Dementia Patient needing pacemaker

normal Dementia Patient needing pacemaker


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78-year old mother-in-law has dementia; severe short-term memory issues. Good physical health; she suffered heart attack at age 49 with bypass surgery. No major events in past 29 years. On routine trip to her cardiologist, doctor decides she needs a pacemaker. My wife and I are questioning whether this is the right option to pursue at this stage. We're consulting with regular physician for an additional opinion. Anyone have a similar encounter they might share?


Posted on 2007/11/27 23:52




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Hi, Soninlaw:

Sorry I didn't reply before now.

As I care for patients receiving pacemakers every working day, I would agree with your questioning. It is a quality of life issue that truly has to be made - most likely by you. There comes a time where the question needs to be asked to what end? This may not be that time for her (or for you). But, it is a question that needs to be asked.

My dad has dementia (among other conditions). He's more confused all the time. In my opinion, I don't think a pacemaker would be in his best interest. That's just me.

Best of luck and prayers to each of you!

Mike Davis


Posted on 2007/12/6 21:57


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Margie 

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I am in the same boat. It is not definate yet ( Dr is doing another test) but thinks my dad will need a pacer. He is 85 with dementia. Another Dr feels he can not make his own medical decision. I am not too sure. What's next?


Posted on 2008/5/4 14:57




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This subject has recurred several times. Probably we should post an article on it. As I said to son-in-law there are so many things where it comes down to personal choices, values, and the facts of an individual situation. Had my dad been offered an opportunity to have a pacemaker six months ago, I think (think being the operative word) that I would have felt that he should not get one, even though it may have bought him another month or year. Indeed, what kind of month or year would it have been? As of last week, he's gone. It's a good thing really, though hard.A life of incontinence, personal care done by strangers (or loved ones who have become strangers) would not have been a life for him.

Ultimately, no one knows what is best in these circumstances better than those who love this people purely and want the absolute best for him her.

As to making a decision, don't let doctors bully you or your loved one into a spot. They rarely know what's best for a loved one in these circumstances.

How do we make decisions like these? Gain the most information you can about the loved one's condition (the dementia AND the heart illness), the prognosis of both illnesses with and without treatment, the possible side-effects of the treatments, and the effects of the one illness on the other with the treatment.

For instance, if the dementia is worsening (or is projected to worsen), the pacemaker make take the natural course of the dementia and put it on steroids. The agitation that often attends dementia may only be made heightened and prolonged by the addition of a better functioning heart. Would this abide well with a loved one's values? The answer may be yes. I'm not one to say. But, would that heightening of the agitation and fears make your (your speaking rhetorically) loved one's life better or worse?

It's late and I've slept hardly at all the past several days so this may not make any sense at all. I sincerely do hope it helps. We will say prayers for all who have asked similar kinds of questions in the past several days.


Posted on 2008/5/7 23:39




katybutler 

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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




Katybutler 

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Dear poster, I would be interested in hearing how this worked out. My father was given a pacemaker in similar circumstances, and we later regretted it. Did you go ahead with surgery in the end, and how did things work out?
all best, Katy Butler


Posted on 2008/6/18 19:58




none Re: Dementia Patient needing pacemaker


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The device allows patients who live far from a major hospital to receive care from a cardiologist.Doctors keep tabs on their patients,who only need to come to hospital if something serious goes wrong.
One of the most common problems is a lead that needs adjustment on the pacemaker, or a low battery.These types of problems can be adjusted from afar.

<a http="www.google.com/">altered link</a>


Posted on 2009/1/30 0:27 | Last modified




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Three things:

First, you are correct. It is possible for a cardiologist to review the pacemaker functioning from a distant location. This applies, as well, to Internal Cardiac Defibrillators (ICDs). It is likewise true that when these devices have problems,it is sometimes due to a low battery or, rarely, a bad lead. It is possible to interrogate the device from a distance. I don't think it would be wise to make changes from a distance because if the heart rhythm starts to have problems there's no one there to treat the arrhythmia (unless it's interrogated from a local doctor's office).

But, with all due respect, that was not what this discussion was about. It was about the value of implanting a pacemaker in a person with dementia.

Finally, we do not allow postings of links - especially to Canadian pharmacies - on this web site. We call this forum spam. The link has been altered.

Thanks for the education on pacemakers. They are amazing devices and getting better all the time.

P.S. We have nothing against pharmacies in Canada (or anywhere else for that matter).


Posted on 2009/1/31 12:11 | Last modified




Guests 

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My friend Ralph lives alone - He just turned 85 years old will he need physical therapy after the surgury


Posted on 2009/7/6 13:58




daughter 

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My mom is 89 and had a pacemaker put in about 3 years ago while my dad was still alive. She was well into Alzheimer's at that time. For the last two weeks she has been in the hospital with a dramatic loss in functioning in which she is now asleep virtually all of the time, only waking for a few seconds at a time and keeping her eyes shut. This is also how she is when we feed her. Doctors think she probably has viral meningitis. The pacemaker is an issue which many in my family cannot even discuss. One thing is certain to me. When placing a pacemaker, conversations need to occur regarding the intent in using the device. I believe that when my father decided that my mother should get the pacemaker, he was only intending to prolong "good years" in her life. I don't think he was saying, "We'll get you a few more good years and that will probably be followed by several really bad years until the battery wears out."


Posted on 2009/10/17 20:06




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Thanks for your post, Daughter. Your suggestions are very wise. These kinds of discussions need to occur and fully hashed out: What are the benefits of a treatment? The burdens? Are we really only prolonging the long-term misery of dementia for the patient? If there are good years, how many can we really expect? And how "good" will they be? If there are bad years that will follow, how bad will they be and how long? Are we doing this for ourselves or really, truly for our loved one? I think each person has to answer these kinds of questions for himself/herself. At the same time, we owe it to our families to be clearer about our own expectations for our care so they get an idea about the kinds of values that inform our choices.

Thanks again for a great post...


Posted on 2009/10/25 4:35




jodie 

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I have read your article an I have the same problem. My Grandfather has a pacer and has had it for about 3 yrs. now he is in later stages of dementia. Is it legal to have it unhooked. His is pulling 99% and all he does is sits and stares.


Posted on 2009/10/29 16:43




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Dear Jodie:

Defibrillators and pacemakers can be turned off for compassionate purposes.

At our hospital in Texas, we do this a couple of times a year when the patient and/or family have decided that the device is undesirably prolonging life. There is nothing unethical about this if it is what the patient wants, or would want, if he/she is competent.

You should discuss this with your cardiologist. The procedure is easily done.

Certainly, the person choosing to do this must have the legal standing to make this choice. But, it is not in violation of any law and, if my father had been using a pacemaker in the latter days of his life and I had possessed Medical Power of Attorney, I would almost certainly have made that choice.

I hope this helps. Please repost if you have any further questions.

I wish you and your grandfather well...

Mike Davis


Posted on 2009/10/31 21:05




Guests 

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OMG,I would NEVER have let the doctors bully me had I had known what a horrible life my mother would have. my mother was 84 and was dyeing a natural death due to heart falure. She could not go to the bathroom ,bath herself ,see ,was a diabetic ,wheelchair bound,and had dementia.....WHY would any DR put a pacemaker into a woman who said NO!!!!!!! I was so used to hospice with my dad I just thought they would listen to her.....but no...they were on her ,and I being the only child became afraid of others judgement....her living will made not a differance,they did not consider a pacemaker "extraordinary means" wow..... she never thought this would happen,she has since been taken advantage of by a caretaker who robbed her,had 3 strokes ,is bed ridden we are broke for caregiving,emotionaly broken as well ,and I am always feeling judged. What ever happened ton a natural death in our country. Medicare wonders why they are broke?: give me a break!!!!! nto the DR who asked me "dont you want your mother to have a pacemaker?at 84 with my father gone.......I wish I would have had the guts to sayNO let her go be with God......because our lives have all been a living hell ,especially hers ........I want that DR to see her on Haldol 3 times a day because she is paranoid....... this is not my mom..... the medical field needs to get a grip...we are the first genaration to face keeping people alive at all costs.....even if it causes you to lose your dignaty,grace.life savings and your mental health.....Thanks alot.......wait until you are put in our position. no body want to see their parent like this.


Posted on 2010/3/11 1:07




pat 

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My father in law is 85 with Parkinsons and short term memory loss. He uses a wheelchair. Will the pacemaker that was put in him today cause his memory to be worse than it already is? So, you are saying, unless he dies from pneumonia he is guaranteed to stay alive like this for ten more years?


Posted on 2010/4/15 18:13




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Posted on 2010/6/17 22:18




deb 

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I think I am going to change my Living Will and put my own wishes specifically regarding a pacemaker.


Posted on 2010/6/20 23:14




BiBi Upstate Ukie 

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Thanks for all of the "Pacemaker" posts- looks like
I'll need to do some deep thinking, and broach this topic with my Health Care Proxies, and include some language in my Advanced Directive.

Good luck everyone.


Posted on 2010/6/24 10:02




Kathleen 

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Thanks for sharing all your stories. Today we were faced with the doctor wanting to put a pacemaker in my 80 year old father who has Alzheimer's. At this time, he cannot walk, feed himself and gets agitated easy. His heart has started to race and then slow way down. He doesn't feel it and you wouldn't know it was happening if he wasn't hooked up to a monitor. Putting a pacemaker will not slow down his disease nor does it sound like it will improve his life or my mother's who is is major caregiver. It will just prolong his lack of quality of life. It's a hard decision but I know this isn't quality life and why prolong the misery.


Posted on 2010/8/5 21:23




daughter in law 

none Re: Dementia Patient needing pacemaker

My 82 yr old father in law has progressive dementia due to a series of strokes over the past 8 years. He has lived in nursing home for 2 years now and requires total care. He is completely incontinent, cannot feed or dress himself and sleeps about 20-22 hours a day. He occasionally seems to be able to follow conversations but does not speak. He was hospitalized 1 week ago with a significantly low heart rate (in the 30's) and the doctors recommended a pace maker(even though he did not exhibit any symptoms of pain or distress). Against the recommendations of each of her children, my mother in law agreed to it. I am upset with the hospital. I feel that they took the easy way out. We directly requested the support of the medical staff and social workers to discuss the implications with her of how this may prolong his life and the quality of life he will have. They did not do that, instead deeming that he was capable of tolerating the medical procedure. So as far as they are concerned he is "cured." I believe this comes close to a violation of an ethical code of conduct doctors, nurses and medical social workers need to think through more thoroughly.


Posted on 2010/9/14 19:36




friend 

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My mom's friend is 65 yrs old with early signs of dementia, and she may need a pacemaker. Should my mom's friend get it? Thank you


Posted on 2010/10/2 2:25




Friend 

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My previous post was: My mom's friend is 65 yrs old with early signs of dementia, and she may need a pacemaker. Should my mom's friend get it? Thank you

My second question is: To the people with their family members suffering from dementia. Was is Alzheimer? If not what type of dementia was it?

Thank you. I would really appreciate anybody's help on this.


Posted on 2010/10/2 16:31




none Re: Dementia Patient needing pacemaker

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Regarding your friend's mother who is in the early stages of dementia and who is relatively young - 65 - that may need a pacemaker . . .

One question we would ask is whether this person ever completed a living will and expressed her desires about what type of medical care she would want in this type of situation. Having said that, because your friend's mother is young and in early stages of dementia, a pacemaker may improve the quality of life in the coming years. It's hard to know how to answer this from your message, however, your friend should ask her mother's doctor questions relating to how serious is the need for a pacemaker, if she did not have the procedure what might be short term and long term consequences, etc. Perhaps your friend should also talk with the doctor that diagnosed her mother, as this doctor may offer more information relating to the impact this type of surgery may have on her mother, physically and cognitively.

I do hope that your friend is able to get all the information needed to make an informed decision about getting a pacemaker - from all the doctor's involved with her mother's care . . .

You're a great friend to be asking these questions too!
Barb
4Hope


Posted on 2010/10/7 9:26




Tan 

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My dad needs another pacer at 84 , he has dementia and is incontinent.I have already been taking care of him for 12 yrs.I have regular power of attorney and they said if he wants another he gets one.He does not have the capacity to see the long term effects this will have on himself and the family.He has been hit by cars twice and they want him to make decisions.I also think it is unethical and irresponsible for the medical system to just throw pacers into anybody.Any profession has to do things that make sense whether it is a mechanic ,lawyer or refrigeration etc. Since when do doctors not have to answer to anybody for the irresponsible acts they are doing ? That little surgery is going to ruin my dads and my life.Just let people die in peace,you cant live forever.


Posted on 2011/6/30 15:20




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I'm sorry to hear about what your dad is going through. It frustrates me that this isn't talked about more. It needs to be addressed. And, sometimes - maybe a lot - physicians do run roughshod over patients.

Therein lies the case for advance care planning.

Advance care planning hopes that physicians are speaking with their patients (and hopefully patients with their families) openly and honestly about their futures, preferences, values and ideals, especially as they age. Unfortunately, no one - not physicians, not patients, not families - wants to have these conversations, until there are few, if any, alternatives. Advance Care Planning tries to anticipate what is coming down the road and make sure that legal and familial preparations have been made.

In your case, I guess the issue boils down to capacity: Does he have the capacity to make decisions for himself? In this respect, you are in an incredibly difficult position. Only a physician can assess capacity, the ability to appreciate the burdens, benefits, treatment options available to your dad, and possible outcomes with any treatment. I'm sure you know all this. I'm just trying to lay out the landscape of the legal difficulties for anyone who isn't familiar with what you're saying. This has the nasty consequence that the physician who is going to be placing the device is also the one who determines whether he has capacity.

You mention that he does not have the capacity to see the long-term results. This is the core question: I suspect that if you can find some legal way to prove your assertion of his incompetence, you might have some legal options via a psychiatrist and a lawyer. Personally, I'd like to see some of these circumstances be addressed in a legal setting.

I wish that he finds peace and that those charged with helping him be at ease will do what is right.

You may find the following article of interest:

http://www.mayoclinicproceedings.com/content/78/8/959.full.pdf


Posted on 2011/7/2 3:30




kathylock 

none Re: Dementia Patient needing pacemaker

My father is 85 yo with dementia/alzheimers disease. My mom has been caring for him for 12 years. His heartrate is down to 40. The RNP called me this week and said he should have a pacemaker. I wanted to ask her if she was crazy.

She tried to tell me that if i don't get the pacemaker he could have a heart attack or stroke and then would be in worse shape then he is now. That just added pressure to get a pacemaker for a man that doesn't know his family and sits in a chair all day. It is pathetic. My Daddy left years ago.

I talk to my Mom about it tomorrow but I think he couldn't even make it through a procedure like that. All I can do is pray that God will give us the answer. K


Posted on 2011/10/14 18:48




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I'm hoping that your talk with your mother helped with the decision about a pacemaker for your father.

I was wondering if your father ever completed an advanced directive before his dementia or ever talked about how he would want to be cared for if some health or medical crisis occurred. If not, then it's harder to choose what is best for him . . but if you knew your dad well enough when he did not have dementia and knew what was important to him regarding quality of life and have all the information you need from a doctor about the risk/benefit considerations of such a procedure - as well as your mother's feelings about all this then maybe it will help with the decision.

And I agree with you that the surgery itself would be hard for your dad - even being hospitalized when a person has dementia is an ordeal in itself!!

I'm sorry that you and your parents are having to deal with this now . . . I, too, pray that all will be for the best for your dad. Please take care,
Barb (4 hope)


Posted on 2011/10/20 12:58




katybutler 

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I am amazed at all the posts since I posted last several years ago about our family's dilemma. It's a tough situation. I encourage everyone with a demented parent "needing" a pacemaker to read "What Broke My Father's Heart," a detailed investigation of this issue in the New York Times magazine in June 2010. (Google "What Broke My Father's Heart" AND "New York Times" and it should pop up. )
My mother and I finally asked my father's doctor to deactivate his pacemaker. It can be done painlessly, without surgery. According to US law and medical ethics, a patient has the right to request the withdrawal of any medical treatment, and family members (or others) who have been named in a durable power of attorney document have the right to request withdrawal IF the patient is incompetent AND would have wished to have the pacemaker withdrawn in such circumstances when he or she was in his/her right mind. That doesn't make it easy. The cardiology associations issued a joint ethical statement in May 2010 saying that this is neither assisted suicide nor euthanasia.
If you are having trouble, ask to be referred to the palliative care department or the ethics committee at the hospital, if there is one, or hospice, or look for a more sympathetic cardiologist. Better yet, go deep into your own moral values and resist the devices when dementia is on the horizon, if prolonging misery this way goes against your moral values or common sense. We were pressured into the pacemaker and were unable to persuade my father's cardiologist to turn it off later, and my father finally died of pneumonia on a hospice unit. One way or another, the end of life is often painful, and don't be guilt-tripped into thinking medicine can postpone death and suffering forever. There are worst fates than death, and I have seen them -- as have many of you.


Posted on 2011/10/25 22:44




katybutler 

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Kathylock -- please trust your instincts on this. In my opinion, you are right, it is crazy.

We were told that if my father didn't keep his pacemaker going, he might get dizzy and fall and break a hip. But as time passed and he declined further, he fell frequently anyway due to old age and the dwindles. It is likely your father will proceed through one form of suffering or another as he dies. But at this point, we are thinking about exchanging one form of death for another, not of somehow magically restoring your father with any device, to who he used to be, as you know.
There comes a point where we are no longer "saving" a life, but prolonging a death.


Posted on 2011/10/25 22:49




freshfallensnow2002 

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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




freshfallensnow2002 

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The smiley faces were accidental...I feel anything but happy now.


Posted on 2011/11/19 3:39




gradd22 

none Re: Dementia Patient needing pacemaker

Dear Freshfallensnow,

You made the right choice! My family chose a pacemaker for my grandmother with Alzheimer's and it did not improve the blood flow to her brain and her quality of life has only continued to decline until she is now suffering a slow death. Even after the pacemaker we went through the stages of aggression, Haldol, and many of the other issues mentioned on this thread. Western medicine should not needlessly extend life!

Peace to you and your mom.


Posted on 2012/1/6 8:19




none Re: Dementia Patient needing pacemaker

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The previous post seems accurate to me. We should not needlessly extend life. It has, sadly, become an end in itself.

Barb could speak to this better than I can, but even if blood flow to the brain were to be increased, due to the nature of Alzheimer's, it would not improve the thinking process. The problem is actually on a cellular level.

Prayers, good wishes for all of you and your dear loved ones.


Posted on 2012/1/17 14:48




Guests 

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My mom just turned 87 and is living in an assisted living facility. She has dementia. Her short term memory is failing..She can do all her ADL's with supervision. Her heart rate slows down to the point she passes out. THis has been going on for years. She has had several cardio consults and some say yes to a pacer and some say no..I am worried if she doesn't get one she will fall and fx a hip. We all know what that means in the elderly. Any advice?


Posted on 2012/2/26 12:57




Charlie 

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My 77 year old mother in law has had Vascular Dementia for 9 years. She is now in a nursing home in the late stages, very confused, bed ridden (turner every few hours, double-incontinence, hallucinations. She eats a few spoonfuls of food a day & minimal fluids.
She recently had a hospital appointment to check the life of her pacemaker. This was very traumatic for her as she had to be taken to the hospital on a stretcher. The hospital advised us that the battery has approx 4 months life left in it & that we need to look at replacing it. My husband & I advised the hospital that we were not sure whether this would be of value to my mother in law to simply keep her alive in this state for a longer period of time.
We have made an appointment at our GPs to discuss our options as my husband feels like he is almost giving his mum a death-sentence if he chooses to not have the battery replaced.
I believe that my mother in law originally had the pacemaker put in for ventricular fibrillation - eratic heart beat.
I am not clear whether the heart would simply stop in approx 4 months as this pacemaker has been regulating her heart beat?
Can anyone help?


Posted on 2012/8/28 4:26




nancybelknap 

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Quote:

Charlie wrotes:
My 77 year old mother in law has had Vascular Dementia for 9 years. She is now in a nursing home in the late stages, very confused, bed ridden (turner every few hours, double-incontinence, hallucinations. She eats a few spoonfuls of food a day & minimal fluids.
She recently had a hospital appointment to check the life of her pacemaker. This was very traumatic for her as she had to be taken to the hospital on a stretcher. The hospital advised us that the battery has approx 4 months life left in it & that we need to look at replacing it. My husband & I advised the hospital that we were not sure whether this would be of value to my mother in law to simply keep her alive in this state for a longer period of time.
We have made an appointment at our GPs to discuss our options as my husband feels like he is almost giving his mum a death-sentence if he chooses to not have the battery replaced.
I believe that my mother in law originally had the pacemaker put in for ventricular fibrillation - eratic heart beat.
I am not clear whether the heart would simply stop in approx 4 months as this pacemaker has been regulating her heart beat?
Can anyone help?



Posted on 2012/12/12 5:39




nancybelknap 

normal Re: Dementia Patient needing pacemaker battery change

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Quote:

Charlie wrotes:
My 77 year old mother in law has had Vascular Dementia for 9 years. She is now in a nursing home in the late stages, very confused, bed ridden (turner every few hours, double-incontinence, hallucinations. She eats a few spoonfuls of food a day & minimal fluids.
She recently had a hospital appointment to check the life of her pacemaker. This was very traumatic for her as she had to be taken to the hospital on a stretcher. The hospital advised us that the battery has approx 4 months life left in it & that we need to look at replacing it. My husband & I advised the hospital that we were not sure whether this would be of value to my mother in law to simply keep her alive in this state for a longer period of time.
We have made an appointment at our GPs to discuss our options as my husband feels like he is almost giving his mum a death-sentence if he chooses to not have the battery replaced.
I believe that my mother in law originally had the pacemaker put in for ventricular fibrillation - eratic heart beat.
I am not clear whether the heart would simply stop in approx 4 months as this pacemaker has been regulating her heart beat?
Can anyone help?



Posted on 2012/12/12 5:39




Kathie 

none Re: Dementia Patient needing pacemaker

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My mother is lost to us but is a gift to the medical society. Had you known her you would have, whether you liked her or not, seen a great person. Full of warmth and intelligence and self worth. She now lays most days on the carpet in the assisted living center picking at the pattern of the carpeting or the tiles. She is short tempered. She is so afraid and she hungers constantly for something she can't name. She babbles but we can't follow her thinking and even if we could, she does not notice when we try to interact. Her cardiologist just had the self serving .... To say that shutting off her pacemaker would be unethical. My mother has a living will that specifically says no artificial interference with the end of her life. How can the piece of plastic with a battery be anything but that? Tell me how to save my mother from anymore hurt! Kathie and my sister Julie and my brother Darryl and most of all,my father, Don.


Posted on 2012/12/13 22:22




Kathie 

none Re: Dementia Patient needing pacemaker

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Nancy, I read your question and I hope you don't allow them to replace the battery. There is a difference between keeping a person alive and keeping a body alive. Only you and your family, if you were close, know if your mother is having a life. What is so difficult to think and to write is that living can become worthless to the person forced to be "alive" when there is no "life". It isn't about money or ethics or any other trumped up guilt trip. It is about quality of life and goodness. Did your mother have a "good" moment this month?


Posted on 2012/12/13 22:43




caregiver 

none Re: Dementia Patient needing pacemaker

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My 83-year-old father has dementia and his cardiologist recommended a pacemaker for his afib -- similar to other posts here. After reading Katy Butler's NYTimes piece, I declined. I could tell the cardiologist thought I was standing in the way of my father's care -- but the truth is, my father felt strongly his whole life that, should he develop dementia, his suffering should not be prolonged. And our whole family is suffering terribly with the toll of the Alzheimer's -- just an immense and incalculable price to pay for maintaining my father's needs and wants. His dementia is moderate -- he is incontinent and child-like, with a low level of comprehension concerning what's going on in the world around him. A sad loss given that he was for many years a brilliant MIT professor. I fear what lies ahead. Should his heart give out before he has to experience the worst, it would be a blessing.

Thanks, Ms. Butler, for having the courage to write so movingly about your parents. You made a difference for us.


Posted on 2013/5/22 17:44




Concerned Daughter 

none Re: Dementia Patient needing pacemaker

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My dad is 81 & suffers from dementia. He lives in a board and care with 2 other Alzheimer/Dementia patients about 5 minutes from my husband & I. Today I took him to have his pacemaker checked & was told he has 6 months battery life left. My sister & I feel he would not want it changed. He is divorced from our mom but they were always good friends. She supports our decision. Other family members think it's wrong and we are playing G-d If our dad knew how he was he would not want to live. Please give us your opinion.
Thanks


Posted on 2013/6/18 0:34




suburbanLAmom 

none mom is 95 with pacemaker, now hospitalized, suffering needlessly

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Mom is 95, diabetic, incontinent (both), lives with us and has part time caregivers come in for help with bathing, eating and attempts at PT. She had a bad cold which became pneumonia, and is now in hospital.
Doctor says if she did not have her pacer, she would already have passed away. Now, she is in a lot of pain, has become confused, her strength greatly decreased, cannot eat, is catheterized, and we are all suffering but not as much as she is! We wish she could just have the pacer disconnected but that is not possible. We pray the angels come to to take her soon.


Posted on 2014/1/14 0:25




none Re: Dementia Patient needing pacemaker

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Webmaster
Joined:
2003/4/26
From: Dallas
Posts: 261
Dear SuburbanLAmom:

We are not responding to posts on ElderHope anymore. We don't have time. We are so busy in our work live in health care that we cannot do any more. But, as I read your post, which I would only have done if unusual circumstances had come along, I wanted to offer further insight.

I'm sorry you're going through all this and that all of you are suffering so.

I can speak with authority on this. You do NOT have to physically disconnect or remove pacemakers. Pacemakers and defibrillators can be electronically turned off. Anyone who tells you otherwise is misinformed. This is not at all hard to do and any electrophysiologist can do it, as well as most of their staff (with a physician's orders).

If someone tries to question the ethics of that practice ask for a consultation by the Institutional Ethics Committee.

I join you in those prayers for her release.

I hope this helps.


Posted on 2014/1/16 13:14




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