Thank you for this question. I try to picture your mother-in-law. Is she old, is she fearful, is she in pain? Has she been stubborn, downtrodden, or trying so hard all of her life? Or is she one who has given up too easily? In times of old an elder might take to her bed for the rest of her life. It was a mystery to the rest of the family. It was often referred to as vapors.

Also, I try to picture you and your family. Trying to give bedside care is not easy at best. At the same time I am touched that you accept the task. At any time you could call an ambulance. Your mother-in-law could be taken to the emergency room and evaluated. But it is hard to go against the wishes of parents.

I think it would be good to get a geriatric care manager, or nurse practitioner or geriatric social worker for an assessment or evaluation. It often helps to get a view beyond the family circle. Your mother might tell a professional health care provider things that she won't tell the family. I once visited a woman and her daughter. As soon as the daughter left the room, the mother told me, "I am going to die soon, but I don't want my children to know."

If you are unable to get professional assistance, try to coax her for awhile. Try to connect her to a sense of her journey in life by surrounding her with her preferences. Would she be touched by a bouquet of her favorite blossoms, or the aroma? Would a soft fabric on her pillow help? Would nice lotion on her back and legs make her feel well enough to want to live? Does she like music or passages from the bible or a favorite poem? Some people like to look at pictures of family. Does she have friends who might visit?

After a time, if nothing works, you might have to respect her refusal.

Tell her, very gently, that you don't want her to die, but that you respect her right to choose. "Mother, we are afraid that you might die if you don't see the doctor." Try to open some communication. "Mother, I am afraid that if you don't eat and drink, that we will have to get hospice." Or you might even say, with love, "Mother, we want to care for you, but we have our own lives to live. We need to hire a caregiver to help you." Sometimes irritation is enlivening.

And if nothing works, you will have to let her go. Sit with her, hold her hand, help her get her affairs in order. Gently ask her what hymns she would like at her funeral. In a time, all too short, your time as a caregiver will be over. You will feel good knowing that you gave it all that you could.