Should you treat an elderly person with dementia who now has pneumonia but always said they wanted to die with dignity? - AgingCare.com

Should you treat an elderly person with dementia who now has pneumonia but always said they wanted to die with dignity?

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My 83 year old mother has dementia, wears diapers, and is confined to a wheelchair. She's in a nursing home. Her quality of life is terrible for a once vibrant, proud, successful woman. She has an Advanced Directive and always told me she wouldn't want to continue living if she was ever in the state she currently is in. She now has pneumonia and the nursing home wants to give her antibiotics so she can be more comfortable. Will this cure the pneumonia and, if so, is that going against her wishes? I told the nursing home she wouldn't have wanted that but they said she would suffer severely if they didn't. I don't want her to suffer but I don't want her to be cured just so she can resume her tortuous existence. She's never going to get better...her present condition will just deteriorate. We don't let our animals endure this kind of suffering...why do we do this to our loved ones?

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I faced a similar situation with my Mum. The difference being that she had been taken to hospital from sheltered accommodation following a fall/stroke. She developed pneumonia rapidly and did not respond well to the antibiotics, but the nurses said it was early days.
Mum was very agitated and unable to speak (from the stroke - her left side was totally unresponsive, and doctors were unsure what other damage there was - at this stage their priority was to treat the pneumonia), but I was able to communicate with her by asking questions and getting her to squeeze my hand. She affirmed that she was in pain and wanted me to get her help. I asked to speak to her Consultant, who was really sympathetic, but explained that pain relief (morphine) would counteract the antibiotics, and therefor Mum could not have both.
I asked for time and went back to have a one-sided conversation with Mum. She wanted pain relief and was frightened - God rest her soul. I explained to the Consultant, and treatment was switched to 'palliative' care. Within the hour, Mum was fitted with a syringe-driver containing morphine, a sedative to make her less anxious, and a drug to suppress the secretions from the pneumonia. The staff were wonderful, and Mum passed away peacefully 10hrs later.
The advice given to get Hospice in is very good. I see where the nursing home is coming from in wanting to give antibiotics, and I understand (having had it explained to me) that morphine can't be given at the same time.
Your Mum doesn't have to suffer, and sad to say that she may not in fact respond to the antibiotics at all - of course, the opposite may be true !
You have a difficult choice, and hospice will be able to help.
Thoughts are with you x
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My dear Mom passed away in the evening on the day after Christmas. I feel very proud, I did the right thing. The hardest thing...the right thing. I was able to be with her the hours prior to hold her hand and give her all the love in my heart. My other family members were there too...but it was me that received the gift of her last breath. I know I did the right thing for her...but to each of you...only YOU and your loved one can decide. I did get hospice involved but wish I had contacted them sooner. I know she is at peace and I have felt the peace finally of knowing she is safe and no longer suffering. I miss her terribly but treasure every moment we had together. It was so hard to let her go. I did the right thing for her, exactly what she wanted...no question. I will hover around here to help others because this website has been a tremendous blessing to me and my family. God Bless you all. -Pumpkin
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Bhenson, There can't be duplicate charges for the same service. For example, my husband already had a housecleaner and a personal care attendant paid for by Elderly Waiver (a Medicaid program) and I kept those and declined the hospice service in those areas (because they were less than we were already receiving).

Hospice often provides their services in Nursing Homes. Talk to the hospice organization about how this works.
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Jeanne, your answer about calling hospice was a good one. I do however, have a question for you. If I'm not mistaken, the nursing home told me that it's either them or hospice because Medicare won't pay for both??? Is this true? Would you then have to bring the family member home? Just curious is this is true. Hugs.
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Quality of life is such an individual call. With no directions sometimes families have to decide quality the best they can. After having both his parents suffer with dementia, my husband told me that as long as he knew who I was that his life would have quality. But the day that ended he wouldn't want to continue. For some people any loss of cognition is not acceptable. Hating being trapped in a bad situation that will not improve, some would say is a life without quality.
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They used to call pneumonia the 'old person's friend.' There was a reason for that. My MIL has a 'do not resuscitate' order with her Med. POA form - but when she gets sick she always wants to go to the ER or hospital - so, when the time comes, how far does one go? My heart goes out to all of you in these circumstances. I thought the suggestion to get Hospice involved was a good one. I will remember that.
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I read somewhere that most of the time dementia patients will die of other ailments besides the dementia. One of the tops ones was pneumonia. They should treat her pneumonia for the breathing distress. Is there anyway that Hospice could be called in? Because with Hospice they will follow the advanced directive and only give her medication for comfort and care. I would look into that. I'm sorry for her suffering. It's such a hard thing to go through during the holidays. God Bless.
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My mom died of cancer last year, and if she had had pneumonia we would've treated it. She was going to die anyway, but at least she would've been able to breathe.
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Thank you JeanneG...great idea. I am sorry to have to call hospice on Christmas but somehow I don't think I'd be the first person to do so. It's been a rough week in the NH, we lost 2 people and then 2 others have fallen gravely ill besides my mother. The staff tells me the holidays are always tough, especially this year. Hugs and prayers for everyone to have safe and happy holidays.
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Pumpkin, if at all possible, get hospice involved. They will be on your side, and help you draw up a do-not-treat directive.
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