Mom is 91 and lives in assisted care. She has dementia, heart and lung disease, among other conditions. Now her liver and kidneys are failing. The doctor is suggesting dialysis three times a week which would require that I take her each time. She’s deaf and doesn’t sign (we use a whiteboard to communicate) so other means of transport are not reasonable. I’m questioning the idea of trying to prolong her life. Maybe it’s time for hospice and to let her go? I’m her POA and only child. This is a horrible situation and I really don’t know what to do.
Unless you literally want to torture her to death.
I don't know enough about dialysis to answer this but I do know that at 91, nobody has that long left.
My Mum passed away at 71 from lung disease last year. Her other problem was increasingly limited mobiiity. When she got severely ill at the end, she didn't want to be resuscitated. I often wonder exactly why, but it obviously boils down to her concern about quality of life. She would have needed a lot of oxygen, amongst other medication & daily life would have been a struggle.
Everybody grandstands in their youth about how they'd rather be dead if,x, y, or Z happens but in your mother's case, I do think I'd rather nature take its course.
If I were the decision maker, I’d opt for hospice. Time for a frank and direct talk with her Dr.
Greed, maybe. (Canada has universal healthcare, for the most part) A different perspective: I think too many people expect doctors to be able to fix everything. Finding comfort in “We did all that we possibly could!”, which may be no favour to the patient. As if there is blame to be assigned or guilt to be assuaged.
I'm very sorry you're in this situation.
It's utter cruelty to take any life extending measures for an elder suffering from dementia and wait to watch them die from natural causes if saying no to dialysis will speed up the process. There's no ethical question here, imo.
Best of luck.
Count yourself lucky mom has kidney and liver failure and will not have to die from dementia. Please don't prolong her life with dialysis 3 times a week. This doctor is cruel and inhumane and I don't think he has any clue about what dementia does to a person.
"Life is devalued when it becomes horrific due to illness. I wish you could have seen my mother, always a beautiful, well-groomed woman with a fine wit and great intelligence. She lived to age 95. At the end, dementia rendered her an emaciated, grimacing skeleton with faded skin that drooped from her withered bones. Her teeth were dark brown. Her hair was almost gone. She couldn't hold up her head, get out of bed without a two-person assist, or talk. She made varied sounds, the meaning of which we couldn't understand. She was double incontinent. She had pain and couldn't articulate where. We don't know how well she could hear or see. She couldn't eat or drink without help, and that was only soft or liquid foods. Some of the last words she ever uttered were begging to die. This went on for more than 2.5 years. It is the way dementia patients end up if something else doesn't cause their death first."
.....Fawnby
I certainly wouldn’t want to have dialysis in my 90’s. My mom lived to be 95. I knew her wishes. She had her wishes documented as well.
My mother didn’t want any procedures that would be uncomfortable for her in her latter years.
She saw no point in prolonging her agony. In fact, she was ready to leave this world long before she did. When a person’s quality of life goes away, their joy of life goes away as well.
Do you feel like your mom would want to go through this? Do you want her to go through this?
Have you ever read any of the PubMed articles? They are very informative and interesting. There are cases discussed on their website if you think it would be helpful to read the stats.
Think about what your mom would want if she could make her own decision. I certainly wouldn't want to go on dialysis while facing all of those other medical challenges. It seems cruel. (((hugs)))
I would not put Mom thru this at 91 with all her health problems. I would call in Hospice.
I don't think either decision is "wrong" or "unethical". You might want to have a further conversation with the doctor about other possible options - hospice being one of them - and what to expect from each option. Sometimes doctors, especially if they have been treating a patient for a long time, have a hard time acknowledging that there's really nothing practical left that they can do for their patient. They don't want to be seen as "giving up" on them. So, they push treatment that, while it may treat the symptoms, doesn't offer a "cure", and sometimes those treatments are more detrimental to the patient's quality of life than the actual conditions they are suffering from.
I hope you can make a decision that you can be at peace with; either way you choose, I am so sorry you and mom are going through this. (((hugs)))
I don't have the guts for it. I have seen what dialysis patients go through three times a week, their day gone to this, and getting there, getting home, exhausted before the dialysis for days, exhausted after it from going through it, the diets, the battling infection from ports. To do this to a 91 year old is a heroic measure indeed.
If you are POA I suggest you go on Forums of dialysis patients for sure. No doctor will level with you with truth I am thinking. The choice is simple without it. Hospice and the good drugs. You are POA. You were trusted with this decision if your loved one cannot make it. You need to embrace that trust and do what you think your elder would have wanted. I am assuming you can guess. I certainly have not been quiet about my own wishes. And as I have often said here, my dad told me for years what not to let them do to him when he was too helpless to prevent it by telling me "Kid, stand between me and the docs with a gun if you have to".