BarbBrooklyn Asked September 2012

How do you handle post heart surgery depression and hopelessness?

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MIL is 80 and has the beginnings of COPD and maybe a bit of dementia. She's apparently always been impulsive and forceful; her children go along with whatever she wants. She had openheart surg. about a month ago for an aortic dissection. she survived the surgery with a small stroke, has lost her sense of taste and now is refusing to eat, refusing OT and pT and just wants to die. She is insisting on being moved to a palliative care facility so she can refuse to eat and just die. Interestingly, she will eat, at least from time to time, pizza, a burger, a hot dog, brought in by her sons. What do you do in this kind of situation? the longer she lies in bed, thinking that she's dying, the more debilitated she becomes. there is no reasoning with her.

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Well, as of right now, she is refusing food and meds. The rehab facility is going along with this and family has flown in to see her.
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MUSIC soothes the Savage Beast...no matter what your own "beast" may be, good music has within it the qualities to calm, delight, rejuvenate (especially memory). The beauty of instruments adds to the experience. See if you cannot have a/some musicians (no matter the level of accomplishment) come to play. Nursing homes love this idea...they see it working.
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desert192 Sep 2012
From what I've learned (both husband and Mom have had open heart surgery - 10+ years ago). Both had depression to a degree afterwards. It is quite a common side effect of this particular surgery (being on heart/lung machine). Talk it over with her Dr., geriatric specialist, and even do "google" search and you will see others with same problem.
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jeannegibbs Sep 2012
Is she on an antidepressant?
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marymar Sep 2012
Your MIL may truly want to be allowed to die naturally, but she may also be testing your loyalty. Only you can figure out which.
The more I've gone through with my parents, my dad especially, the more I sympathize with allowing them to move to hospice/palliative care if that is what they wish. I'm also developing permanent aches and pains at age 56 and can only imagine how unhappy I might feel at age 80 or 90 if my senses fail and my body is so limited that I can't do much of anything any more.
Sometimes we think that we children should be able to provide enough happiness to make even the poorest quality of life worthwhile for our parents, but I think we assume too much. Their pride can make them feel embarrassed to be around us in their diminished condition.
Only you can tell whether the depression is a phase that can be improved, but my personal feeling has evolved to a point where I'm not sure using anti-depressant medication is the right thing to do in all cases. Sometimes, people are depressed because they are just very aware of the truth that things are going downhill and will never get better. I don't necessarily think they should be medicated out of that. I think this is the time when you honor their wishes and give them as much love and attention, and as little nagging and forcing of medication and food, as you possibly can.
I hope I don't seem like a doomsayer, but the fact is that we don't live forever. I don't think that forcing someone else's life -against their wishes- to last longer than the quality of their life and comfort is in their best interest. We all fear dying, but we also fear pain, tedium, and becoming a burden.
If the family really isn't ready to allow palliative care, you should meet with MIL's doctor and discuss her condition and prospects for improvement. As far as I know, she can move out of hospice if her health and/or attitude improve.
My mantra since the passing of my father is- when you are elderly, there are worse things than dying.
Best wishes to you and your family.
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NancyH Sep 2012
My folks had a couple of friends who went thru open heart surgery with great success, but hit a depression afterwards that mad them almost suicidal. So I know it's possible, but I don't understand what goes on in a person's body that would change them so much. I also know that before my mom died she lost her sense of taste, and she told me 'why eat when you can't enjoy it anymore?' So you have a person who is depressed after surgery, and also can't taste anymore. To me that's a recipe for disaster. She needs to be seen by someone who will prescribe her something to get her over the hump. If she has longevity in her family history, you may want to point that out to her. My mother-in-law is 88 years old, but she could very well have another 10 years left because her dad (who she takes after) lived to be 100.
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