Dear Carol: After being rushed to the emergency room, my 87-year-old mother was diagnosed with a major disease. She was stabilized and sent home with the information that without risky surgery, her life is limited. They were frank enough to say that while Mom would probably make it through the surgery, she won’t regain her present quality of life, so they aren’t advising it. Mom’s doctor agrees so she has declined the surgery and is home with hospice care, which is in keeping with her long-term thinking.

Though mourning her impending death, the family is at peace with her decision. What has me unsettled is the comments from people who feel that we should “make” her do everything possible to stay alive. One woman told me that Mom’s basically dying by suicide. You’ve addressed this before, but please say it again. People’s end-of-life wishes should be honored, right? — LW.

Dear LW: It’s sad that your mom had to make this choice, but she knows her own mind, and yes, her decision should be honored.

In the first place, her choice is a valid approach to end-of-life care. Additionally, this decision is between your mom, her doctors, her clergy if asked, and to some extent her family. Just for the record, she’s not dying by suicide — she’s allowing natural death to occur. There’s a major difference.

I want to make it clear to readers that those who want every procedure that could possibly prolong life should also have that choice, as well.

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When I’ve addressed this topic in the past, the argument has usually been between family members, which at least has some merit. In your mom’s case, hurtful comments are being made by people who have no business even speaking up.

Your situation reminds me of caregivers who write about cruel judgments regarding the decisions they’ve made for the welfare of their parents or spouse. This is especially prevalent in dementia care where such comments hurt the most. Here are the words that I used recently in one such column, and I believe it works in this situation as well:

“If these 'friends' don’t make an effort to enhance their short-sighted views and truly support you, limit the time you spend with them. If necessary, don’t see them at all, at least for the time being.”

I will add that you could also respond with, “Why would you say such a thing?” or something similar. Some people feel better after speaking up after hurtful comments, while others find doing so just adds to their stress. The bottom line is that when it comes to your mom’s health, people should either offer support or stay silent.

I’m sorry about her illness but I am happy for all of you that she was given the choice about how to respond to her diagnosis. She has chosen comfort care which, again, is completely valid. Keep making memories with your mom and count on hospice to smooth the way in her end-of-life care.

Carol Bradley Bursack is a veteran caregiver and an established columnist. She is also a blogger, and the author of “Minding Our Elders: Caregivers Share Their Personal Stories.” Bradley Bursack hosts a website supporting caregivers and elders at www.mindingourelders.com. She can be reached through the contact form on her website.