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My 86 year old mother has 90% blockage in left main coronary artery (I’ve read this is the mother of all widowmaker blockage locations). Also 80% blockage in left circumflex. She started hospice two and a half months ago after heart failure decompensation and heart attack. Doctor said her blockage is “not compatible with life”. But for the past month her breathing has been now fine and they want to discharge her from hospice. I’m concerned about the next decompensation which will come, unless fatal heart attack comes first. Anyone have similar experience? How long has your loved one lived with a critical blockage? I’m trying to reconcile “not compatible with life” with her being fine with her breathing and BP. I’m just waiting for the shoe to drop and without hospice, figuring out what to expect.
(And while her heart symptoms are better, her dementia symptoms are declining).

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Perhaps the physician meant not compatible with life if your mother becomes unstable, either with CHF exacerbation, which would increase the workload of her heart, or if she starts to have another heart attack because the blockages develop a blood clot across the 90% narrowing, which would be likely to completely block the blood flow to the heart arteries. There is no set answer for that. Some people can still motor on for weeks/months. If being discharged from hospice, can you talk with a Palliative Care Team about next steps and outlook?
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We found that end stage heart issues can last far longer than one might think. No one can accurately predict how long your mother may have. I hope you’ll spend this time enjoying her presence, hard as that can be with what feels like a dark cloud hanging over you. Let her do and eat what she wants. I wish you both peace
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Heart disease is (in spite of all the procedures etc) still the number one reason listed for cause of death.
There is incredible evidence that stents don’t work yet folks persist in having them done. My husbands cardiologist says stents don’t save lives, proper diet and exercise do. Good advice for my 69 yr old husband who has no stentable (if that’s a word) blockages but maybe not much comfort to an 86 yr old with CHF, diabetes, dementia etc. When I asked my moms cardiologist about hospice, he referred me to a heart transplant center where they managed CHF. She only saw them once a year because they made a nurse and doctor available to advise me on adjusting her meds depending on her blood work, weight, INR etc. 24/7. She had home health and a therapist who also helped. It worked for a long time. She did not die of CHF.
Ask her doctor to order home health. If she has original Medicare, she should qualify for home bound services. She’ll get a nurse and a bathing aide. They can do any blood work her doctor needs. Look for one that also has a hospice associated. Then you can go between the two as needed. I am very surprised that the hospice you have now is not recertifying her. My DH aunt is on hospice for about a year now with only dementia as the reason. She was on HH for several years before. Really the only difference is she gets more care with hospice than she did with HH. I see your mom has quiet a few issues.

I can truly appreciate the confusion you must be feeling. With hospice it’s call us for all issues. Off of hospice, it’s back to the doctors offices if you don’t have something else worked out and with COVID Delta ramping up, I’m sure you don’t want to be taking her to the ER. I’m assuming she has a cardiologist? Is she on warfarin? I would ask for some guidance and either call another hospice or find a good HH that can switch you over to hospice when needed.
Wishing you an easy transition of services and let us know how it goes. Your experience can help others navigate this tough situation.
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