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My dad is 90 and has been in memory care for almost a year. He has recently started refusing food. Hospice took over his care last week. How do we know if his pacemaker is prolonging his miserable life?

Robert123--

You make a pretty sweeping statement about (one assumes) ALL NH's--and that is really false information.

I have seen the gamut of NH's. Ones that treat their clients as family and the care is stellar and loving and gives the family the calm knowledge that they are doing the best for their LO.

I've also seen ones that turned my stomach at the filth, neglect and lousy care.

It's up to family to make sure that their LO is receiving quality care. And to visit and be supportive of that care.

A post like yours, painting all NH's with the same dirty paintbrush is not helpful, nor is it true.

I'm really sorry you have had a bad experience. While yours is not without merit--a lot of people come here to talk about the relief of having a LO in quality care.
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dseag2 Oct 9, 2021
Midkid, I couldn't agree more. My mother is in hospice in Assisted Living and each time I've visited there 3 nurses have come in to check on her comfort. The Medical Director constantly communicates with me to let me know if there are any substantial changes.

Her time in AL actually made her blossom when she first moved there prior to going into hospice. Now that she is at the end of her life I know she is in good, capable hands. It is super expensive but you get what you pay for.
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JeanMT: Imho, kindly direct your question to your father's cardiologist. I assume that your father's pacemaker is keeping his heart in sinus rhythm. Prayers sent.
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Reply to Llamalover47
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Hospice has no right to choose who lives and dies! Instead find a way to help him eat. Perhaps it is the place he is in and he is depressed and needs his family now to be there with him. These lock downs are cruel and unnecessary
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Reply to FamilyNeeded
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ROBERT123123 Oct 9, 2021
I completely agree with your answer for this 90 year old patient. The family should start worrying about getting him food before anything else and before his weight starts to come down dangerously. I don't agree with having our family members in hospices and nursing homes either. I lost my grandmother in a nursing home which simply ignored her. I had to clean her and put her in bed. They were not even giving her all her medicines and this put her in danger. All these places are not only cruel they are evil. What I will never understand for the rest of my life is why these places do all these things to our seniors and yet they are getting money for them all for no care given.
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Have the conversation with hospice and his cardiologist. This should help you put the pacemaker decision in a proper perspective for your father. Then the decisions should flow naturally without angst. Best wishes to your family
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Reply to MaryNTN
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His pacemaker is keeping his heart rhythm stable. If his pacemaker is an implanted automatic defibrillator, it only works when he has a lethal heart rhythm. If he has atrial fibrillation or heart block, his pacemaker overrides his usual heart rhythm to create a more normal heart rhythm. A normal heart rhythm and his pace maker actually helps him to have a better quality of life. Turning off his pacemaker most likely will lead to death, immediately or in time.

May I suggest that you talk to hospice and his doctor(s) about the conditions that you consider misery. There are numerous ways to help your father to have more comfort until he passes naturally.
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Reply to Taarna
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I had a friend whose husband had a pacemaker.  He had other issues going on and his quality of life was not good.  He decided that he did not want to keep going through procedures and medication and told his doctors that he was refusing any efforts to prolong things.  They asked him what date he wanted his pacemaker turned off.  He was shocked by that because he had had a pacemaker for many years.  They explained that the pacemaker was extra measures to keep him alive.  He chose a date, they turned it off and he passed within a couple of weeks.
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Reply to Jamesj
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Is it *just* a pacemaker or is it a pacemaker/defibrillator? If it's a dual unit, you can have the defibrillator turned off, so your dad won't continue to get "shocked" at the end. If there's no way to get him to a cardiologist, you can ask hospice, they can provide a device ( I believe it's a magnet) that will keep the defibrillator from activating continuously, which could cause discomfort to your dad, and distress to you if you see it happen.

We did this with my mom, and it caused her no problems whatsoever.

Prayers with you and dad through this journey.
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Reply to notgoodenough
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Pretty sure my daughter says they keep trying to shock the heart after it stops.
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MACinCT Oct 6, 2021
That would be an AICD
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Does a pacemaker keep a hospice patient alive?

Pacemakers are not resuscitative devices, and they will not keep a dying patient alive. Most dying patients become acidotic before cardiac arrest, which effectively renders a pacemaker nonfunctional, as under such conditions, the myocardium does not respond to the pacemaker's discharges.

Here is a link to an article on the subject:

https://blogs.chihealth.com/pacemakers-and-death/
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Reply to lealonnie1
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That is a really good question to ask the hospice doctor. The quandary is if he has to be transported to the special cardiology department to shut it off
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Reply to MACinCT
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From HRSonline.org (Heart Rhythm Society) --

A pacemaker does not actually beat for the heart, but delivers energy to stimulate the heart muscle to beat. Once someone stops breathing, his body can no longer get oxygen and the heart muscle will die and stop beating, even with a pacemaker.
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Reply to MJ1929
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That is such a good question. I just don't know the answer. Is his doctor someone you trust to ask? My mom began refusing food and her caregiver began feeding her even when she refused. I asked her doctor about this and he was very reassuring.
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