I posted earlier about taking my dad (mild dementia) to a geriatric doctor. They found his heart rate to be extremely slow.. under 40 and made an appointment with a cardiologist which we went to today. He said he needed a pacemaker or he would possibly go into cardiac arrest within the next couple of weeks. We made an appointment for him tomorrow to get a pacemaker.
He has decided that he doesn't want it ..and said he is ready to go. I do understand his decision. His quality of life is still pretty good tho and he would feel much better with his pacemaker as he would have more energy..etc. ..but i do understand that he may not want to continue with dementia.
I'ts hard.. and I'm really sad... Basically he is going to most likely pass away in a few weeks..or maybe months of cardiac arrest.. i can't stop crying.
I'm really not sure he undertands the magnitude of it.. i hope he does..
I wouldn't want that for myself. It's probably harder on you that it is on him. It's tough on all of you...but I think you have to go along with what he wants in this case. {{Hugs}}
This was devastating to hear; but the doctor told my father the situation and he understood. Unfortunately, he did not last long after this prognosis; but passed away shortly after from renal failure. We just took it one day at a time and truly treasured any time I had left with him; making the most of it knowing the days were numbered. I feel he understood the gravity of the situation and was accepting of it; as your father appears to be. You can try talking to him again to make sure he understands. Perhaps he will change his mind, or perhaps not. They know themselves when they just don't want to take any measures any longer. As difficult as it is for us to accept; we need to go along with any decisions they want. They are the ones facing the surgery and any other complications as well. Hugs across the miles. Take care.
I understand how hard this must be fore you! Often the anesthesia used for surgery has extremely negative effects on cognition. Following the surgery you would see a definite progression in the dementia that may or may not reverse after a few weeks. Respect your dad's decision and be there for him. Call in hospice to help you through this. I know that if it were me, I would make the same decision your dad has.
I left for a few minutes and my mom said he asked about the surgery like he was maybe reconsidering...but that is to be expected with his dementia. He didnt say anything after i got home tho. I cant hardly be around him without crying..i dont know how mom does it.
Please tell me we are doing the right thing...i feel so sad.
My Mom had a pacemaker inserted about 3 years ago she has afib. Her cardiologist says it's going over 90% of the time.. It will probably need to be replaced earlier than most..Her dementia is between stage 5-6 on Alz. scale. Her heart may be beating but her brain isn't.. As her POA and she has a Living Will I will not sign off on a battery replacement. She is 92 and she's lived a long life. She entrusted me with making these decisions for her when she was of sound mind and I have to to see her wishes are met..
Update..i got my dads bloodwork back and his kidneys are also failing. The dr. Office called and wants us to go to a kidney dr. Im thinking we will just skip all the drs from here on out and try to make him comfortable.
We have a call with someone my sister knows who works with hospice to go over what hospice does and how to set that up.
My moms sisters are not being very understanding and questioning our decisions. Me, my brother, and sister are composing an email to them to basically say to respect his wishes and do not question them.
My dad is at home and blissfully happy...having a few goodies and enjoying a visit from his grand daughter.
This makes me think about my own end of life wishes..
I know this is a difficult decision for you. But, now the kidneys as well, would be just too much for him. Google "effects of anesthesia on brains with dementia". Find a good article and send that to aunts as well, it might help them to understand.
But the thing is, the pacemaker could make him feel so much better. He won't feel nearly so worn out when his heart rate is around normal.
I guess it isn't the minor operation that's bothering him, then, but the thought of slogging on and getting steadily worsening dementia?
Very, very difficult. There are so many unknown factors to consider.
I think, if I were you, I'd ask him not to cancel the operation, but to talk it over in detail with his geriatrician or his older age psychiatrist, whichever is advising him and the family about his dementia. It's a question of how many years, possibly, of good quality of life it might buy him, and that might be quite a few.
And, as Pam S pointed out, if it's not helping him it can always be removed. These procedures are surgical, but they're day case only, very minor. Local anaesthetic only, I'm not sure they even bother with any sedation to speak of.
I hate to think I'm making this harder for you, but I don't think I'd give up on him just yet. My best wishes to all of you.
Implantation is done as outpatient surgery, but for some patients an overnight stay is recommended by the physician to ensure there's no bleeding and that the pacer is correctly positioned.
My mother had to keep her right arm raised all night long so that the wires could remain in position; she even had to wear a sling.
Anesthesia is definitely used; this is an invasive procedure.
As to removal, my father's was removed but that occurred when the battery was failing and he needed a new one.
Hope this helps clarify some of the pacer issues.
Ba8alou, why is that, do you know?
My dad has dementia. He is terrified of being in a nursing home and wants to die at home with his "boots on" ...so to speak.
As his dementia progresses, a nursing home is almost a certainty..so i believe this could have played into his decision.
He would not even know what procedure he had or why that thing was under his skin the next day...or why he is even in pain.
I do remember Mom complaining that they "have me all tied up!" and wiggling out of her sling after she got home.
God bless you and your family in this difficult time.
My husband had both a pacemaker and defibrillator for several years before he developed dementia. He was very adamant about DNR after the dementia started, and he decided he wanted the defibrillator removed. We made an appointment with his cardiologist, who was shocked at the request. He had never had anyone wanting it out before. He told me we should think about it some more. I replied that he had been thinking about it for months. Then he faced my husband, both sitting on stools and on the same level, looked into his eyes, and said, "If as we are talking your heart stopped and you could get a shock that would start it again and then we could continue our conversation, wouldn't you want that shock?" And my husband replied, "No. I would rather die of a heart attack, like all my brothers, than to linger with dementia."
The doctor was surprised -- shocked might not be too strong a word -- but said he would not subject Hubby to a surgical procedure to do this, but that when the batteries were to be changed, he would remove the defibrillator . (I think he may have had to change the pacemaker at that time.) Hubby was OK with the pacemaker, as that device made his life more comfortable. He was not OK with a device that would potentially prolong his life.
The "procedure" lasted way longer than expected and I was getting worried. The doctor finally came out and said everything was OK but they'd keep him overnight for observations. And then he said, "I been thinking about this a lot. You made the right decision."
This situation is different than the one your father faces. Hubby already had the implanted device, and it was not the pacemaker he wanted removed. But I did believe he was competent to make his own decision and I would have supported whatever he wanted. That can be extremely hard!!
Hugs to your entire family. I hope that you can make the most of the time left to you.
My moms sisters are STILL a problem...even after i sent an email pleading them to respect their decision to be nothing but loving and supportive. They say...bla bla...want to be supportive BUT here is what I would do...hope this doesn't hurt you...OMG ...they ARE hurting my mom..i am really shocked by their reaction to this.
There will always be situations like with your aunts. These sorts of things tend to bring out the know-it-all in everybody, to say nothing of the dysfunction.
these same aunts have not even seen mu dad in years nor will they be around in the aftermath when the pacemaker does not work its magic.
Hugs as this is the hardest thing to let them be and let them go. I often think what if mum had to have an operation with her "dementia" i think i would not want it and i know she would refuse too. Its only natural to want them around forever but sometimes we need to think of what they would like i know if i had the chance to talk to my dad it wouldnt have made a difference and id have to have respected that.
Will light a candle for you!
My sister who has been very supportive up till yesterday and was going to come next friday so we could all be together for fathers day just told me she is putting her trip off..and that she can no longer discuss my dad dying. She is the one that has been really supportive. Her support suddenly ended and wont answer calls or texts.
My brother is comming today and still there for supporting his wishes.
My uncle who hasnt spoken to my dad in years called..im sure it was to chevk out if we were lying about him having dementia. Mom says ..he was able to talk to my uncle like the old times. So i guess they now thimk he does not have dementia. For 10 minutes he can easily hide it....but not for any extended period.
Anyway i see how hard this is. I see now how even if you want to go peacefully...its a battle.
Thank you all for your support. You guys understand what our family and my dad is really up against.