My mother-in-law is 82 with dementia and Primary Progressive Aphasia (PPA). She has a wound on her lower leg as a result from radiation. The wound has put her in the hospital multiple times for infections. She has a failed skin graft and now has broken her tibia.
The surgeon wants to amputate below the knee vs. doing three surgeries over the course of several months. I am wondering if she would be eligible for hospice care. Stabilize the leg without doing any surgery.
Thoughts?
It will give you much support, and your MIL much comfort, and allow family to visit without her being in pain
One additional issue with amputation, especially if she is/was ambulatory. My grandmother had leg amputated, but constantly FORGOT, and would try to “walk” on both legs.
It is a big shock (and bigger strain on your body) when you are transferring her, and she picks up her good leg to step on the amputated one.
I copy here for you a response to "Brigette", who has a similar question on our forum:
"If your Dad has advanced dementia, who is POA? How well does the POA know your father, and what his wishes for an extended and VERY problematic surgery and recovery would be? Because prolonging the life of someone in this situation may be a mistake, and may result in a torturous and ongoing situation. This requires talking not with a demented patient, but with the person who is POA, guardian or next of kin regarding options.
As an RN I am here to tell you that amputations OFTEN go wrong. There are clotting issues and healing issues as well as much pain due to phantom limb; there are issues of mobility. Anesthesia will/may worsen dementia. My own option would be palliative and hospice care for this senior were I the decider. Many many amputations end up not healing and further surgeries are required. This results in losing limbs an inch at a time, and constant care."
You need to have a discussion with the surgeon about what the recovery for either of those involves -- her dementia may cause her reject treatments like IVs, medication, PT, etc. This might help the hospice decision to be "easier', so that you never second guess the decision.
I'm so sorry for this distressing situation. May you receive clarity, wisdom and peace in your heart.
I would not put a person with all these issues through surgeries or amputation. When the procedures are over, she still has dementia. Her cognition will most likely decline due to surgery or anesthetic, and she may not understand what is happening or how to do what’s required of her for recovery.
You are on the right track about stabilizing and hospice. Let her live however long she has in peace and with as little pain as possible. I’m sorry that you’re having to deal with this, and I wish you the best.