Barbara Bush, the wife of former US President George HW Bush, is in "failing health" and has decided to no longer seek medical treatment, the office of the ex-president says.
The statement issued by family spokesman Jim McGrath says the former first lady "will instead focus on comfort care". She is 92 years old.
The short statement on Sunday did not indicate the nature of Bush's illness but said that she had had a series of recent hospitalisations and had made the discussion after consulting her family and doctors.
"She is surrounded by a family she adores and appreciates the many kind messages and especially the prayers she is receiving," the statement added.
Bush is the mother of former President George W. Bush, 71, the 43rd US president.
Her husband, the 41st US president, is 93 years old.