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Cardiologist told me 2 days ago Mom has moderate to severe valve disease of 2 valves and wants to do surgery to replace. The last echocardiogram 6 months ago was mild to moderate and due to her age, no recommended surgery. Mom was also placed on an oral blood thinner due to the new onset of atrial fibrillation. I was stunned when this cardiologist (not her regular) REALLY pressed for surgery and at that time, I said I know my mom does not want surgery, nor do I her only living child and POA/HCS want her to have surgery. She was discharged from the hospital yesterday to rehab.


My question is, is it wrong of me to NOT want her to have open-heart surgery? Mom and I have talked at length for a long time and she has said for years that she wants no more surgery, and I as a nurse agree. She has been a very young 94 year-old and has never wanted to have a stroke or Alzheimer's. Now both have happened, and I know how very risky and the odds of a very poor outcome if she were to have surgery, esp. heart surgery.


But I just talked to one of my 3 children on the phone, and his immediate reaction is to have the surgery ... "she could live another 10 years". He sounded angry; but I know he is shocked by this news as well. He will be visiting her tomorrow.


Mom was asleep when the cardiologist told me 2 days ago and I haven't yet talked to her about it as she had been sedated at the hospital (very anxious and fidgety) and only awoke near the end of yesterday in rehab and I wanted her to adjust to the rehab facility and be as comfortable as possible before I left for the day, which she was. One of my daughters is visiting her now, and I'll go over later to see how she is doing.


As of yesterday, she still does know family but her short-term memory since this is gone; her vision has been affected so that she is unable to see or recognize that the TV is a TV, and could not find the utensils on her tray last night, but she was able to trouble-shoot using the fork and aiming in the direction of the food.


Isn't NOT having surgery in her best interest? My SIL (my brother and only other sibling died 3 yrs ago), and daughters agree with me. But I want my son to understand as well. My kids are in their 30's and 40's and lost their dad my husband when they were teenagers. Their Grandma is very special to all of us.


Sorry so much rambling....

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Myownlife, I would wait until the Urinary Tract Infection has cleared up to see how Mom is doing memory wise. An UTI can mimic dementia, along with other symptoms in much older patients.

Plus I wouldn't be surprised if your Mom had delirium while in the hospital as 95% of elders do.... same with being placed in Rehab. Not easy being placed in a setting which is so different from being at home, new noises, new faces, different food, and the lack of sleep from hospital noise around the clock.

I would make an appointment with your Mom's regular cardiologist to get his/her opinion. Depending on the issue with the heart valve, there might be other options besides surgery.

I agree with your Mom, do not have the surgery. As you know, surgery at 94 is very high risk, and it would take a very long time for recovery. Plus if your Mom is just starting to have dementia, surgery will greatly increase the dementia. Your Mom knows who you all are, after surgery she may not and never will.

One has to think quality of life compared to quantity of life.
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I wouldn't take any heroic measures, including a risky heart surgery, to prolong my 92 year old mother's life since she has A-fib, moderate dementia, has suffered a stroke, can no longer walk & is wheelchair bound, and has a host of other issues too numerous to mention. The dementia alone is reason enough not to pursue surgery, in my opinion. When the quality of life is THIS significantly reduced, what on earth is the point in 'living another 10 years' when it's likely to be in a nursing home with the need for 24/7 care? Dementia is a cruel disease with no chance for improvement. My mother lives in a memory care facility and what I see when I go there is nothing short of heartbreaking. Just my 2 cents worth.
Best of luck!
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I certainly agree that you should wait until the UTI clears and reassess.

You should also find out if the surgeon is talking about open heart surgery or aminimally invasive valve replacement procedure.
Big difference in the procedures. The latter might improve your moms quality of life tremendously.
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I would not do the open heart surgery. Anesthesia may very well cause further decline and quite rapid. And what Barb and FF said. Wait until UTI has cleared up then see how her short term memory is.
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94 and open heart surgery, there is no way, and a surgeon who wants to do this only wants the money. There is no need for your son to agree, you need to do what is best for your mother, this is not up for a family vote, you already know what your mother wants. Trying to appease everyone will only end up in more chaos. Make a good decision for your mother and go with it.
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Thank you, everyone, for all your answers. I am on the verge of tears tonight; I will do what's best for Mom but it's hard. I understand I just "sprang/sprung" this news on my son today whereas I've had 2 days to process it.

Visited Mom this evening and within the 3 hours I was there she continually asked where her purse and suitcase are, what's happened and cried/pleaded /begged me to take her home, oh, and bargained. 20 + times for each question in that time.

Her physical status is back to baseline (a bit unsteady) and really good, longterm memory, but the short term is gone. I hope it comes back but don't know right now. She's paranoid and sent me a sideways glance that if I didn't want her to see what I'm doing at home she would just go to her room and stay out of the way.... if I would just please bring her home. [ I am on the couch with the one precious remaining dog after having the other put to sleep the day after my mom had the stroke.... so yeah, I'm having a really good time..not ]

I hope and pray that Mom's mental status will improve but this may be the real event that has her go to assisted living. I'm 65 and have been out on leave for almost 3 months and will be returning to work in another 2 weeks. I'm about ready to break and truly need and want to work at least another 5 yrs. I want to give my Mom what she wants and have her here at home, but it's all up in the air right now.

Again, thank you so much for everyone's response. And I will definitely followup on Monday with the UTI and there is a care conference that day so I can get input.
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lealonnie1 Jul 2019
They are ALWAYS worse in rehab and the hospital....confused and dazed, with delirium even. My mother was seeing mice running on the floor while in rehab when there weren't any. It took a while, but once she got into her new place in memory care she got much better, Memory wise, no more delirium etc. I know how gut wrenching this whole experience is for you, especially with your mom begging and pleading to go home. She's fearful of the unknown and rightfully so. But, if you make the decision to place her in Assisted Living, she will be fine. There is lots to do there, plenty of ladies to chat with, socialization, movies, bingo, outings.....its like day camp for the geriatric crowd. You can become a daughter again instead of a care giver, and visit as much as you'd like...help her decorate, etc.
Whatever happens here, I wish you good luck and Godspeed.
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