Husband has vascular dementia. He is in a MC facility. He recently had ischemic heart attack. Echo showed some blockage but minimal damage to heart. Doctor wanted to do cauterization under mild sedation. Spouse will easily become agitated and aggressive so I said no. he’s being treated with meds. What happens if he has another attack? What Would you do about the cauterization? He is not a cooperative patient? He doesn’t understand what is happening to him. He’s not able to adequately communicate? I have conservatorship.
My father also had vascular dementia and heart problems in his later years. Some procedures, like stent placement and a pacemaker, improved his daily life and made him more comfortable. His doctor was able to use anti-anxiety and sedation to make the experience of the procedures easier. More intrusive procedures, like coronary bypass, were withheld. One of the more difficult decisions for me was about a hip replacement: I was concerned Daddy would not be able to rehab properly after surgery. Because of the pain and limited mobility his hip was causing him, I very reluctantly allowed the surgery and to my surprise he rehabbed very well and enjoyed his new hip for a number of years.
In most cases, there is no "right" decision. There's only you making the best choice you can considering all the factors.
BUT--I am a 66 yo woman in basically good health. The procedure was long-ish but the sedation was about as minimal as it could get. I shook it off in a day, which is not normal for me.
If I were in a care facility, I would want palliative care only. Doesn't matter how old I am, I just wouldn't do it.
However, this is a decision you need to make for DH. There's no right or wrong--just a choice. But do your research and talk to the Dr about all possibilities of outcomes.
First thing you need to know is that, knowing your husband's deficits, they will almost certainly be able to medicate him to a level of comfort. Second thing I would tell you is that they can sometimes put in stents (think little tubes to hold sclerosed and narrowed arteries open more, thus increasing blood flow. This is non invasive and may benefit him.
THIRD things you need to know is that you have a right to have all of this and MORE explained by the cardiologist so you can make the best decision for your husband.
The reason I would not have this done is that were this my husband, and knowing now how he feels, he would not wish to survive long with mental impairment. Therefore, a heart attack giving him a final exit would not be my concern, and would be in some ways a deliverance he would wish. I felt the same about my brother who very much wished to die rather than face down decades of loss from his diagnosis of probable early Lewy's dementia. I was glad when sepsis too him in a relatively short amount of time. He had a good life. He would have hated mental losses and was already suffering them. I hate the idea FOR him.
So this is a personal decision. No one knows your husband better than you. The decision is now in your hands as to whether to do palliative or hospice care.
As to what happens with a heart attack? Each is as individual as your own thumb print. Some are deadly and some are not as you can see by your husband's current condition.
I am so sorry. This is such a dreadful things to be called upon to make a decision that MAY/May NOT be life threatening, or make a decision to move forward (because things can go wrong in these procedures as well. Nothing in medicine is benign).
I hope you have support. If the MDs will not take the FULL time to explain everything to you and help you with this decision then my answer would certainly be a hard NO. Good luck, Carchie