Former US first lady Barbara Bush is seriously ill and no longer wants to seek medical treatment.
The 92-year-old wife of US President George H. W. Bush is being cared for at her home in Houston, Texas after deciding she does not want to remain in hospital.
Bush has been in and out of hospital recently and is now in "failing health", according to a family spokesman.
"Following a recent series of hospitalisations, and after consulting her family and doctors, Mrs Bush, now age 92, has decided not to seek additional medical treatment and will instead focus on comfort care," the statement said.
"It will not surprise those who know her that Barbara Bush has been a rock in the face of her failing health, worrying not for herself - thanks to her abiding faith - but for others.