Terminally ill FIL wants to end his own life. What should we do?

[ConcernedDIL]

There is a fairly long back story here, but I need to tell it in order to get to my point...

My lovely FIL was diagnosed with a terminal illness three years ago. His original diagnosis was a rare form of dementia but that may or may not be re-diagnosed in the next month or so as a similar and equally debilitating and terminal illness.

The symptoms so far are loss of speech, loss of motor function, extreme tiredness, headaches, lethargy, depression, loss of confidence in a social situation and tremors. He has slowed down in every way possible. He gave up work last year and is on a steady decline. He spends his days at home but doesn't get up until around midday. On a good day he might be able to mow the lawn before collapsing in front of the TV, on a bad day he can't even get out of bed. The bad days are getting more and more regular.

Luckily, he has a very supportive wife and family - including sons who live locally, myself and two other DILs. Plus my 2year old DS, who he absolutely dotes on.

The prognosis is not good; he is expected to die within 5-9 years of diagnosis but as the illness is so rare there is no telling where on that path he is. What we do know is that there is much worse to come. Eventually he will need total care and may need to live in a home before his body gives up.

One of the strange things about his illness is that although he has deteriorated in so many ways, he has not "lost his marbles". It is more that he knows what he thinks but he is so stuck in a fog that he can't express it fluently, which is possibly more of a curse than a blessing.

Anyway, in the last couple of months, my MIL has discovered that he is considering ending his life. He has ordered a book and a DVD on the internet on how you can do it with helium at home by yourself. (BTW He refuses to consider Dignitas). As I say, he has not lost his marbles - one of the cruel things about his illness is he knows exactly what is happening to him.

MIL was utterly devastated about this. She has had time off work and been treated by her GP for shock. She uses a local support group which is of some help but what she really needed was time to think.

In an effort to help them both through this period, my MIL booked them a luxury holiday which they both enjoyed. There were some obvious difficulties but the holiday was well worth the effort, certainly for MIL. MIL returned feeling very positive.

Today, about 3 days after they returned from holiday, my FIL has said to MIL that he does not plan to be here in a years time and wants to end his life. She is very upset once again.

Their sons all know about their dad's feelings and although they do not want to lose their dad, they seem to all feel that if that is how he feels, they understand and do not want to stand in his way.

I have several questions...

In my mother in law's position WHAT WOULD YOU DO? He is not asking her to help him do the deed, but should she support him or try to dissuade him?

Do you have any advice for me / my DH and the rest of the family - how do we support both of them? (FIL doesn't want the rest of us to know about his current feelings)

Has anyone been in this situation and if so do you have any words of wisdom?

Sorry for the V long post, thank you for reading and for any advice you can give. x

Firstly so sorry about the situation you are in. Ive experienced Similar but different.

My father was treated for cancer and after the treatment he told me that if the cancer came back he'd kill himself. I was 18 when he told me this, had no idea what to do what the information so I just sat on it. As far as I know I was the only one he told.

So six years later he was diagnosed with the terminal form of the same cancer. I had what he'd said in the back of my mind but couldn't tell my mother who was barely coping with the diagnosis. But then strangely he didn't want to talk about dying, and was almost manical in his belief that there would be some sort of miracle. I wondered at times if this was a cover for planning suicide cos he had a period of sorting things out, trying to plan and leave things tidy . I tried to just make sure that I had no regrets about spending enough time with him, helping day to day etc, kinda in the knowledge that I could get the phone call at any time.

In the end he died naturally of terminal cancer and never mentioned suicide, even though he had more than enough drugs etc available if he wanted to. Watching him at the end of his life was horrific, I almost wished that he'd chosen suicide rather than the depressing, painful and indignified last month of his life.

Your FIL is an adult, and you say he is of sound mind. I think you have to respect his decision, sad though it is for all of you.

Wishing you strength x

Thankyou for your post. Interesting that you didn't talk to your father about it when the cancer returned.

My instincts tell me that talking about things is always the way forward. However, he didn't want my MIL to talk to us about it and although she needed to, she has asked that his sons don't discuss it with him. (and I don't think it is my place to do that anyway)

As I say my instincts say talking is always best but I wonder in this instance it is just too fragile and personal.

I think you need to respect his decision, and support him where you can, but you must not be involved in assisting him. You all need to be very careful about your involvement.
It's also important that your MIL talks to him now about what will happen financially if he takes his own life. Do they have a mortgage? How will she cope on a practical level?
Emotionally it will be very difficult whatever happens.

I agree that you need to respect his decision and offer support. Of course, you cannot help him physically, it's still illegal.

However, I have heard from those in the terminal care professions that towards the end, a lot of morphine is given to "help the patient". As this is a different disease and there is unlikely to be disease involved I'm not sure this is an option that will present itself to you.

I did have a friend facing a similar situation and he was advised by a medic to stock up on sleeping pills. He did this, and strangely, once he had the option of taking his own life whenever he chose, he no longer wanted to make that choice. I think he found comfort in having some control over when and where his passing would be, that it was his choice, and not the choice of the disease.

I agree with bagel monkey. I would get some advice from the organisation that used to be voluntary euthanasia society. I believe they changed their name.
I wonder why he won't consider Dignitas? the cost (around £7000) or the travel would put a lot of people off.
Good luck to all of you.

What a horrible situation for you and MIL.
If it was me dealing with this situation, the first thing I would do is keep the channels of communication open with my DH. Lots of people carry on as if this conversation never took place and this only alienates and isolates the person even more. For a proportion of people expressing suicidal thoughts it is actually a cry for help and want they really want is to open up the channels of communication and be able to talk frankly about how they are feeling.
I would tell my DH that I completely supported his decision and right to end his life, even though I didn't agree with it. I would then ask him if he would speak to his GP/psychiatrist/counsellor and and seek treatment for depression. If he didn't feel any better after a set time scale say 4 to 6 months then I would understand.
When people have a terminal illness often doctors treat any depression attached as 'to be expected' after all they are dying. This is completely unacceptable. There is a lot of data to suggest the terminally ill benefit from treatment for depression as much as the rest of us.
There is little in life more terrifying than facing your own mortality. People need time and space to speak honestly about their fears, this is why the hospice movement have been so successful in caring for cancer patients.
Lots of people with cancer assume that if their disease becomes terminal they would want to end it. Actually with the right support and care VERY few people actually feel like this.
Unfortunately the care for other diseases is often sadly lacking in comparison with cancer.
For you I think the best thing you can do is be there for your MIL and FIL. Try to encourage his to accept aggressive treatment in exactly the same way you would if he didn't have the underlying condition and was expressing the desire to kill himself.
Ultimately it is his decision and no body should die feeling all the complicated feelings you would expect AND guilt and shame because of their families feelings.
Good luck, it's a horrible situation for everyone.

This sounds such a sad situation .

On a practical note, what will happen to your MIL financially if he was to take his own life as I think life insurers don't pay out if a policy holder has committed suicide. Checking that out and then discussing it with your FIL (or your MIL discussing it with her DH) may be enough for him to have a rethink as I am sure he wouldn't want to leave his wife without financial support.

In my last paragraph I mean accept aggressive treatment for depression.

Thanks for all of the replies. With regards to the financial situation, my MIL has had to "get her house in order" early on in diagnosis of the disease. Because he has been diagnosed with a form of dementia, she now has power of attorney. He no longer works so there will be no further loss of income. Unfortunately they didn't have life insurance - I think it may even have paid out already if they had because he has such a horrendous disease.

So I don't think there are any concerns financially (in fact, if they don't need to use any money for caring she could perversely be better off, but that isn't even a consideration).

With regards to any of us helping him, that's not going to happen. He is a very proud man who dotes on his family and all the indications so far are that if he were to do this, he would do it himself. He has researched methods and I think he is still totally aware that he would put his family in a very compromised position if he were to ask any of us to help him. He just wouldn't do it. And to be honest, we all have to much to lose to do anything of the sort, regardless of the emotional and psychological issue involved. Although her situation is desperate, I don't think MIL would be capable or inclined to help him at all. The issue is whether he can "do the deed" himself before he gets too ill to. And I think the window in which he can do it is closing, which he is aware of and knows he needs to act on soon.

Daintynuts yes you are right about keeping lines of communication open betweem MIL and FIL. I think this is something that we need to coax MIL to do - it is such a horrendous thing to deal with I think the tendency is to ignore it and hope it goes away. Should their sons also be involved in the discussion or is that a step too far??? Also I know you say he should accept treatment but unfortunately for him, there is pretty much nothing. It is a complete f*cker of a disease.

ripsishere thanks for mentioning the voluntary euthanasia society - I will google.

I just want to be absolutely clear that none of us want FIL to do this. I just want some advice on how we can best deal with the situation.

(Starting to feel a bit twitchy about the legalities of even talking about this!!!)

Isn't that an awful thing? you are trying to do the best by your FIL and yet feel twitchy.
I honestly doubt that even if you helped in some way, you would suffer any punishment. You aren't professionals and won't gain financially. I hope you didn't think I was suggesting you would gain fiscally. I was horrified by the Dignitas cost. I stupidly thought it was free.
Look after yourself.

I meant accept aggressive treatment for depression. If you or I expressed a desire to commit suicide people would expect us to receive help. I don't see why your FIL shouldn't be the same.
I don't want to out myself on here but my job is treating cancer patients and I actively treat their associated depression, but my colleagues are often reluctant. The research suggests up to 2/3 of cancer patients are clinically depressed and are being let down by their clinicians. I consider anti-depressants as critical as anti-sickness tablets or ant-biotics. I also arrange counselling. Depression kills.
If someone ends their life and it is NOT through depression then I would feel I had done all I could.

I really feel for you all.

ripsis no I didn't take it the wrong way at all, it just suddenly occurred to me that my words could be misconstrued and used against me at a later date!

daintynuts yes I totally agree. He is currently being treated for depression and has been since the start, but due to his symptoms there is only so much medication he can have before it would exacerbate the situation - ie, make him even more out of it.

His GP and consultant are aware of his suicidal thoughts.

The thing is, that they're not suicidal thoughts in the normal sense, are they? Normally we associate those with people suffering tremendous depression or dreadful circumstances. He's actually being quite rational. What is the point of living if every aspect of your life is about suffering and causing others to suffer?

He's been a good FIL to you and you all need to be a good friend to him, now. Let him access someone to talk this over. Give him your permission, so to speak, to consider this option.

I've always thought life must be unbearable if you want to end it but physically can't do it and other people try to jolly you out of it. Give him some dignity and show true love.

I think if I was the FIL I would be very angry if folk implied it was just depression making me want to die. Probably not what DaintyNuts meant, but very risky it could come across that way. I'd feel like folk were ignoring my real feelings & wasting time until it might be too late to take the decision I wanted.

If he were my relative I'd try to get him to talk openly about what he wants and how he's feeling -- to everyone. Not judge any of that, make it clear no shame involved in any of his options.

If I were the FIL I think I would try to hang in for the sake of the MIL's feelings, but talk openly with her about what that would ultimately mean for her (to have to watch & endure).

I don't think I'd ever agree to live as long as I could through a dreadful terminal illness for the sake of someone else's feelings.