My Father had a heart attack 2 years ago. At that time they replaced his pacemaker with a pacemaker defibrillator. Since then his dementia has increased and he is not eating. Shortly after he came home from the hospital 2 years ago he got a feeding tube because he was deteriorating rapidly. We did this with the hopes that his appetite would return and life would get back to normal. But that didn't happen. He still has the feeding tube and has gotten very weak. He sleeps all day but has no quality of life and he's sad. A few weeks ago he went on hospice. Since then we had his defibulator shut off but his pacemaker was still going to be operating. Last week his pacemaker began to beep indicating a low battery. Given his condition I don't think a doctor will be willing to put him under to change the battery. I'm very torn. I don't want my father to suffer but I don't want my lack of action to accelerate his demise. When he's awake he's alert and aware of the fact that he's been in bed all day, every day...and he's sad. Should I try to pursue getting the pacemaker battery changed? I'm very conflicted. Any insights would be appreciated. Thank you.

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Your father is on hospice care b/c he's reached the end of his life and wants to be kept comfortable until he's called Home by God. For that reason, I would not have the battery replaced in his PM at this time.

My mother has advanced dementia & I pray every day that God takes her Home. Her quality of life is dramatically reduced and she's in pain every single day. I would never take ANY life extending measures for her under any circumstances, so I say these words to you as if it were my mother I was making this decision for.

There comes a time when extending an elder's life is nothing but cruel. Allowing them to transition into the next stage of their life is the best thing we can possibly do for them, in my humble opinion.

I'm sorry for your situation, and I wish you peace with your decision.
Helpful Answer (7)
Reply to lealonnie1

Taylor; We aren't talking about a hearing aid. Replacing a pacemaker battery is an invasive surgery that requires sedation/anethesia and a stay in the hospital. Very disorienting for a dementia patient.

When my mom was well into dementia, she developed heart block which required a pacemaker. My brother's and I all held joint POA for health. My mother would not have wanted this in her younger days, but we asked her if she wanted the surgery and that the alternative was dying rather quickly and painlessly. She thought about it for a few moments and said "yes" she wanted the PM.

FGRINSTIX, can you ask him in one of his lucid moments?
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Reply to BarbBrooklyn

We all have to wrestle with decisions like these when LO in advanced dementia…. I did when my husband developed aspiration pneumonia because he stopped swallowing… and I had to decide about a feeding tube…. I absolutely knew my husband wouldn’t want it… but it was difficult decision just the same. You can always find doctor to operate and clergy to insist
prolonging life … but the way I tht about it was … even if these measures were to be successful… what quality of life are they coming back to … . And would they want it ??? The next day g-d had taken the decision out our hands and my husband passed. Anyhow always lots great advice here … this site always been my go-to .. hope helps you too … good luck !!!
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Reply to Helenn

He must be pacing all the time for his battery to be low. 2 years is nothing for the life of these things.

I would contact the cardiologist that installed it and find out what is causing the battery to be going.

Honestly, I wouldn't put him through it. It's a pretty easy surgery for the battery but, you will have to remove him from hospice to have it done and he might not make it through and he will be put under anesthesia, so the risk of further decline is great.

My dad was not doing well and he had a triple bypass, all because the surgeon wanted to operate. He did not make it out of the hospital. He was pacing 70% of the time and lasik wasn't pulling the water off anymore. My point is that you will find a surgeon willing to operate, even if they know that certain death is the end result, do not use that as your determining factor.

Look at the quality of his life and decide from that.

I am so sorry that you are losing your dad. May God give you strength and wisdom to make this decision.
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Reply to Isthisrealyreal

My father would absolutely KILL me if I attempted to prolong his life in such a state. He’s the “plug the plug” kind of guy, and very big on ‘quality of life’ and having dignity later in life.

If it was my child, I’d do whatever I could as they have so much life left to live. But with my parents, I wouldn’t prolong the inevitable, just for my own sake. They wouldn’t want me to. And I don’t think I’ll like to suffer that way either.
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Reply to Lizbitty
FGRINSTIX Aug 17, 2021
Thank you for your comments and insight. I truly appreciate your taking the time to help.
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I am so sorry for your heartache and hard decision.

I am caring for my mom since her stroke and several times have had to “think really hard” about what mom would want (and I say this from the ICU after her stroke to toxic encephalopathy - feeding tubes though she now eats on her own to even some of the bad UTIs before I knew about how awful they are - each time I think about moms wishes - sometimes I even take out her health care proxy etc and re-read her wishes several times before I choose anything for her. I feel comfortable that when the time comes that I will honor my moms wishes - as well as make any decisions that would always protect her to comfortably pass when it’s her time - I think because we are close and always had these talks that I know my mom is not afraid to go when it is her time - she talked about it as her beautiful next journey so I know these talks will always help guide me and I’m grateful for those talks we always had.

It so hard making choices for someone else and to feel we are choosing what they would choose. I think you are here asking From pure love and I believe you don’t even need us to help answer this - I think you know and you came here for support and You will receive all the support in the world - you deserve to feel comfort in knowing your Dad will be okay and you don’t need to put him Through anything else - he knows you would if it would give him something better. I’m giving you the biggest hug and wishing you peace and comfort.
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Reply to Momheal1
FGRINSTIX Aug 27, 2021
Thank you so much ❤
My prayers, thoughts and hugs are so with you. The two previous respondents have wise answers. As hard as it is, contact his cardiologist, and his primary care provider, the Hospice care group, and a spiritual advisor ( if that is comfortable for you) ask for guidance and advice. When dad is awake and alert, spend positive times. Take care of yourself right now, too. God bless you and your dad.
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Reply to Aliciaboots1

The doctor advised us that my mother would be very uncomfortable without having the battery replaced. The pacemaker was not keeping her alive so the question of a new battery was more of a comfort issue than prolonging life. She was under local anesthesia and did just fine. I really haven’t thought about that decision since then……. I pray that you can decide and move forward knowing that you have done your best in providing love and care.
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Reply to RubyLouise

Since you have placed him on hospice, I would suggest letting nature take its course. When the battery goes, let him go.
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Reply to Taarna

I know this must be a horrible, weighty decision. Whatever you decide, please allow yourself to feel no guilt. With the extent of your father’s dementia, if it were me, I don’t believe I would make the decision to have the battery changed. I’m assuming they would use anesthesia, and I’m sure you know that likely will set his dementia back even further. It is horrible to be in charge of someone else’s life or death decisions.
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Reply to Mjlarkan

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