He is over 90 now, has not recognized the family for over 4 years. He is still given treatments for his diabetic condition and injections to encourage eating. Am I wrong to believe all meds should stop except to relieve any pain? I know he would not want to live like this. He is in an ALZ unit.
As weight drops, insulin needs to be adjusted. Mom's daily readings were normal with an occasional low dip in the mornings. Even so, she started having morning episodes where her mind would completely go. This went on for months. Sometimes they lasted into the afternoon. We were told it was likely lack of oxygen by the nurse even though her oxygen readings remained normal. I finally remembered a doctor once telling me insulin needs to be adjusted with weight so I demanded a HbA1C. Her insulin was not just lowered...they discovered she didn't need to be on it at all! A day later, our Mom was back. No more mindless morning episodes. This may not be the same in your case, but don't assume they are tracking his insulin as his weight drops. Ask to see his last HbA1C test results.
Mom was in Palliative Care at home for 11 months, then transitioned into hospice the last two weeks of her life. She was prescribed a pill to increase her appetite, but it didn't work. We took her off all her meds in increments. It was difficult because we had to acknowledge she was dying. First the vitamins went, then her allergy and acid reflux meds. We consulted the Palliative Care doctor when it came to her thyroid and heart meds, and she was taken off them when she transitioned into hospice. The only meds we continued to administer and increase were for pain.
Recommend a heart-to-heart talk with his doctor.
- you can't not treat diabetes, as far as controlling blood sugars from day to day goes at least.
- you can not give an appetite stimulant.
Why? Because... [thinking aloud]
Insulin and routine blood monitoring are basic systems maintenance, not onerous for the patient, not heroic, but preventing extremely unpleasant symptoms. To withdraw these would be at the same end of the spectrum as withdrawing food and water.
An appetite stimulant, on the other hand, goes beyond routine care and by implication anticipates a future where the patient, having "got back to normal," will resume his previous habits. Since that is not going to happen, there is no benefit to the patient in having his appetite stimulated in this way. Mind you: stimulating his appetite in other ways, such as offering well-presented treats, snacks and drinks, is still worth doing because any potential enjoyment is of value to him in itself.
But in principle, no I don't think you are wrong to want all medication to be withdrawn unless it is of demonstrable, realistic benefit to the person *as he is now.* Where you might want to stretch a little bit is in relating the person's present condition to what he would theoretically have thought tolerable when he was fit and of sound mind. He isn't the same person now, and his personal red lines will almost certainly have been re-drawn.
At some point it's not a matter of extending a person's life. It's about letting them go in peace, I believe.
They can help you make the decisions what to stop and what will be the result of stopping the medications.
Hospice will also provide medications that will relieve him of pain.
You will also have the support of a Nurse that will see him weekly, a CNA that will come in at least 2 times a week, maybe more and a Chaplain if you would like and a Social Worker.
You can talk to the director at the facility he is in and ask about the different Hospice organizations that are in your area. Then call each and "interview" them and ask for an assessment.
he will automatically will do it by if he chocks b/c they forget to eat & drink ...we gave my mom yogert = bad spelling sorry . so my stance was to help her as long as i could i do not think he really needs the diabetic stuff what difference is it going to make ..but to finish the meds off so be that but to keep giving him more so money is made no!! also his breathing is going more shallow ...but to treat the rattling a asthma inhaler can help i do say use that will help him to be more confortable they say it does not matter i think it does . my mom had dementia ..so you will know when to stop - when he chocks ok ..be more cautious then go very slow ..i did everything right for my mom ..use your feelings pay attention that will let you know to do the right thing or not ..god made us that we would know what to do or not ...unless you are deaf to your own feelings .dont seem that you are deaf good luck ..also if you have morphine to use they should give that to you or him ..that do not stop use when needed .do you have him on hospice care he needs to be on that ..my mom was for 3 weeks so ok by good luck
There is no hope for recovery from Alzheimer's disease and he is 90 years old. Death with dignity is what I think you want for him. Unfortunately, his doctors do have a monetary incentive to keep him alive and keep Medicare paying. It's perverse but, sadly, it is how our system has come to work.
Doctors do not have the final say especially when you and your family feel that their ongoing treatment of him goes against your family's cultural and/or religious beliefs and what you know his wishes would have been.
If you're his daughter or spouse, have a straight with his doctor. Doctors often err on the side of treatment and they need to clearly hear the immediate family's wishes with regard to over treatment.
One day we asked them to feed him and he threw it up and died later that day. Probably not the main reason, but hard to shake the guilt that our forcing him to eat killed him. But it may have been had we not encouraged eating he would have been more peaceful on his last day, whenever that would be.
Doctors and staff sometimes have rules that prolong life needlessly. Ask for a gerontologist and hospice advice to guide you.
May you and your family be at peace.
This morning I am going to pack a picnic lunch, and we will take our aluminum chairs and go sit by the river at one of the most photographed spots in the country here in Sedona.