My wife and I are trying to care for her 93 year old mother Alma who lives in her home about 1 mile from here. She has a pacemaker which is about 8-10 years old. She has been on Coumadin but she is getting stubborn about taking her medications. Says she feels better without them. However she has complained twice within the last 7 days that she has woke up in the middle of the night with breathing problems. Her doctor retired 1 year ago. Should we take her to the emergency room?