My Mom is 90 and has moderate dementia. She lives at home alone. She had asymptomatic Covid two weeks ago and was hospitalized. The doctors say she needs a pacemaker. She doesn’t seem to understand what is involved despite multiple explanations. She has a DNR and doesn’t want to prolong her life and is anti intervention. This is complicated as I live in a different country from her, am an only child, and she had very little family. What should we do?
She cannot do anything for herself any longer, and all she does in sit in her chair all day and complain that she wishes she were dead. She is now outliving her finances.
No one benefits from giving a 95 yo immobile, incontinent person a pacemaker besides the hospital and cardiologist.
I am personally against letting suffering go on and prolonging lives only to let us suffer more pain. Especially with dementia, which is mental torture in most cases. I wish I knew then what I know now. We are not meant to live forever, until we are shells of ourselves, just because medicine exists to keep the heart pumping.
Good luck to you, and rest easy if you let the pacemaker issue go. It sounds like you care very much about doing the right thing, but there comes time when medical intervention is...intervention. And not in our best interest. And even if hard for you to do--it was her wish.
I’m mentally exhausted with dealing my parents’ issues. Her getting this pacemaker was a really bad decision. God only knows what her daughters will need to deal with now. She wishes she was dead and the rest of her family is starting to wish it too.
My mom had a DNR and she underwent pacemaker implantation successfully. It was done under a local anesthesia. When she entered hospice, her doctor "turned off" the defibrillator, but that was more for us, her family's sake than hers. It was explained to me by her hospice team that her device would NOT keep her alive, but with the defibrillator on, it might shock her internally once she started her "transition", which would not cause her any pain, but can be distressing to family who see it.
If you are uncertain about this, I would talk to her cardiologist at length (or whatever doctor is recommending the procedure) and ask him/her all of these questions as well as voice any concerns you might have. Contact the doctor's office and see if they have an option for a Zoom meeting or some such video conference to talk about this. I would ask about the pros and cons of the procedure and garner enough information to make an educated decision rather than rely on the opinion of non-medical people who may not have the correct information.
No, SP. A pacemaker isn't a "defibrillator for the heart". Most pacemakers that are implemented also include an external defibrillator ***HOWEVER*** the defibrillator has the ability to be turned off in the doctor's office.
My mother had her pacemaker implanted at 85 years old with advanced congestive heart failure. It wasn't "sold" as a procedure to prolong her life; indeed, it did not prolong her life. Nor did it not keep her alive once she was actively dying. What it DID do was to manage her A-Fib, which was getting to the point of concern that she was going to stroke out. While her dying of a stroke at 85 would have been sad, the GREATER concern was what would happen if the stroke DIDN'T kill her. There was the possibility of paralysis, blindness, unable to swallow, and all the other lovely things that go hand in hand with a stroke.
Did it make her quality of life better? That depends on how you would rate that. It didn't make it possible for her to run marathons or leap tall building in a single bound. It did nothing to make it easier for her to breathe. But it kept her from having a catastrophic medical event that would most certainly have made her quality of life WORSE if she had survived it.
When the time came for mom to go into hospice, I took her to the cardiologist to have the defibrillator function disabled. The tech came in with his laptop, typed in a few things and told her "ok, it's off". I've paid online bills that were more complicated and invasive than that.
The OP should reach out to either mom's doctor, if OP has HIPPA privileges, or to whomever mom designated that and ask THEM if this procedure is medically necessary. What potentially could happen if mom doesn't have it, and what is the likelihood that it would actually happen? Those were always the first questions we asked when it came to my mom as she got older.
While I agree that there are many medical procedures that become redundant the older you get - the post about the man with advanced dementia being told by his doctor he needed a colonoscopy leaps to mind - I don't think a blanket "absolutely no treatments whatsoever" is the right way to go either.
You just contradicted yourself in your post. If the pacemaker was not intended to extend life, doctors wouldn't bother implanting them.
Seems pacemakers just make sure the heart beat normally. From what I understand, its a simple procedure. If it will help Mom feel better, I see no problem in getting the procedure done. But I don't think it prolongs life. When Dementia hits the part of the brain that controls heart and lungs, the person dies.
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