Re: Dementia Patient needing pacemaker

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none Re: Dementia Patient needing pacemaker

My father died two months ago at the age of 85, after struggling for 7 and a half years with the after-effects of a couple of large and many small strokes. For the first few years, he was semi-independent and could think, go for walks and to the local pool on his own. Without thinking it through, my mother and I (who both had medical power of attorney) agreed to the insertion of a pacemaker about two years in so that he could get through a hernia operation.
We regretted this very much during the last two years of his life, as his vascular dementia increased and he could no longer complete the simplest task, such as putting on his shoes, by himself. We feel we interfered with the natural course of his dying. There is often a relationship between the health of the heart and the health of the brain. Prolonging the survival of the heart when you can do nothing to promote the health of the brain was, in my opinion, a mistake.
He stayed home, and my mother's life, and his, was difficult beyond imagining. We learned only towards the end that the pacemaker had a TEN YEAR BATTERY LIFE! Not only that, but the surgeon who inserted the pacemaker would not cooperate at all when we asked to have it turned off. (This can be done ethically, legally and practically, but not all doctors, understandably, feel comfortable doing it.)
We think that as a result his last years were painful and prolonged. He finally died on a wonderful hospice unit of pneumonia. It was hard to watch. There is a possibility that without a pacemaker he could have died more quickly. A friend of mine is presently grieving the prolonged death of her mother, at age 87, following open heart surgery and the insertion of a pacemaker. In this case, however, she had all her marbles before the surgery. I recommend thinking this process through very carefully. Part of the problem is that Medicare reimburses doctors far better for surgery than it does for the painstaking emotional and physical care required to make these decisions with wisdom. Thank God my mother had a sympathetic General Physician.
I am also a writer and interested in hearing directly from people who are experiencing this dilemma.

Posted on 2008/6/18 19:56

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