHY he feels this way that is preventing me from getting angry with him. Or maybe I should??
It's a very difficult question - do 'we' simply accept that someone has reached the stage where staying alive has no value to them? After all, it is their life, and maybe they have a right to choose whether to give in or not.

On the other hand, when you have a family around you, you also have responsibilities to those who love you. I always say that the moment you have a child, your life ceases to be your own - you have no RIGHT to endanger it, because of the immense grief it would bring to your son and daughter. (eg, you don't have a right to pursue a dangerous hobby like mountain climbing!)(my husband got his pilot's licence, but would not fly once our son was born, as he knew it would not be fair to 'indulge' in a hobby that might deprive his son of his father)(I was OK by the way with him flying!)

So with your husband, I don't know whether he DOES have a 'right' to 'invite death before he needs to'? What do you feel about it, as of course you will be the one most affected by it.

I don't think, speaking only personally, that life 'per se' SHOULD be clung to, if someone does not wish to. Especially if 'quality of life' is poor and unimprovable. But that is only in the context of whether it would negatively affect others.

It's a question that affected me once my husband was diagnosed with terminal cancer, and I can still remember seeing him looking up on the Internet how to end one's life. He very naturally feared a 'bad end' from the cancer, and we discussed the 'trip to Switzerland' etc between us. I supported his determination to take matters into his own hand, if the alternative was a grim death. (We were 'fortunate' in the end in that the decision never had to be made - the cancer got him first, and very quickly, but blessedly painlessly)

All that sad, the 'rational' consideration of 'turning one's face to the wall' outlined above - eg, does your husband have the moral right to die before he needs to medically? - is itself almost hopelessly clouded once you bring in the issue of depression! Because once depression is in the frame, then how 'rational' can his thinking be about whether his quality of life is so poor he does not want to continue with it even if medical science can extend it? The depression itself is a major - probably overwhelmingly so alas - contributor to his poor quality of life....

It's a pernicious question. Do you feel that if he were not 'depressed' he would be more positive about doing everything in his power to keep going? Or do you feel it would be impossible for him NOT to be depressed by his grievous state of poor health anyway!!????