Dad (93) has been going downhill gradually since his bout with pneumonia in June. But still insisted on living alone, with help from family members. He fell last Thursday and his health took a nosedive. Yesterday he was so weak he couldn't get out of bed and became incontinent. After much pleading and begging, he relented to the dreaded 911 call. This proud man was now relying on his daughters to change a diaper and the bedding after leaking through. Once he was settled at the ER his BP was still erratic, dropped significantly, and his heart rate jumped to 270. I had to make the decision to approve a cardioversion or allow him to die. The choice was obvious, but in hindsight.... did I do the "right" thing? He'll need 24 hour care now and it will break his heart to live in a facility. I'm at odds as how to move forward. His mental faculties are sharp which sometimes I think can be a detriment. At this juncture I'm drowning in guilt because I think I should have set him free to his last journey.

They ALL SAID “We want to live at home (and if they thought far enough into the future, DIE at home)”.

We ALL SAID “He’ll DIE (it will break his heart, it will kill him) if we have to (seek residential care, put him away, stick him in a nursing home, abandon him)”.

But the FACT IS, many elderly who are physically disabled or suffer dementia or are fall risks or are embarrassed by being cared for by family etc etc, actually learn to love their caregivers, enjoy pleasant surroundings in residential settings, and realize a renewed appreciation for their “new” lives.

I was the “noble daughter” until my own health began to crumble, and my young family came to miss a full time mom.

And as it happened, I DIDN’T “abandon” my mom. I had more quality time with her, and more interaction with her, than I had when she clung to the cozy little home where she’d lived before the fall down her steep steps almost killed her.

Elder life is not for sissies, BUT ELDER CARE isn’t for sissies either. You quickly learn that you have no “good” choices, and maybe ALL the choices STINK, but with LOVE and as much current information as you can pull together, YOU, AS CAREGIVER, SOLDIER ON.

You LOVE your dad, you made a choice with potentially no good outcomes using your love for him and in the heat of an emergency, all the information that was available to you.

And you know what? You couldn’t have done ANYTHING DIFFERENTLY. Continue to base YOUR DECISION MAKING on your love for him, the facts at your disposal, and his SAFETY and WELL-BEING and PEACE and COMFORT.

If you are doing that, you can’t do anything more. Hopes and Blessings…..
Helpful Answer (20)
Reply to AnnReid
PJAMMY2022 Sep 18, 2022
Thank you so much for unguilting me! I retired from a job I loved after my mom fell and hurt herself…tried to continue to work once I got her somewhat settled but her deterioration continued….I couldn’t. She also is legally blind and her right her doesn’t work…moved her closer to me but the going back and forth was exhausting and I thought if I moved her in it would be easier…one month later…NOT! She’s more demanding because I’m here…she doesn’t mean to be and she’s not unkind…I got some help but have realized I’m sinking and have been sinking into a depression for awhile. I feel like a prisoner in my own home. There are days I’d like to get in my car with my dog and just drive away and leave it all! Wow…feel bad saying that. My brother lives about 10 minutes away but we’ve never gotten along…he gets her once a weekend and speaks very unkindly about me and making accusation. It’s really sad because if he would help just a little bit…but it’s not going to happen. That’s the reality. So I’m praying I’ll get a clear guidance on what to do…I personally think she would benefit from a nursing facility…thanks for listening…
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Either decision would have left you with guilt. I think since dad's mind is intact you should have a conversation with him about what he wants in terms of life saving measures going forward.
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Reply to sp19690

You made the right decision in the moment and allowed your dear father time to close out his life on his own time. The cardioversion was a very minimally invasive measure and I'd have done the same.
I've worked in Hospice, 5 years as an RN and I can tell you with certainty that your Dad will make his exit when he's ready to; you've only given him the time he needed with loved ones. When he's ready, he'll leave this earthy toil.
I was on the other side of a decision with my Dad and had to call an end to life support with his 19 day CoVid battle after being placed on a vent in ICU. I feel like I'll never be settled with having made that call, even though I know clearly that I was following his wishes.
The choice to never start life support may one day come to you and you'll know not to go down that road and to allow him a peaceful journey whenever that time may come.
Make the most of your remaining time with your Dad and maybe consider talking with him about your decision in that moment. He may surprise you.
Our parents are such treasures and it's so very hard to say goodbye. Just love him and hold his dear hands in mutual comfort or exchange your customary expressions of love and affection with every chance you get.
Funny how much I miss my dear Dad's care worn hands.
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Reply to Luta65

When you hold the life and death card for someone, the right decision is probably the most difficult to make.

What did you dad want to do in this case? Did he tell you?

I know what I would choose for myself if I were in dad's situation.
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Reply to polarbear

You're in a 'damned if you do/damned if you don't' situation Abby. Either way, you're going to feel badly here. If you didn't approve the 'cardioversion', you'd have felt terrible guilt in allowing nature to take its course. Now that you approved this procedure, whatever it is, you're feeling guilty for prolonging dad's life which will now be in a Skilled Nursing Facility. Either way, you lose.

Dad's mind is intact, ask him what HE WANTS moving forward, which should have been made known all along. When others leave decisions in their children's hands, we make choices based on what WE feel to be the best decisions FOR them. That's how it works.

Ultimately, dad is 93 and in poor health. When his number is up, it's up. With or without a 'cardioversion', his heart WILL stop beating when it's tired and finished beating. That's not to sound callous or cold, just to say, we all have a certain amount of heartbeats here on earth, and that's it. Even if you wound up extending his life for a while, that's all you did: extend his life for a while. He can now choose to sign a DNR and make other decisions that will not prolong his life any further. He's free to make his own choices now, and after you speak to him, you'll have a better idea of what he wants his final days on earth to look like.

FWIW, it's no better to have a parent with dementia to watch go through an end of life journey, that's for sure! I wouldn't wish that on anyone, ever, under any circumstances. You are better off with dad having his mind intact and finding out his end of life wishes than you are having him incoherent with advanced dementia and having to make ALL of his decisions for him. That's no cake walk, trust me. His life in a SNF may not 'break his heart' the way you think it will. It may be a great weight lifted off of him to have others caring for him in such an environment, w/o having to rely on his daughters to change his incontinence briefs.

Wishing you the best of luck with all you have on your plate. Extend yourself some grace now and realize that you're doing the best you can under extremely stressful circumstances. There are no 'bad decisions' when a daughter is making them based on love. Remember that.
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Reply to lealonnie1
sp19690 Sep 18, 2022
I agree but sometimes even when a person's number is up medical interventions prolongs life past a persons expiration date.

Hopefully dad is willing to talk about further interventions going forward.
Oh Abby! I know the feeling!

At 92, my mom, with dementia, already living in a NH started having erratic and low heart rate. Cardio told us that a pacemaker was jot an "extraordinary measure" which mom's DNR and other documents said should be refused. My POA brother ended up asking mom did she want the device and she said yes, clearly after some thought.

I was left thinking that mom, 20 years earlier had always told me that she DIDN’T want to live like that, i.e., debilitated, old, in a home.

I think you did the right thing. (((HUGS)))
Helpful Answer (8)
Reply to BarbBrooklyn
sp19690 Sep 14, 2022
I think you missed what OP said. She did the life saving measures and now he will have to live in a nursing home and have his diaper changed daily. She regrets that decision.

And how do you ask someone with dementia what they want? Shouldn't moms directive made before the dementia have been what was honored not the decision of a demented elder?
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Whatever choice you made, you made from love. Even if it feels like you did the wrong thing at times, you did it because you love him, and you were stressed and made the best choice you could at the time. Sometimes our best isn't the same from one day to the next, sometimes our 100% varies too. (I stole that pearl from The Four Agreements)
When the time comes again, maybe you'll choose differently because you love him? Cut yourself some slack, you did the best you could and did it with love.
Helpful Answer (8)
Reply to Redish

Since his thought processes are sharp, you saved his life. Good call! Now use this time to talk with him about the quality of life he wants in these later years... and about advanced directives: DNR, organ donation, iv hydration, tube feedings... Then, get those desires in writing,
Helpful Answer (7)
Reply to Taarna
PeggySue2020 Sep 18, 2022
Organ donation for someone who’s 93?
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Sweet Abby. I'm so sorry to read about this very, very tough decision. It sounds like any decision you would have made would have been made with love and compassion. That is what really matters...

Personally I believe none of us can do more than God. He determines the number of days one will live regardless of the decisions we make. When I struggle to figure out the right thing to do, that's when I find peace knowing everything is as it should be.

His design for each of us is perfect. I do not have the power to disrupt the universe. I only have the power to love.

I pray you find peace in knowing you are a loving, compassionate daughter...and that you are greatly loved as well. I will say a prayer for you and your dad.
Helpful Answer (7)
Reply to VVinAshland
sp19690 Sep 19, 2022
I have to disagree with his design for each of us being perfect. I don't believe god would ever think that putting a child knowingly in an abusive hone is a perfevt design. The human mind just like to body can be diseased and defective.

Surely god didn't intentionally make people defective in theit brains which results in many if the evil that people to to other people and animals.

Plus i hardly think a person rotting away with cancer is a perfect design. Imagine when we didn't have alk the medical advancements like pain pills and antibiotics and pills for mental illness how much more people suffered.
Unfortunately, there is no right or wrong choice here. You do what you feel is best at the time. My husband was in the last stage of dementia - did not know anyone, could not walk, was incontinent, had trouble eating and swallowing even liquids. I signed a DNR as his health care proxy, but when his pulse started to get higher and higher, the physical therapist wanted him to go to the emergency room. I decided with the advice of his doctor to do nothing except call hospice. He lapsed into a coma and died a few days later. I feel at peace with that decision and I know he is in a better place. I feel grief, but no guilt. I'll pray that God will guide you when the next emergency comes up.
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Reply to WearyJean

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