Re: Dementia Patient needing pacemaker

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none Re: Dementia Patient needing pacemaker

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I am my 85 yr old mother's medical POA. Last January my sister and I made a decision to decline a pacemaker when she was transported to the ER from her assisted living with complete heart block. She has Alzheimer's and is well into the disease, though at the time she was fairly high functioning, meaning that she was in good health, fully continent, and able to carry on limited conversations.

It was a difficult decision to make, but we couldn't see prolonging her days in this terrible disease. We made the decision with little guidance. They didn't even give us a cardiac consult in the ER. It basically was a decision that we made with our hearts.

Mom was admitted at that time because she had Rhabdo and they treated her for that. During her hospital stay, I queried the Hospitalist about our decision. He hesitated, but finally came up with the words that he supported it. 24 hours later when I saw him again on my mom's floor, he told me that after having thought about it and having a chance to observe my mother more, that he fully supported the decision not to give her a pacemaker due to the degree of her dementia.

Mom has been through hell since then, including a 5 week stay in a geriatric psych unit to try to treat her increasingly aggressive behavior, and becoming very ill with c.diff which recurred twice and resulted in her losing 30 lbs.

Sometimes I wonder if we had given her the pacemaker if she would have had a little more blood flow to her brain that might have curbed her aggressive behavior. She came out of the psych hospital hallucinating and incontinent. She is off those meds now, but remains incontinent.

We recently put her on hospice (they took her on failure to thrive) to give her another layer of support since we declined the pacemaker 9 months ago.

I'd appreciate thoughts, comments or insight into the situation. I have a geriatric care manager who thinks mom should get the pacemaker even now. Mom CANNOT make decisions for herself, I have a neuropsych eval from a year ago that states that.

Posted on 2011/11/19 3:30

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