I feel like Mom's primary doctor is winding her down. She isn't interested in any more blood testing. She doesn't think it is important to take any medications except for her prescriptions. Mom has stopped seeing her cancer surgeon, oncologist, ophthalmologist and dentist. The doctor wants me to change her pacemaker to remote monitoring. She is 91 and has late-stage dementia following a massive stroke in July 2014. She needs assistance with everything she does. I am her 24/7 caregiver. Her doctor hasn't made another appointment because she doesn't know if Mom can get there. I feel like I am just left alone with no support if something happens. I don't know if this means she thinks Mom doesn't have long to live or if this is normal in her age and condition.
All the same, I take your point that your mother is just as entitled as any other patient to person-centred, conscientious medical care. So, talk to the doctor. Ask her to explain her thinking and her clinical decision making. I think it is very likely that once you have discussed this thoroughly you will perhaps come to agree that it is in your mother's best interest not to be forced through more and more medical hoops for less and less benefit - but meanwhile, you're not satisfied and you are entitled to a clear explanation. I hope you'll get one.
No one seems to know what is happening with Mom...no one has found a medical reason for her steep decline lately.
I guess it just is what it is. The answer seems to be. "She's 90"
If you think she is ready for hospice, ask the doctor to approve a hospice evaluation. Call the best hospice in your area and ask them to do the evaluation. Once on hospice, there is a lot of support for you and your Mom. In my area, hospice sends an aide 2 hours a day, five days a week. A nurse comes about every 2 weeks, more frequently if needed. Spiritual counselors came for the patient and the family. There was a 24 hour hotline with a nurse for any issues. It provided extraordinary support. Get a list of hospice services for your area and call each one to see what services they provide. There is no additional charge for this if Mom is on Medicare. Good luck
I am sorry to say it, but dementia is a terminal condition. Many doctors would feel that no further blood work or other tests is warranted because no further treatment would be advised. You deserve a clear explanation from her doctor, and if you are not satisfied you are welcome to seek another opinion. (I suggest a geriatrician.)
Palliative care or hospice seems appropriate in late-stage dementia.
If your PCP is already approaching things from a palliative rather than curative point of view, and aiming to reduce the burden of interventions on your mother, then I expect she would actively welcome your addressing the issue. Doctors hate bringing up the subject of end of life care because they are scared of shocking or distressing patients and their relatives; but the fact is you need to know. Start the conversation.
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