My uncle is 82 and in sub-acute nursing home care. He has been there for about 10 days. He is refusing physical therapy and has signed an Advance Directive to stop all medications. He has eaten next to nothing in the last three weeks and also signed a directive that he is not to be force-fed or given water. He is still taking water and maybe a few bites of food at each meal.

His major problem is not being able to walk due to severe arthritis of the legs and hips. They tried to get him up into a wheel chair, but he says he finds it painful to sit. He wears a diaper but is able to use a urinal himself. He feels that his quality of life will never return to what it was. He was used to being fairly active up until about six weeks ago. He also has never been married and has no children. I am his niece, and he has a brother and a sister still living.

My question is this: What will happen to him next? If he continues to refuse food and liquids, what will happen to his body?

I visit each day for a couple of hours just to make sure he is clean and cared for, and to help him comb his hair, clean his partials, and watch TV with him. His basic needs are met by the staff. I told him that I will respect his decision but keep hoping that he will change his mind and try to get past the pain and take physical therapy to try to walk and sit again. His medications, which he now refuses to take, were basically for high blood pressure, high cholesterol, arthritis pain, and thyroid.

We keep telling him that if he would try to stand and walk again, he could come into our home and we would manage him and care for him here at home. He doesn't like the idea, even though he likes our family. He's stubborn, proud, and very embarrassed at the thought of having my husband and me care for and clean him, even though we have made it so clear to him that we would welcome the opportunity.