Wednesday, November 4, 2009

For Me the Choice is Simple

Today mom and I had our hair cut at the salon.  While there the young stylist trimming my hair let me know her 89 year old grandmother also had Alzheimer's and presently was in the hospital after falling at home.  Her grandfather who is 90 years old cares for his wife  and was helping her out of a chair when she fell backward breaking 3 ribs.  While at the hospital it was determined that she had severe heart arrhythmia and needed a pacemaker.  Based on her description her grandmother appears to be close to the stage Lily is in. Once discharged from the hospital she will be going to a nursing home for rehab.  The family feels once she is in a nursing home she probably will not return home as caring for her is very difficult for her husband.

While listening to her talk about her grandma I could not help but think that if this were my mom I would not allow a pacemaker to be placed.  Why you might ask?..... Lily has a reasonably good life at this point.  True, from the neck down her health is great, but I see my mother slowly withdrawing from the things in life which have always made her life enjoyable.  Looking down the Alzheimer road I see what we have in our future.  Eventual loss of all her abilities to take care of herself and participate in a quality life.  She will no longer speak, walk, or nourish herself becoming so weak that sitting up will not be possible, eventually sleeping her days away, slowly starving till her body begins to shut down.  Alzheimer's disease is always 100 percent fatal.

If her heart were to give out before developing the symptoms of end stage Alzheimer's that would be a blessing and a much easier death.  I have no guilt saying this as I know my mother and if she were in her rational mind she would tell me not to do anything to prolong her life. She would hope to go quickly and be kept as comfortable as possible.

My other concern would be the cognitive function lost due to the anesthesia which is common in the elderly with dementia.  Once lost it is rarely regained and one may find they have traded quality of life for a longer life.

So for me the choice is simple.  I will continue to make what time she has left as comfortable and enjoyable as I can but when the time comes that her body begins to fail I will let nature take its course holding her hand, loving her, and letting go.


  1. You provide such a great service to others with aging parents. I so much appreciate your reflections as you care for your mother. My daughter, Amy, was your former neighbor and told me about your blog. You are truly inspirational, and your mother is blessed by your love.

  2. Thank you Cindy. I miss Amy, Ted, and the kids. I hope you all have a wonderful, healthy, and happy Christmas!

  3. Wow. I wish that I could have shown my sister this on Christmas Eve. That was the day that we learned that my mom had taken a sudden turn, and that she wouldn't live. There were well-meaning comments from people who just couldn't understand our approach, because they hadn't walked in our shoes. And the well-meaning comments stirred up pain.
    Thankfully, our other sister (a geriatrics physician) had helped us talk through our approach several times in the months before we were faced with decisions, so we were clear. You are absolutely right -- and it's the same approach we took with our mom. As hard as it was to let her go, we kept reminding ourselves that it was better in the long run.
    And you're loving your mom every step of the way. You are absolutely doing the right thing.

    Another thought - your mom raised you to be the person you are; she formed the "you" that ended up being a nurse. In a way, you're using your nursing knowledge and background (which she enabled you to get) to give a gift back to her. My physician-sister said that she felt that maybe in some circular way, it was her "destiny" to be a doctor, so that she could come full-circle and use her knowledge to make the best decisions for Mom when Mom could no longer do it. I found that so comforting.
    You're living your destiny by loving your mom in this way, Kerry.