Pacemaker for dementia Dad. Any thoughts?
My dad has dementia and has lived in a memory care facility for over 2 years. He is frail, beginning to have trouble walking, and is almost non-verbal. When of sound mind, he filled out DNR paperwork and made it clear to me he would not want to live beyond "quality of life". He even spoke of suicide/assisted suicide. He always said he would not like to end up like his mother, who spent her last years bedridden with advanced dementia.
Dad is 81. Lately there has been some discussion about him possibly needing a pacemaker. My reaction has been "No". If his body winds down naturally and he dies a peaceful death, I think that is what he would have wanted.
Part of why he was moved to memory care is that my alcoholic mother refused to care for him and said he was "not her responsibility" after 50 years of marriage. She has verbally abused him and has said many times he would be better off dead, she wishes he were dead, etc. I am generally the one that nursing staff looks to for dad's needs, although technically mom is first in line as POA. Mostly she is AWOL :(
This morning we briefly discussed the pacemaker issue and she says her answer is "Yes" to the pacemaker, if that is what the doctor's suggest.
OK: Thoughts from the Forum about pacemakers, Please!.....
There are many follow up appointments after the surgery to consider as well. If my mother with dementia at 92 were to be faced with getting one, I'd refuse. Prolonging her life when the quality of it is shot seems like a silly option at this point. All we do is go back and forth to ERs, hospitals and rehab as it is, nevermind adding ANOTHER issue into the mess. Again today she asked Why Am I Here ?after taking yet ANOTHER fall this week. She's already in a wheelchair and suffering several other chronic health issues in addition to dementia and living in memory care. There are people here who will insist that EVERY medical intervention should DEFINITELY be taken to prolong your mother's life for even ONE more day. I question the compassion of that logic and challenge the notion of it having anything to do with love, but being a fear based reaction instead. Sometimes love means knowing when to let our parents rest in peace and THAT is a true act of love. And faith prevents us from making fear based decisions because we know that life, in reality, is eternal.
Wishing you good luck and Godspeed with your decision, my friend. All the best
Your father made it very clear what he wants. Time to speak to doctors about your mother’s alcoholism and just kick up a stink. Time for an argument with your mother Do you think she knows this will hasten his end? Can you go to the home administrator? Just keep making as much noise as possible till they give it up
Years ago my 97 year old great uncle (no dementia) fell because his heart rate dropped. Although he had a DNR, the doctor talked us into a pace maker. Unfortunately because my uncle had broken his hip in the fall, he went from hospital to rehab to nursing home. He had been living at home and was never going to be able to go back. His final months were not what he would have wished for and I wish we had said no to the pacemaker and followed God’s plan for him.
Having a low HR can make the person tired, scared to stand up as he may get dizzy, etc. I am of course not familiar with your dad’s history. But having a pacemaker may indeed improve some quality of life.
I would look into pacemaker insertion. Yes it’s tricky in the beginning but hopefully with family support he will get through it.
I am aware he signed a DNR. This is a tough decision but if you feel the procedure is just too much or the risks involved are too high.
Pacemakers fire electricity to help the heart beat as it should, but a pacemaker in and of itself will not make a dying heart muscle beat. If someone with a pacemaker has a heart attack, the pacemaker won’t keep the heart going. If the heart muscle is dead it will not “pick up” the paced beat and continue beating because the conduction area in the heart (SA node) is dead so if this is a concern of yours speak to your father’s providers.
Good luck in your decision.
At EOL (end of life) you will have to have it shut down or it will keep "zapping" his heart.
He has expressed his wishes in the fact that he has said previously that he did not want extra measures taken. I would consider the insertion of a pacemaker an extra measure. AND...while being operated on the DNR will be "suspended" so if he does arrest during the procedure they WILL do CPR, they will shock him and the great likely hood that doing CPR will break most of the ribs and possibly the sternum this will cause him great pain during recovery. A recovery he may not fully complete.
I would opt not to have the pacemaker put in.
Ask the Doctor..."if this was your Dad knowing what his wishes are would you proceed with a pacemaker? Will this actually IMPROVE his QUALITY of life not just PROLONG it?" (if it would actually prolong it at all)