My 86-year-old mother has dementia but loves her dementia day centre which she attends 5 days a week. However, she developed pneumonia a couple of weeks ago and was taken to ER by ambulance and was put on antibiotics. It was also noted that she had a 2.1 block and we were told that a pacemaker would need to be fitted. However, now that she is almost over her pneumonia the doctors are beginning to back out of the pacemaker with excuses that she has dementia and is elderly which I find discriminating and horrifying as we were originally told that this 2.1 block would definitely change and could kill her as they do not consider it worth resusitating a dementia patient whose heart stops as they said it is not usually successful. I was extremely angry with this weekend doctor as now we are living in fear of when it is going to change if she does not have a pacemaker. She obviously does not want to die and does not fully understand the procedure which is supposedly fairly safe and although I have explained it to her when she has a lucid moment and she agrees with having a pacemaker fitted, she momentarily forgets what it is all about and this forgetfulness is what doctors seem to be relying on. Once nurse said that it is not such a dramatic procedure and there are a few ways to anaesthetise her without it being a general anaesthetic which I was worried about. Then today another hospital staff said that fitting of pacemakers in dementia patients is not very successful and has many complications such as infection etc so my response was that perhaps doctors can't be much good then! I am furious with their attitude but will know more tomorrow when I speak to the consultants I hope. Has anyone else experienced this kind of discrimination towards elderly dementia patients? My mother is forgetful and impatient but did have a quality of life within her means and now is depressed in a hospital dreaming of getting out and seeing her friends. Since being in the hospital for over a week now she cannot walk very far and gets breathless and is sometimes dizzy as she gets up which is going to make her an invalid without a pacemaker and waiting to die.

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Has anyone mentioned that she would need to be on blood thinners for the rest of her life? Turning a fall into a potentially deadly situation?

Not to mention the biweekly testing it takes to keep the levels within range so she doesn't throw a blood clot or damage her kidneys?

Pace makers all come with defibrillators nowadays and they are not simple no big deal surgeries. The nurses that are telling you this are out of line. They will be putting wires in her heart, that is how PMs work. They will be cutting her open to do this and she will have hardware that is felt externally. Can she realistically deal with all of this?

I have had several family members that have had them, from my 5 month old nephew, who died at 21 from heart failure by the way to my 75 year old dad. It should be seriously considered and I personally think that the doctor is behaving responsibly and not discriminating in the least. Just because something can be done, doesn't mean that it should be done.

All of the challenges she is having are not because she needs a pacemaker, it is what happens when you are hospitalized, you are sick and bed ridden and you loose strength from all of that. She should be referred to rehab to regain the strength she has lost from being ill and bedridden. Please talk to someone that can help you understand how this works and what happens when you are bedridden. You loose your stamina from one 24 hour period of inactivity, we all do, it's just way more obvious in a frail old person.
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97yroldmom Apr 2019
My experience was different. None of the people I mentioned had/have defibrillators.
My mom was on blood thinners but not the others.
I think I would get a second opinion. I realize that it is a very stressful time for you.
I am glad your mom’s pneumonia is better.

I have had a bit of experience with PMs. But Dementia comes in so many forms that it’s difficult to know what wouid be the deciding factor to not do the procedure.

My mom, without dementia, had a pacemaker at 91 due to a slow heartbeat (bradycardia) She developed CHF and slowly declined. She had no problems with her pacemaker but commented that she wished she had never gotten it. This when she was struggling with her CHF at the end of her life. We, of course, assured her that the PM wasn’t keeping her alive.

My MIL, with Dementia and a strong zest for life, got her PM at about 82. No problems at all with the PM. She was diabetic and died of cancer at 86.
My aunt in her 70s was exercising at a gym. When she tried to take her pulse, she nor her instructors could find a pulse. She was given a pacemaker. She later developed Parkinson’s and dementia. In her early 80s now and on hospice, she had her PM replaced because the doctor explained that her death would be frightening when the PM stopped. Again. No problem with the PM.

I have another aunt, 92 with dementia, who has a pulse rate that is getting slower and slower. She has told me (at an earlier stage) that she does not want a pacemaker if it’s ever suggested. I worry about that decision should the occasion arise. She does pick at her skin and I think it could prove challenging. I hope I never have to make that decision.
I also hope you find information from medical staff that can help you make the right decision for your mom. At the end of life we have to remember that we can possibly extend life from what might have been an easier death only to put our loved ones through much worse.
I have no idea of the best course of action for your mom but I encourage you to hear the medical staff out. Pixie I would be more concerned about a doctor who rushed her into a procedure without the caution. I know you are concerned but listen closely.
My wish for you is that you find peace with whatever course of action is chosen.
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Do your part taking your mother's health to heart.
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They will need to assert the pacemaker under her skin/muscle. There is a healing process and the incision will be painful. Will Mom understand that she can't touch the incision or take the bandage off. Can't remember which my GF has pacemaker/defibulator but to check on it they have to shock it. Its painful. Do u want to put Mom thru this.

Dementia gets worse not better. They end up having no quality of life. Just sit in their own little world. I watched my Mom decline monthly. TG she went peacefully. I would not have prolonged her life.
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Wow, that's a really tough place to be in. Making the hard choices for a loved one can be gut wrenching. Based on what I have learned through Red Cross classes it's true that if someone's heart really flatlines then resusitation is impossible but that's true for everyone and not related to dementia or even old age. Pacemakers are usually placed due to A-fib or some other electrical related heart condition. Pacemakers require a lot of care and caution. I would not agree to putting one on someone with dementia because they would likely suffer greatly and could even kill themselves if they began to tug on the external parts of it etc. That's a personal opinion based on my limited experience of loved ones who have had pacemakers put in. I am trained in Adult/Infant & Child CPR & AED but I am not a doctor.
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