My 87-yr-old mom's pacemaker has a battery that is wearing out in approx. six months. She has had dementia for 7 years, and can't remember my name, but remembers I'm her oldest daughter and can hold her own in a conversation, complete with good advice. Both her primary Dr and the senior nurse at her ALF say any operation with anesthesia will cause her to lose a lot of cognitive memory and that it won't be recovered after the operation. Her pacemaker is used about one-third of the time, says her cardiologist, meaning her heart isn't totally dependent on the pacemaker.
My quandary: She's told me for years (long before her dementia really kicked in) that she felt she has lived too long. She has a living will. She has a DNR. She's not depressed - she's a very cheery person and is usually pretty happy, with a good sense of humor. But I'm concerned about doing anything to speed up her cognitive decline. I know doctors can keep people alive for a long time, but should they? Where does quality of life fit in? I'm my mother's POA and healthcare surrogate. My sibs have not helped with her care other than to visit her occasionally (well, 2 of the 3 have and they live very far away; the 3rd who lives 2 hrs away hasn't visited in almost 4 years). I haven't talked with them about this.
Based on what you have said, if I were in your shoes, HONESTLY I would not have the procedure done.
Also, do NOT discuss it with the siblings. Do NOT.
It will not end well.
My mom has a DNR. we decided not to have a pacemaker put in for my mom (she’s 90 with Alzheimers) It was the hardest decision of my life but I know it’s the right one.
I would suggest reading "Being Mortal" by Atul Gawande before making the decision. Only because it helped me, and maybe it will help you.
Good luck!
Having said that, your mother is enjoying a reasonably good quality of life, isn't she? She is usually pretty happy and cheery - no pain, no anxieties, no depression? That being so, if she does need her pacemaker battery replaced to maintain her current condition you should go ahead. It shouldn't, as far as I remember, require full anaesthesia: I should check with her cardiologists whether the sedation that would normally be used carries an acceptable risk compared with the risk of not maintaining the device.
Will it help clarify things for you if you invite your siblings to voice an opinion? In my view you have no obligation to discuss this with them, but if you feel the conversation would be useful and right, that's different.
My uncle had had dementia and bowel cancer that had spread. I took the decision that he would be confused and unhappy in hospital having treatment and arranged pain relief palliative care . Despite being told he’d only have weeks - he enjoyed a further 15 months stress free mostly happy without medical intervention.
Do what feels right for your mum - I wish you both the best
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So, schedule the procedure. Take a list of questions for all doctors. If several doctors are not giving you good chances for positive outcomes, then it might be better to let nature take its course. My bet is that mom will do fine... and I was a critical care RN for many years.
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