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My dad is 90 and has been in memory care for almost a year. He has recently started refusing food. Hospice took over his care last week. How do we know if his pacemaker is prolonging his miserable life?
Is it *just* a pacemaker or is it a pacemaker/defibrillator? If it's a dual unit, you can have the defibrillator turned off, so your dad won't continue to get "shocked" at the end. If there's no way to get him to a cardiologist, you can ask hospice, they can provide a device ( I believe it's a magnet) that will keep the defibrillator from activating continuously, which could cause discomfort to your dad, and distress to you if you see it happen.
We did this with my mom, and it caused her no problems whatsoever.
Pacemakers are not resuscitative devices, and they will not keep a dying patient alive. Most dying patients become acidotic before cardiac arrest, which effectively renders a pacemaker nonfunctional, as under such conditions, the myocardium does not respond to the pacemaker's discharges.
A pacemaker does not actually beat for the heart, but delivers energy to stimulate the heart muscle to beat. Once someone stops breathing, his body can no longer get oxygen and the heart muscle will die and stop beating, even with a pacemaker.
I had a friend whose husband had a pacemaker. He had other issues going on and his quality of life was not good. He decided that he did not want to keep going through procedures and medication and told his doctors that he was refusing any efforts to prolong things. They asked him what date he wanted his pacemaker turned off. He was shocked by that because he had had a pacemaker for many years. They explained that the pacemaker was extra measures to keep him alive. He chose a date, they turned it off and he passed within a couple of weeks.
Have the conversation with hospice and his cardiologist. This should help you put the pacemaker decision in a proper perspective for your father. Then the decisions should flow naturally without angst. Best wishes to your family
You make a pretty sweeping statement about (one assumes) ALL NH's--and that is really false information.
I have seen the gamut of NH's. Ones that treat their clients as family and the care is stellar and loving and gives the family the calm knowledge that they are doing the best for their LO.
I've also seen ones that turned my stomach at the filth, neglect and lousy care.
It's up to family to make sure that their LO is receiving quality care. And to visit and be supportive of that care.
A post like yours, painting all NH's with the same dirty paintbrush is not helpful, nor is it true.
I'm really sorry you have had a bad experience. While yours is not without merit--a lot of people come here to talk about the relief of having a LO in quality care.
Midkid, I couldn't agree more. My mother is in hospice in Assisted Living and each time I've visited there 3 nurses have come in to check on her comfort. The Medical Director constantly communicates with me to let me know if there are any substantial changes.
Her time in AL actually made her blossom when she first moved there prior to going into hospice. Now that she is at the end of her life I know she is in good, capable hands. It is super expensive but you get what you pay for.
His pacemaker is keeping his heart rhythm stable. If his pacemaker is an implanted automatic defibrillator, it only works when he has a lethal heart rhythm. If he has atrial fibrillation or heart block, his pacemaker overrides his usual heart rhythm to create a more normal heart rhythm. A normal heart rhythm and his pace maker actually helps him to have a better quality of life. Turning off his pacemaker most likely will lead to death, immediately or in time.
May I suggest that you talk to hospice and his doctor(s) about the conditions that you consider misery. There are numerous ways to help your father to have more comfort until he passes naturally.
Hospice has no right to choose who lives and dies! Instead find a way to help him eat. Perhaps it is the place he is in and he is depressed and needs his family now to be there with him. These lock downs are cruel and unnecessary
I completely agree with your answer for this 90 year old patient. The family should start worrying about getting him food before anything else and before his weight starts to come down dangerously. I don't agree with having our family members in hospices and nursing homes either. I lost my grandmother in a nursing home which simply ignored her. I had to clean her and put her in bed. They were not even giving her all her medicines and this put her in danger. All these places are not only cruel they are evil. What I will never understand for the rest of my life is why these places do all these things to our seniors and yet they are getting money for them all for no care given.
That is such a good question. I just don't know the answer. Is his doctor someone you trust to ask? My mom began refusing food and her caregiver began feeding her even when she refused. I asked her doctor about this and he was very reassuring.
JeanMT: Imho, kindly direct your question to your father's cardiologist. I assume that your father's pacemaker is keeping his heart in sinus rhythm. Prayers sent.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
We did this with my mom, and it caused her no problems whatsoever.
Prayers with you and dad through this journey.
Pacemakers are not resuscitative devices, and they will not keep a dying patient alive. Most dying patients become acidotic before cardiac arrest, which effectively renders a pacemaker nonfunctional, as under such conditions, the myocardium does not respond to the pacemaker's discharges.
Here is a link to an article on the subject:
https://blogs.chihealth.com/pacemakers-and-death/
A pacemaker does not actually beat for the heart, but delivers energy to stimulate the heart muscle to beat. Once someone stops breathing, his body can no longer get oxygen and the heart muscle will die and stop beating, even with a pacemaker.
You make a pretty sweeping statement about (one assumes) ALL NH's--and that is really false information.
I have seen the gamut of NH's. Ones that treat their clients as family and the care is stellar and loving and gives the family the calm knowledge that they are doing the best for their LO.
I've also seen ones that turned my stomach at the filth, neglect and lousy care.
It's up to family to make sure that their LO is receiving quality care. And to visit and be supportive of that care.
A post like yours, painting all NH's with the same dirty paintbrush is not helpful, nor is it true.
I'm really sorry you have had a bad experience. While yours is not without merit--a lot of people come here to talk about the relief of having a LO in quality care.
Her time in AL actually made her blossom when she first moved there prior to going into hospice. Now that she is at the end of her life I know she is in good, capable hands. It is super expensive but you get what you pay for.
May I suggest that you talk to hospice and his doctor(s) about the conditions that you consider misery. There are numerous ways to help your father to have more comfort until he passes naturally.
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