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My 92 year old mother has been receiving injections for her macular degeneration for several years. This past year, she had a stroke and is now in stage 6 of dementia and has been on Hospice care for almost 8 months. Should I continue to have her eyes treated to maintain her sight or will stopping at this point create other problems?

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I was in the same boat in October with my father. His ophthalmologist was over an hour away and the trips were getting harder and harder for him, sometimes taking several days to recover physically and mentally from being taken out of his al and having to be in the car and then wait in the waiting room 2-4 hours. After much anguish over this, I couldn’t bear the thought of dad being confused AND blind, I called his optometrist who had treated dad for many years. ( The ophthalmologist couldn’t find time to speak with me.)

Since reading is no longer an option with his dementia, Dads optometrist suggested that I remain watchful at meals to see if dad could recognize the foods he was eating and if he could see where he was going in his walker. He explained that with dads case, he wouldn’t go completely dark but would have foggy spots. this advice has been so helpful. I have not taken dad back for another shot and he seems to be seeing what he needs to see. Since every case is different, please reach out to your moms eye care doc to see what he/she suggests.
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Jimbo99 Feb 2020
Those are the harder calls to make. Perhaps a different delivery method such as eye drops at more frequent intervals ? We had a dog that needed an ointment gel applied. The dog was a Lhasa Apso, I asked the vet if there were eye drops that would be a more effective delivery system. She came back with a bottle of it. That was for cataracts, but it was the same drug the little fur baby needed. It was no more or less effective for preventing the blindness for he actual cataract cloudiness, but t a certain point it was more for reducing higher eye pressure. In that regard the supply lasted about the same as the ointment gel. After Chloe had lost her vision I continued to administer it for any benefits for relief of dry eye, itching or pain.
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My MIL was same age as your mother. She had injections for probably 15 years despite having pain for days after a shot. She really fought to save her vision. But as her dementia progressed, it became really difficult to get her to the doctor once a month for this. She had stopped reading due to dementia, and really could no longer consent. FIL stopped driving and also had dementia so I started going to doctor with them. She had been stable and had not had a shot in 18 months so it was just monthly exams. When she moved to memory care, I just stopped taking her. They don’t go bling with AMD. They lose the center of their field of vision. She did not read or even watch TV due to dementia. There seems to be a point when the AMD stabilizes. While a bleed could happen at any time according to her doctor, she was at the point that we would not have agreed to any more shots anyway so no point in the exams. I would stop with your mother.
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Is she in pain if she does not get the injections?
Is she is pain when she gets the injection?
Is it safe and easy to transport her to the doctor to get the injection?
Is she compliant at the doctors office or is it a struggle to get her to cooperate?

Is this for both eyes? If not how is the vision in her other eye? Could she manage as she is now with reduced vision or vision in 1 eye?

I think the answers to these questions might make answering your question easier.
She may live another year even on Hospice will she and you be able to manage with the loss of vision in that eye (or both if it is effecting both eyes)
If getting the injections improve or stabilize the quality of her life I would continue, if they don't I would discontinue. But given my points above if it is no longer safe to transport her or if she is not compliant I would discontinue. Getting to the pain issue, pain can be managed either way you decide to go.
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MD runs on both sides of my family. All I can do is relate that when the elders in my family totally lost their sight, they lost their will to live and declined rapidly. It was for them, the final nail in the coffin, they just gave up.

Sending support your way!
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There are many great recommendations in this thread. I would also add that discussing this with the Hospice Care team may be very beneficial. If they are involved in your Mom’s daily care, they will be able to weigh in on how she does day-by-day and whether continued shots will help her in the scheme of things.
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It's hard. In order to decide you will need to get a realistic understanding of how long she may live and weigh that against how quickly her eyes are likely to deteriorate, unless she has an unlucky bleed the loss will likely be gradual. As I picture the way my mother was in her final years I don't think I would opt for having the injections, she slept most of the time and often kept her eyes closed even when she was awake. At that point I'm not sure that better hearing and vision would have really made any difference to her QOL.
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As long as she's ambulatory and cooperative, why not continue treating her eyes. Don't you think going blind would cause problems? I took my mom to the dentist as long as I could, and got her eyes checked yearly--even with end stage Alzheimer's.
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I would ask her Dr if not taking any more shots for a year decline your mom's eyesight so much she would be blind. If not then stop the Injections.

My Father is 95 and several years ago he had the series of injections once a month.
I believe he had a total of 10.
Anyway, after that he didnt go back and he can see enough to tell who you are and watch TV and even tell if the light is red or green.
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Grandma 1954 has some very good questions to help a decision. As someone who has lost eyesight at one time or another and had surgery to restore it, I can attest that it can be terrifying to lose one of your senses. It depends on how much eye sight will be lost and if pain is involved or difficulty in transport. I would use these questions as a guide.
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How much discomfort does it cause for her to continue? That is what I always ask myself about my 95 yr old dad’s issues.
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