I have already posted a few questions, but I actually have a new problem (they seem to be unending at the present time). My father had his leg amputated late last year (a couple of days before new year's day). Now the bone is about to break the skin and protrude (if it hasn't already), and he needs surgery to correct his. I have not yet spoken to the doctor. He called and left a message saying that he needed to know what I WANTED TO DO about it. I guess I am going to be given a choice??? The concern is his numerous health problems and his advanced dementia. He is at a high risk for surgery (not a good candidate by any means). He pulled through the amputation and he was in not-so-good shape then, but he is even worse now. I mean he is looking frail. I just got a call from the NH on Monday/Tuesday saying that he was eligible for Hospice, and that means that they think he only has about 6 months to live. They are picking him up because of his advance dementia. I was told they could do the surgery while he is on hospice for comfort and pain measures, but his other leg may eventually need amputation as well (not now, though - and he may not live long enough for that). What should I do? Does anyone think they are going to ask me if I want him to have the revision surgery? I guess it is questionable and RISKY because of his health. If they are giving me a choice (I am his POA), then does anyone have any advice to share about what they think I should do? This is a no win situation. He keeps losing weight, and if he has more surgery, I guess the bone could very well protrude again and so on. What should I do?
However, concerning your dad, if the bone is exposed, it needs to be medically taken care of due to the risk of osteomyelitis that will effect other bones in his body. In my past experience as a RN (before I became disabled), the majority of competent physicians would use a local or spinal anesthetic on elderly patients whenever possible due to the all the risks related to general anesthesia. And, as far as pain is concerned, I believe that even although an individual is in the end stages of dementia or Alzheimer's can still FEEL pain.
My mother passed away in a nursing facility from complications of Alzheimer's and heart disease. Every visit with mom was a heartbreaking experience because every time the staff re-positioned her, she would cry out in pain. But, mom never lost her great sense of humor, even prior to her death, I could tell her a joke, and she would laugh so hard that she would have "tears of laughter." And, she NEVER forgot how to lovingly stroke my hair and give me a kiss right up until the very end of her life.
Just hang in there childofvet, and do what you think that your dad would want you to do!
God Bless!
I would talk to the hospice staff and see how confident they are that they can keep him comfortable and pain free without the surgery. If that is the purpose of the surgery and they feel they can achieve that without the risk and trauma of an operation, I think that is what I would decide.
With the dementia it is much harder to say that someone has 6 months or less to live. Medical professionals feel certain that he is in the final stage if they are recommending hospice, but it is hard to predict how long the final stage will last. You might want to discuss this specifically with the doctor who is recommending hospice.