Should 95-year-old mother with dementia be taken off wound vac? - AgingCare.com

Should 95-year-old mother with dementia be taken off wound vac?

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She was put on wound vac about 1 1/2 months ago after surgery to fix broken hip. The wound is a lot shorter, but the nurse thinks it is deeper than it was and Mom keeps pulling it out so the dressing has to be changed a lot more often than it would if she didn't have dementia. This probably helps to irritate it more I would think. My main concern for her now is her comfort more than anything else. She has been in enough pain since this all began. I think the wound is causing her more pain than the actual break. Her geriatric doctor said that if comfort care is what we are going for now, that we could take her off the vac and use sterile dressings but the PA that put her on the wound vac seems to think that it could increase chance for infection. I don't want her to have to go through any more surgery to clean the wound out again if it gets infected, but the wound vac doesn't seem to be doing any good any more. I hope this all makes sense. What do you all think I should do? When she first got out of rehab, she was able to walk short distances with a walker, but now it is all she can do to stand. She is in a wheelchair. She of course doesn't understand any of this and only knows that her leg hurts. She is on a pain patch that has just been increased in strength. Thanks for any and all thoughts.

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I don't see anything wrong with offering the food to her. If she doesn't want it she won't eat it. That is all you can do. It's not like you are force feeding her. Just giving her an option.
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That is so true. I know how difficult it is as I go through the same questioning if my decisions each day. There is no right or wrong. Our moms are on their way out of this Earth experience. We just need to make the best decisions we can to give both them and us comfort. It took me a while to realize that my comfort matters too. I make the decisions I feel are best for mom and that I can live with. A tough one for me has been whether or not to hand feed mom. Some people (my sister, some if the hospice personnel) feel if they can't pick it up and feed themselves, you should just allow them to slowly starve. While I understand that and do not feel those that make that decision are absolutely wrong, I cannot do that. I offer food, if she eats it great, if not great too. I need to offer it for my comfort.
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Thank you all so much for your responses. It really does help to hear others have gone through very similar situations. I met with the PA today and she did ease my mind immensely. She let me know that there is no right answer. We decided to take her off the wound vac and try sterile dressings for a few days to see how it goes. We can always put vac back on if it turns out to be the better option. If it causes infection, we then need to decide how aggressively to treat it or just keep her comfortable and let nature take its course. The PA explained it this way; a hundred years ago when something like this happened, the person passed on and it was ok. Now we have all of this modern medicine to keep people alive so much longer but at what cost. God didn't intend for people to forget everything they ever knew, not be able to stand, wet themselves, lose control of their bowels and whatever else and have quantity of life instead of quality. At some point you just keep them comfortable and let God take over. That is something I really needed to hear. She said whatever you decide, don't feel guilty. Thank you all for listening.
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I felt the same way you do. For months I have felt it was my responsibility to fix everything wrong with Mom. Cure every problem. I felt completely responsible for mom's life.

With her health failing, and pain issues that apparently cannot be cured....I finally called in hospice.

Honestly, once they took over, their doctors and nurses directing her care....I feel such an enormous relief, and they are very good about keeping her pain well under control. That burden has moved off my shoulders.

I understand exactly your feelings. Focus now on getting her the care to keep her comfortable.

*hugs*
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I'm not sure what I would do in your situation. Have you consulted with wound care specialists? I'm not sure they would have any better options, but at least you would feel you had dotted all your i's etc
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Thank you for answering. Yes, palliative care is what I want for my mom now. I don't want her in any more pain than absolutely necessary. I feel like I have my mom's life in my hands and I don't like that. If we take the vac off and she gets an infection, I will feel like I made the wrong decision. It sounds like she would have to have surgery to clean out the wound if there is an infection, and I have promised myself and mom that there will be no more surgeries. Do I just let the infection go? I hate this!
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You do realize that the term comfort care means palliative care or hospice, don't you? They are focusing on making her comfortable but allowing the disease process take over or slow healing, whichever comes first. They cannot restrain her so she will continue to pull off the dressing. It is recommended instead to focus on helping her pain and suffering.
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