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Her pneumonia seems better and I was reassured that as she is not showing any symptoms regards the 2.1 block that she can attend as an outpatient to have a temporary monitor fitted for couple of days to see if she needs a pacemaker. However on reading her discharge notes I noticed that her 2.1 block is of a mobitz ll type that "mandates hospital monitoring and a pacemaker" according to a web page about this condition can lead to a total block. She is still coughing and now realise that she has been sent home with the threat of suddenly dying when this could have been prevented with a PM. She hated the hospital so much that at the moment says that she does not trust anyone cutting her up but she really does not comprehend that she could otherwise die. I promised never to lie to her about her condition even if it is unpleasant but now she does not trust me nor believe how dangerous her condition is and should she start to die I will forever have that look on her face that I have seen before that says that I lied to her. This is something that I will not be able to live with. I also believe that she may not tolerate having a pacemaker as so far she has ripped off her cannula 3 times and blood pressure bands numerous times because "they hurt". So you can see what state I am in. I can't eat or sleep with worry and there is also the threat that this will also affect my sister who had a subarrachnoid haemorrhage some years ago with a shunt fitted and now has a fistula on the brain and will not live through another stroke or aneurism. I have no other family.

Dear Margaret once again thank you for your advice. I have always told my mother the truth and only this morning when she was quite lucid I exp!ained how ill she was and that I would help her with whatever decision she wishes. She actually said that She would risk having a pacemaker fitted. I explained that we should first see or talk to others who have had this procedure with all the pros and cons associated and then She could decide whether this was right for her. The only thing that I am certain of is that She wants to carry on attending her day centre and be able to walk to where ever she wishes whether accompanied or unaccompanied and I agree totally as this to her means quality of life.
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Call her physician. They need to be notified of the BP cuff and cannula removal. Call the social worker at the hospital. If she does not want medical care any longer, Hospice is a great program and will provide home services to keep her happy and comfortable. Sometimes older adults with medical conditions don't want the pain and agony of treatment.
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You don't have to lie to your mother. Tell her the truth about the options of having or not having people 'cutting her up', and the risks either way. She makes the choice (which is her right) and you have to live with it as does she. Stop blaming yourself for all of this! Your mother is elderly and has serious health issues. Yes she will die, and you don't know when. That is reality for all of us. You will need to make your own life with so little 'family' - but in the end that is what we all have to do. Have courage.
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