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My mom, who wants to die and doesn't want any artificially prolonged procedures, and has stated so in her written wishes, may be encouraged to have a pacemaker. She doesn't want it. Do we go against her wishes or is this not considered artificially prolonging her life?

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Stop having her see any specialists if she's still going to them. She no longer needs a cardiologist if she doesn't want treatment like a pacemaker, and her PCP can prescribe any heart meds she might still want to take.

Some people think that because the doctor's office (not the doctor) makes an appointment that you feel obliged to agree to. Then you show up, and the doctor assumes you're there because you want treatment. You feel like he knows best, so you end up agreeing to it. The doctor will never tell you to stop treatment if he thinks you're there because you want it.

YOU have to put an end to the cycle of doctor visits, and then the endless treatments and advice will finally stop.

I'd ask her PCP for a referral to hospice. It'll take a huge weight off you and your mom.
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HONOR HER WISHES!

A year ago, my Mom was diagnosed with a condition that could be treated with surgery. 92 at the time, the surgery would be very risky. I asked her primary care doctor what he would do if it were his mother. He stated he would not recommend doing it. Mom and I did see a specialist, and even he said it would be risky. I asked Mom what she wanted, and she said "No way, Jose." I knew the condition could worsen at any time, and possibly take her life. It came down to quality of life, which she was enjoying. She was 93 when she died of the condition in January, which was triggered by other issues that had developed. She did not suffer, and I am so happy I had, as her son and caregiver, an extra year of seeing and hearing that wonderful woman.
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Good grief. Are you serious?

If she doesn't want it that really ought to be the end of the conversation.

But to dot the i's and cross the t's: who is recommending the pacemaker, what is the rationale, and has this all been explained to your mother?
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The end of life in the U.S. is a big business. Hospitals, doctors, group care facilities, funeral homes, churches, etc. are part of this lucrative industry. They extend life for no practical purpose, except for milking the Insurance companies and federal and state agencies of as much money they can get before they allow the patients to die. People build a savings nest after many years of hard work and sacrifice just to o see it go in smoke when they get old and sick. Many die penniless or in debt.
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Cover999 May 2022
Those places you mentioned, see a lucrative market and are each trying to get a piece of the pie.
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If the a person with a pacemaker dies, the pacemaker will stop. Pacemakers send tinny electric impulses to the heart, which make the live myocardiac muscle fibers contract. Those electric impulses can't make dead muscle fibers contract.
Incidentally, cremation funeral homes will charge a minimum fee of $75.00 for removing the pacemaker off a dead body.
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JoAnn29 May 2022
My daughter is a nurse and has witness the pacemaker or maybe a Defibulator keep trying to start the heart. Maybe it stops after awhile but it does click.
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Alva can ring in here. My daughter is an RN who has worked in Nursing Homes. A person will still die at some point even with a pacemaker. And when they do you can hear the little click click where the pacemaker is trying to start the heart.

My friend had a pacemaker or a Defibulator can't remember which but she had a hard time with it in her 60s. I think its an incision and the pacemaker is slipped under the muscle and there are leads. Her leads became twisted.There is some discomfort pain with it. She will be put under.

Really at 99 I don't know why a doctor would even recommend it. I would not put my parent thru it at that age.

None of us wants to lose a parent but we are mortal. Your Mom is 99! She has lived a long life. She is tired, let her go.
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Odaat59 May 2022
Our daughter’s MIL and myself are both intensely focused on what we DO NOT want, she’s gone to greater lengths to make sure her outcomes are what she wants, she’s also older by ten years. And a PA, who has performed hospice services, for dying friends and family. She is much more direct than me, and I’m very direct. Our adult children would literally feel us screaming at them, from our dying state, if someone tried to put a pacemaker in us, at that age.

JoAnn….I got the chills when you said one can hear the pacemaker trying to bring the dead back to life, even after they are gone. It’s like the worst science fiction show, and I never want to be the star.

I was brought up being told nothing about my parent’s after life wishes, no clue what they want for a funeral, really, and I don’t ask. I was told decades ago, that I wouldn’t be on any legal papers, allowing me to decide for my mom, cause I would “let her go”, maybe too soon, and back then, she wanted to stay until God officially took her “home”. It hurt less when I was younger, cause it was untrue. I do for me, what I want, but I am honorable and would follow my parent’s wishes. What I been doing, no matter my feelings, opinions for a very long time.

My kids know they best let me go, my husband as well, and pretty much anyone who knows me. I don’t need to be here forever. Your advice has helped me often over the years, thank you.
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The greed of some cardiologists, surgeons, and hospitals knows no bounds.
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PeggySue2020 May 2022
Well no ct, actually there is. Because the taxpayers end up paying most of such procedures. Some surgeons make most of their money that way.

Like I have said, this will not go on forever. At Medicare enrollment, everyone should be given a choice. An account. Medicare should pay for more assisted care or mc options but they don’t.

Make Medicare funding available to those who don’t spend hundreds of thousands, millions, on your third line exotic treatments for your cancer, your cardiovascular disease, or whatever, the less that should be available for al mc that should already exist. If I were past 70 and there was a choice, I’d choose the mc or al option,
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It may keep her heart beating for a while, but who knows if that can be considered a life extension. Since quality of life is more precious than length.
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Over Mother’s Day, my sister recounted how her colleague’s aged parent had a pacemaker implanted. The elder lost what remaining functions they had soon afterward as they declined physically. The pacemaker kept the elder alive to the point that they ended up a shell of themselves, a body just existing, in a nursing home.

They were both there accepting awards as surgeons themselves.
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She can decline the surgery. I would.
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Just say no. Decline the surgery.
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Why in the world would anyone want to prolong another's life at age 99? She has spoken, she said No, respect her wishes. It is her decision not yours.
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Cover999 May 2022
Some hospitals could subtly push for the procedure.

They could use the "Doctors are concerned...." to try to convince you or even her to go ahead with it.
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No way would I want that procedure, at 99 years old, and my family knows my wishes, as I have made sure. I slept better once it was formalized, and notarized, and ten copies made, to be sure I have one, for just in case. I’m early 60’s, and cannot imagine a hospital, or whoever, forcing that on me at age 99, regardless of my condition.
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If your mother is competent, her wishes prevail. If not, I hope you or someone responsible has durable medical power of attorney and your mom has advance directives expressing her desires as to end-of-life care. If she does have advanced directives, look at the what she specifically has stated. Consult with her physicians. I would think a pacemaker, which is an invasive procedure, would be considered an artificial prolongation of life. If she has stated that she doesn't want it, that should be honored. Even if she does not have advance directives or an MDPOA agent, you may be able to act as her proxy. If you know that she wouldn't want a pacemaker, advocate for her wishes. You don't say who is encouraging her to have a pacemaker placed. This is the person or persons whom you need to engage.
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I worked in physical therapy.. I vividly remember the 90 year old women who I was working with, she was crying , to die… they put a pacemaker in the year before…

im a firm believer that man’s medicine gets in the way of Gods plan…
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Beatty May 2022
That happened to my relative.

Although pacemaker was input when not conscious after a heart attack - no life directive had been completed.

On waking, she let the Doctor have it. Who do you think you are, playing God? It was my time to go. The Doctor explained they must attempt to save life unless instructed to not resuscitate.

She signed that DNR as soon as legal.

Family then knowing her wishes, respected them after that.

Age shouldn't matter.. but it does. If this was a 42yo with depression, wanting no intervention then a Pschololgist may be needed. But at the wonderal advanced age of 99, I personally, would honour the lady's wishes. She is choosing Mother Nature.
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No, you don't do it against her wishes.
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Your mother is 99 and she said she doesnt want a pacemaker. Honor her wishes and tell whoever is pushing her to get one to respectfully back the hell off.
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A pacer is definitely considered a 'prolonging' life measure. The surgery for a pacer is no big deal; it's done under sedation, but the point is, your mom does NOT want life prolonging measures taken to extend her life! So say no if you are her POA or she can say no herself if she is of sound mind. The doctors seem to always push to save an elder's life, especially if there's a ton of $$$ to be made from Medicare from installing a pacemaker, which was $60K for IT alone, if I recall from when my DH had his put in back in 2019, not including the surgeon's fees/hospital fees, etc.

Best of luck!
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