I need to know what to say to my granddad as he has expressed a want to end his life.

My dad is 83 yo with dementia living in an ALF. We lost our mom to Alzheimer’s last year- very hard on everyone especially our dad (there are 6 of us “kids”). Dad has always had a quiet wit and we have always enjoyed a good laugh- even to get through rough times. But more and more, his favorite phrase has been “just pull the plug “. He still walks around with a walker, bathes himself, eats regular food- but he knows his cognition is really starting to slide and I think it scares him. My siblings may handle it differently but my daughter ( his oldest granddaughter) and I say this to him -“You have outlived both of your parents by 25 years- that means you got to spend 25 more years helping your children grow up, educating them, attending all important family events, being a part of raising 9 grandchildren- that is something neither of your parents had the opportunity “. And I just try to emphasize (again, something that we were told over the years) that life is change, sometimes good, sometimes not so good, but change nonetheless and to be grateful for all of those opportunities that were denied YOUR parents. My daughter and I have a also made some photo albums with old family pictures (even ones of our mom’s growing up) which he enjoys looking through with one or more of us. I know the dementia will get worse and some of our most frank conversations are about the future, but I always try to spin the conversation back to the FACTS of a life simply well lived. And the best gift you can give your grandad (in my feeling) is your presence and your time.

You need to talk to his doctor. He is probably depressed especially if he still realizes he has a problem. My friends Dad would say "give me a gun". He was in a home, though. Wife had her health problems. Children scattered but my friend who had to work.

As I approach my "golden years," having observed family members in various states of disability and care needs, I have started to change my mind about assisted suicide--for myself, that is. Perhaps your grandfather would be interested in information about that, if it's legal where you live.
My heart goes out to you, and to him. It sounds like he's a very thoughtful, empathetic soul, who doesn't want to hurt or even discomfort others. Our USA society doesn't seem to have great provisions for old disabled folks who don't want to live as a burden on someone else.
It's hard to know what to say to him. I wish my family members would be receptive to such a discussion with me, but I don't have dementia (I think); so your situation with him is different. I think you just listen, ask questions so you understand his feelings about it, and answer his questions directly and honestly.
Many people would--wrongly, I think--refuse to talk about this, although the dementia may be a big factor in how you want to approach it. Personally, I think it's cruel to tell someone his concerns don't matter, that everything will be fine, etc., when he clearly knows that everything won't be fine. Perhaps asking him to explain his reasoning will bring to light situations that could be changed or explained to provide him with reassurance that the future won't be as bleak as he fears.
He and you are blessed that you have inherited his empathy, love and understanding. You will do and say the right things out of your love for him.

When I was growing up, it seemed like all the elderly people I was exposed to spoke of wanting to die. It was like a contagious disease. I remember it was a mantra that was largely ignored by their families. Like seriously, what could they say? I always thought these elders were looking for attention and recognition. Maybe it was true and they were, and maybe not.

However, when my mother was in a nursing home and suffered from dementia, she made a comment once about my grandfather (her father). It got me to thinking and I did some investigating of her papers. Fifty some years after the fact, I found out my beloved grandfather had hung himself in the garage of their home. Even though it was ancient history, I can tell you it was devastating. My mother was so far gone,I couldn’t ask her why he committed suicide and why it was hidden from me, even as an adult. It was scary. I remember telling my doctor and asking her if she thought this could be an inherited trait as I have children and grandchildren. For the rest of my life I will continue to be devastated by the knowledge of what my grandfather did to himself, and to me. It ultimately was a selfish act with little thought of consequences to those he left behind. I remember my grandmother stopped finding joy and happiness in everything she previously did. She stopped laughing. My mother was angry, haunted and nasty, especially to me, just entering my teens. I always assumed it was something I did. Now I understand, but it’s still very painful.

You can share what I’ve written here with your grandfather. Tell him to think of what sadness and upset he’d leave behind...for generations by committing this act.

Just the fact that Grandpa still reasons and can comprehend cause and effect, plus has control over his bladder and bowel movements leads me to believe his cognitive function is pretty high.
If he is of sound mind, he needs to write down his wishes, legally in the form of a will and medical directive (end of life directive).
You could establish a doctor/patient relationship with a medical professional in a state where assisted suicide is legal, and take a road trip when the time is right. Study up on the law of medical assisted suicide in that state and know what his rights are, and make a plan with Grandpa's wishes prior to him no longer being able to communicate his wishes. I believe most states require a terminal diagnoses, meaning that he has been medically diagnosed with a disease or illness that is fatal within the next 6 months. Dementia is not a fatal disease.
My hubby is 15 years younger than your Grandpa, diagnosed with Parkinson's Disease 10+ years ago, has been living with rapidly declining dementia for 2+ years, and no way can hubby communicate nor cognitively reason as well as Grandpa. He doesn't even believe he has any cognitive decline. His Geriatric Psychiatrist says most person's living with dementia don't recognize they have it. I guess we could call this a blessing in disguise. Hubby says sometimes that he wishes he was dead because he feels like he is living in a horror movie, but has never imagined nor expressed ways to follow through with suicide.

I know people who work in long term care and it is a well kept secret that many people have attempted suicide. Just because old people are closer to their natural end of life doesn't mean that we shouldn't take them seriously when they tell us they would rather be dead, especially concerning is the fact he has detailed plans about how to go about it. Please speak to his doctors about this or call a suicide hot line for advice.

You might find this of interest.


https://www.google.com/amp/s/amp.cnn.com/cnn/2018/05/10/health/david-goodall-australian-scientist-dies-intl/index.html

https://www.google.com/amp/s/news.sky.com/story/amp/my-final-hours-with-david-goodall-the-104-year-old-doctor-who-chose-to-die-11367408

I am not advocating suicide. I am saying it’s a real consideration for elders. Your grandfather might experience a certain amount of stress relief to be able to discuss this with someone. Medicare will pay for therapy. Maybe a visit with a licensed professional would help reduce his anxiety.
Sometimes just having a safe place to unload these thoughts can help.
A few sessions for yourself might help you learn to guide his conversation to help him release these thoughts.
Usually we recommend to distract a dementia sufferer from hallucinations or distraught ideations.
He does seem very aware for having had years of dementia.
The last two years of my mom’s life, she told a grandchild that she wished she had not had a pacemaker. She mistakenly thought it was keeping her alive.
I know it’s stressful to hear him being so tired of life.
Also you might try going to him for advice. Tell him your troubles and let him be of service to someone.
You might try interviewing him on camera. Asking him questions about his earliest memories. All of this not to stop his talk of suicide but to remind him of happier times. Make a cup of tea. Have a pen and paper. Take notes. Let him do 90% of the talking. Take your time. Hugs to you both.

Assisted suicide should be legal in all 50 states.

He does not want to get to the point where he can't do anything.

in such cases you have to take more care of your granddad because his mental state is not ok and in this stage he can do anything. so give him a proper care and assistance.

My dad said and felt the same way as his health was declining.
I had a hard time dealing with listening to his ideas on how he would kill himself. At first I was getting so upset I actually went into the bathroom and got sick. I was so upset with him and
didn't know how to deal with it.
One day dad was doing well. his dementia wasn't that bad. So
I decided to sit next to his bed and tell him how much I loved him. I explained how much it hurt me to hear he wanted to end his life. I explained to dad that when I was born you were there for me always, good and bad times. How he never let me down and how his shoulder was always there for me if I needed it. I told him I felt the same way as he did , I said I loved him endlessly and wanted to be there for the good and bad times. I said daddy, you saw me into this world with mommy now its my turn to
be there for you. please allow me to hold and love you to the very end.
my dad cried and told me he loved me and wanted me to be there for him.
Dad never spoke of hurting himself again. We cried and laughed till the very end. We were together holding each other when he took his last breath.
It has been one year since my dad passed. My mom passed three weeks later. I am heart broken but I have so many memories of my parents that will always be in my heart.
I miss them so much.

Hello. I dealt with this with my 92 y/o father. The way that I handled it with him, was to be a a super good listener, and Really listen to his thoughts, feelings,etc.
i chose to talk with his primary physician first. He was able to get me the name of a dr. Who supports death with dignity .
i had to remind my father that the dr. Determined that he did not qualify; must be 6 months or less to live (medical reasons) when he would forget and start talking about it again. That dr. Charged $420.00, yet it was reimbursed some time later.My reasoning for letting him talk to the Specialist, was because I felt that he had the right to know. I prefaced this with a statement of, “I want you to know that I love you, am not ready to lose you, yet I feel that he he had the right to know, and the decision was not mine, but his to make. Respect for his rights was important to me.
you also build trust with respecting his rights as a person, and treating him that way. Hope this helps.

My mom says the same kind of things. I tell her God isn’t done with her here on earth. I’m trying my best to keep you as comfortable as possible. And I need you in my life. I listen and I try to tell her that I will be doing the same thing. I treasure every moment with my mom and it doesn’t matter if I clean her but God knows she took the best of care of all of us, it’s my turn to take care of her. Praying for us all.
Susan

Great thread and replies. I have the type of mother who would always say this whenever she was disappointed in me, for 15 years or more (shout-out to anyone else who has one) but with brain decline it’s gotten worse. 1) please make sure he has a DNR; my mother still won’t sign one, which is crazy, and 2) there’s a lot to learn in the book Being Mortal by Atul Gawande, which I read because of recs on this site and it was very good - people will mostly want to die for not feeling like they have a purpose. Consider whether you can help find a purpose for grandpa. There are other good solutions above, but include this one. I haven't been able to help my mother with that, but I aim to.

This is a very real and profound question. I believe it comes down to how well supported you are as a caregiver. I would not have said this during my seven years as primary caregiver of my Mother living in my home till her death - with Alzheimer's Dementia and bowel cancer.

Take a look at the care team and support around HIM and YOU. What are the finances like? Does the family pull together? Are there good family caregiver programs and support around you and him? Explore the care team picture with him. Let him know you have it covered - if that is possible. If you are isolated and the care picture does not feel well supported you really have to check your own heart and intentions. This becomes a really personal decision - if you feel fully committed to changing the outcome and offering empathetic care to your Granddad. It's a slippery slope when you open your heart in that way and without the supports around you that slope can become a rabbit hole and you will not know where you will end up - perhaps a beautiful and or difficult place?
Good luck to you, you are a brave soul.

It is interesting how many elders express wanting to die. I think it is perfectly normal. Imagine yourself living in a place where you are just waiting out the days for life to end...there is no purpose in your life, no joy...just the existence of being alive with dementia and dependence. My dad often expresses the wish to die and when he does I just empathize and listen. I give his wish respect. If I was him, I’d want to go too. He’s 97 and lived a very good life up until a year ago. He is miserable now that he’s wheelchair bound, can’t walk, totally dependent and lonely in LTC. He misses all his friends. This is no way to end one's life. I agree that we should have the choice to control when we die. He wants "the good lord to take him" as he says and this is what I pray for. We are living too long past our expiration dates.

You need to talk to Granddad's physician. I had to put my DH on Zoloft for the last year of his life. He didn't want to die, DH's problem was he didn't want to leave me and it was worrying him too much.

I just learned there is actually a pill that can be taken to end your life - the VA makes it available to veterans - I don't know more because I only recently heard about it.

Your Granddad is probably extremely lonely and this doesn't help. If you want to help him, you need to see that he is receiving proper nutrition. I still remember back in the 70's when poor nutrition was linked to what was then called senile-dementia. After that report, you never hear of senile-dementia, it is all about Altzheimer's now. But seniors still need proper nutrition.

My DH lived to be 96 yrs 8 mos and until his body started shutting down, his brain was fairly well intact. He took the "dementia test" annually and still got high grades showing no dementia. But I made sure of his necessary nutritional needs. Sites like AgingCare helped me a lot.

I empathize with you but have no advice except to pray.

Grace + Peace,
Bob

This is probably going to induce strong feelings for a lot of people however I believe you’ll find this article helpful. I did. It’s about Rational Suicide.

https://www.nytimes.com/2018/08/31/health/suicide-elderly.html

Empathy, empathy, empathy. Reflect his feelings back to him in your own words so he hears that you get his hardship/pain. You might remind him of all his wonderful qualities that have made him special. If he has been courageous, recognize it and let him know as he’s being courageous now having to live with such uncertainties but still choosing the more moral path. Suicidal ideation is very common in the last phase of life. It sounds like he still has enough moral awareness of why suicide wouldn’t be ‘right’ so that is good. If you are worried about this, you can ask specifically if he has a plan and get a professional involved if he seems serious. Many elderly people express such thoughts without a genuine plan to self-harm. They’re often verbalizing this as a desired escape plan from further misery or anticipated pain. Ensure him there are ample meds available from hospices/physicians to minimize pain and discomfort. Try to distract him with photos or music that may be enjoyable to him and give him lots of affection if he responds well to that. Losing mental faculties and imagining pending death are pretty scary images. Maybe you can introduce comforting images or faith based (if he has a strong faith) images that are uplifting. Ultimately, what you have control over is what you do, not what he thinks. But you have s lot of power to help lift him up. All the best.

The Lancet Commission has a very interesting article on the value of death and how our society has gone to great lengths to devalue it. An excerpt from the article quotes the surgeon and writer Atul Gawande - “In the past few decades, medical science has rendered obsolete centuries of experience, tradition, and language about our mortality, and created a new difficulty for mankind: how to die.”

I was very surprised when my 90 year old FIL, who is in great health, said recently he would rather die than not be able to continue to do the things he always did. He recognized he was slowing down, which for him meant only walking 3 times around the perimeter of his property every day instead of 6! He isn't depressed at all, he's a happy person who enjoys life so his comment opened my eyes to how it must feel to lose the things that are important to someone's quality of life. He truly believes he has lived a good life and doesn't want to muck that up with a prolonged death. I sure hope he's around for many more healthy years but if not, I know he's OK with it and that makes it a little easier for me to accept.

I think it will help you if you get clear in your own head where your thoughts are on the matter. It can be hard to let go of loved ones, and for some their religious and personal beliefs seem to instruct holding on to life at all costs. Each person must square their response with their own beliefs and balance that against the needs of their loved one. For me the result of this thought process was this response to mom’s wishes for death: “I understand mom. And I promise not to try to make you stay. When you hear God calling, you should let go. We will all be OK here, and you will get to be with Grandma and Pop-Pop. Sis and I will take care of Dad till he comes to join you. I love you so much. Everything will be OK.” Wishing you wisdom, strength, and peace.

Assisted Living and Nursing Homes are making a lot of money from dementia not being considered a fatal condition with only six months to live. My RN daughter put her father, my ex, in a nursing home. He has Lewy Body dementia, and just lies there--he doesn't watch TV, he doesn't read, he rarely talks--yet his heart is sound, no trace of cancer. His meals are mostly Ensure. There was a brief period when he said he wanted "suicide pills" rather than spend the rest of his life in a nursing home. This isn't really life, and I don't want to put my children having to deal with me as well. I too am physically healthy at 81 but have one gene for Alzheimer's and worry constantly about me--but the window between realizing you have dementia and being able to kill yourself is very small. I don't know how to open it and jump out at the right time!

I have not read all the responses yet because I did not want my thoughts to be skewed
I am with your Grandpa.
I have thought about what plans I would carry out. I do have a "stash" of pills that I would consider taking.
Knowing what my Husband went through with his Dementia, what I went through caring for him the thought of sparing someone the ordeal of caring for me is a sound one. The thought of me not knowing who I was, my Grandkids, my friends I can not comprehend that.
There are states that allow "medically assisted suicide" the problem that I see is by the time you are "ready to end it" you may not be able to administer the drugs yourself and someone else would have to do it and that is the problem. So there is the same problem with my "stash" of pills. When I would most need to take them I might not be able to.

As for your Grandpa. If you can talk to him about this it might help. (Both him and you)
Tell him there are a number of things that have to be done first.
He needs to sign a POLST or DNR. A POLST is more detailed than a DNR. Either document needs to be signed by his doctor.
**At that doctor visit you should also discuss this with his doctor are antidepressants a possibility?**
Then the next steps for you to take with Grandpa is..All the rest of the paperwork Will, POA and anything else that might be required. (Is the house his? are there properties that need to be handled?)
Then you need to take him so he can help arrange his funeral. What does he want as a service, casket and burial or cremation, any other details. He should help write his obituary.
If he can accomplish all this I would be amazed. I know my Husband would not have been able to do this.
It is possible that your Grandpa is thinking of suicide because he feels he has no control. Getting some of these things done might put some control back in his court and he may realize he has a lot to do before he takes his life. Also doing these things will take time and we all know with Dementia time is the enemy and by the time he completes these things he may not physically be able to do what he wants to do. Or he may "forget" about the idea of suicide.

Share with him the absolute love of God of Israel; a love not of this world. Be respectful yet firm. You do not know how God will use him, and how is working in him simply because we are not God but his creation. God lives in us by faith.....you may be the person the Holy One would like to use. These could be the most fruitful times of his, and your life.

I am answering this only from my point of view & watching my mother suffer thru kidney failure. First I would like to say that I do consider myself somewhat of a christian, I dont like to walk around screaming it for my own personal reasons & I find that it can quickly be a turn off to some people. I can talk about the lord without scaring them to death..

That being said here is where I stand on this issue. I suffered a car accident in 1987 & believe me 42 surguries it has taken its toll. I do go to pain management every month & hate it with a passion. Everyone thinks that you can throw a antidepressent pill at the issue & that just isnt so. Yes, Im depressed, but mostly I hurt like hell 24/7.. Every single morning when I wake suicide is on my mind. Thats why I choose to respond to this message. Im sitting here now in terrible pain with hopes that my meds will kick in soon & I will feel better. But the issue remains, at what point will I choose to take my own life. Everyone says "O thats soo sad"., Well, yes it is but it is just how things are & they can't be changed. Neurpoathy in my feet so bad I can hardly walk, failed spinal fusion & failed cervical fusion. Yes, I could make the doctors richer by having more surgery, but an honest one will tell you that its not going to take care of the pain. And this Opoid crisis has totally destroyed the real ligitimate pain patients chances of getting help.

Then there was mom. Suffering from dementia & kidney failure. She lived with me & I took care of her for many years. She didnt want to go to a home & wanted to die in ours. I told her as long as I had a say in the matter she would/could do what she wanted. She actually stopped her dialysis on my 51st birthday. I could see it was taking its toll on her. She struggled to get ready every other morning, she suffered, she would often fall, but mostly she was in pain. A pain that many of us will hopefully never know how bad. When the Hospice RN came to talk to her on the day she quit dialysis she wanted to make sure mom knew what she was doing. When she ask that question, Now Miss Betty, do you know whats going to happen now? Do you know your going to DIE.. I about fell over..My heart was crushed..

But as much as we want to keep our loved ones here on earth it really isn't fair that we try and hold on to them for our own purposes. I think the real reason people talk about suicide is its a plea for help & sometimes its just a simple warning they are tired. In a sense mom took her own life by quitting dialysis. I just had to let her know that I supported her with what ever decision she would make while going outside out of her sight to cry over her decision. She passed 4 yr ago this month and she isn't in pain now.

I have some pretty crappy doctors but in a perfect world when I expressed how I was physically feeling they would listen, they would offer to help & not throw a nerve pill at me. Like I said, Im not depressed I'm in PAIN. Well, I guess I am depressed, anyone who suffers from chronic pain is depressed. I'm not suicidal I'm just a realist & I'm tired. I don't plan on jumping off that bridge just yet, for the moment I am planning on buying an RV and hitting the road before I do take that final leap. So when you granddad says things like this again, please PLEASE don't tell him he is being "SILLY", thats the WORST thing you can say. His problems are REAL & so is his PAIN. Perhaps just talk with him about what makes him feel this way & then see if there are things his doctors can give him to relive some of that. It may be that depression is his main problem, But JUST LISTEN & TALK with him not discounting anything he says. I remember mom asking me for a Xanax. I had to keep & give her all her meds. She said "Son, you just can't imagine what I'm going thru". No, even I couldnt imagine. She knew she was dying & had days. So shower him with love & listen to what he is saying. God Bless

the "system" would rather keep them alive as long as possible for the money the medical facilities can milk out of them. You could take him to his doctor and they will prescribe him a plethora of antidepressants to stop him talking like that. It's all about chemical control.

Since 1997, Oregon has had Death with Dignity.
https://www.oregon.gov/oha/ph/providerpartnerresources/evaluationresearch/deathwithdignityact/pages/faqs.aspx

My mother who is 93 and in pain every day from debilitating arthritis and neuropathies, has often expressed a wish to end it all. She says she is so tired of waking up each day to the same pain. She hates taking pills and questions why she needs to if they are not helping her. She does not even want to consider taking an antidepressant other than what she already takes.
I have come to the point...after 10 declining years being the main caregiver, of wanting to grant her wish. It is apparent that she has no quality of life. She sits home all day with three nurses taking shifts and I do her errands, cooking etc.
It made me squirm to hear her speak this way...my faith is against suicide. Yet, I look back at the dogs we had who were suffering and how it was apparent that the only choice was to humanely put them out of their misery.
Sadly, if we are religious, we cannot depend on our higher power, to be humane. For whatever reason we mortals cannot fathom...our loved ones suffer and suffer terribly and long. It actually makes me question my faith and want to scream in frustration that more horrible days lie ahead of my mother and all who love her.
Right now, I try to validate my mother's feelings. I say to her, "Yes, you are tired and in pain and it must feel horrible and I am so sorry about this." Then, after awhile of reflection, I try to distract her with family news or asking if she wants to play a game. I know this falls flat but is the only way I can help her deal with her situation.

Very, very difficult. But my initial thoughts are to have him participate as much as possible. Take out to a little cafe, go by a nice park, take him to a bakery, even to a museum. These are acts of love and even with dementia, I feel acts of love come forth and can be felt. It also keeps him, in some degree appreciating life. I had a woman in my apartment building who was getting dementia and I took to a senior center where they did volunteer work, mailing envelopes. She participated & had contact with other people and loved it. I feel that even with dementia, we should have people participate & appreciate life as much as possible. Again, you're going through a real difficult situation.