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Dad (93) has been going downhill gradually since his bout with pneumonia in June. But still insisted on living alone, with help from family members. He fell last Thursday and his health took a nosedive. Yesterday he was so weak he couldn't get out of bed and became incontinent. After much pleading and begging, he relented to the dreaded 911 call. This proud man was now relying on his daughters to change a diaper and the bedding after leaking through. Once he was settled at the ER his BP was still erratic, dropped significantly, and his heart rate jumped to 270. I had to make the decision to approve a cardioversion or allow him to die. The choice was obvious, but in hindsight.... did I do the "right" thing? He'll need 24 hour care now and it will break his heart to live in a facility. I'm at odds as how to move forward. His mental faculties are sharp which sometimes I think can be a detriment. At this juncture I'm drowning in guilt because I think I should have set him free to his last journey.

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I don't think that you can ever know whether the decision you make for another's health (or survival) was the correct one. Several decades ago when he was healthy, my grandfather made me promise to never let him live if terminal. He ended up in the ER with severe pneumonia, renal failure, cardiac arrhythmias, and on a ventilator. Blood pressure all over the place and unconscious non-responsive. Doctors asked me if I wanted them to continue or discontinue ventilatory support. The latter would most assuredly mean he would die. I went in and talked to my grandad for a while...never knew if he either heard or understood. Then came out and asked doctors to shut off ventilator. He died about 10 minutes later. Was it the right decision? You never will know. So, find hope and peace in the fact that you made the decision as a caring loving person considering his wishes.
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Can you imagine 2nd guessing the other option you had though? You did the right thing. Like someone else said, everyone can get affairs and good byes and desires out in the open. This is such a hard time being someone’s child, having to make these decisions. My heart goes out to you.
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I think you did what was right for yourself and your father. You have said his mind is sharp, so he has his own mind. Let me add something that no one else seems to address, life over death. I have just found out I have a very bad heart, and I also live in constant pain. Yet do I want to keep on living? Yes, of course I am not that old and cherish each moment I have to live. What lies beyond this life? Perhaps you are religious and believe death is a step to heaven. Having studied many religions, I do not know. All I know is even in pain I choose to live (as long as my heart will keep on) Cherish each day you have with your father, let him know he is loved. At his age and in his health, you won't have him forever. May you have peace in your heart knowing you are doing what you feel is best. Hugs
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Abby2018: Emotional heartbreak (living in a facility) is one thing; physical heartbreak (if you hadn't approved the cardioversion) is yet another. You made the right decision with the procedure. Hugs sent during this most difficult of times.
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You did the right thing! You had to try to save him. But, you may not need to put him into a long term facility. Look at in home care and see how much his insurance will cover to have a nurse check up on him at home. It will break his spirit if you put him into a place he can never leave. I can tell you from experience that it will lead to misery and death. It is no wonder people become so depressed in these places that they want to die with all the abuse and neglect there.

Please check into home care and let whatever time he has left be happy ones. Continue to pray for him! God can work miracles! God Bless you!
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tygrlly1 Sep 2022
Abby 2018.'my heart goes out to you , and the awful decision you had to make obviously came from a place of love for your dad. In response to Family Needed, I would agree that home care is the ideal..but FAMILY NEEDED , please choose your words more carefully regarding nursing home care, if that is what is ultimately decided by Abby and recommended by his medical team. I am a retired Social Worker , with over 30 years experience in the long term care field. I had the honor of working with a number of nursing care facilities that were outstanding , and where very elderly patients flourished..because of the committlent and love by the staff , who choose to do Gods work. Unfortunately we only hear about the bad ones. To describe all nursing homes as places of misery, death , abuse and neglect is not at all comforting to Abby, who is struggling hard and needs support...not more guilt and scare tactics.
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Sadly Abby, you were placed in a position that no child should be. I know, because I was in a similar place with both my dad and my Stepdad. Fortunately, my Stepdad and my mom both had a Do Not Resuscitate (DNR) notification in their Medical Power of Attorney and Living Will. It kept me from having to make that decision for them.

With my dad, he did not have a DNR, and I had to stand by and watch him being resuscitated and then placed on machines. With the help of doctors and lawyers, I was able to get a court ordered DNR for my dad after much anguish.

You may want to check to see if he has a legal/written (notarized) DNR. If your father is still of sound mind, and no DNR exists, you might want to suggest he get one. That takes the onus of a "life or death" decision off of the loved one's shoulders.
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A Geriatric Psychiatrist can assist you and Dad. It sounds like he is ready for a Nursing Home. A Gastroenterologist appointment may get him out of diapers and onto Assisted Living...........the psychiatrist can speak the truth and offer medications.
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I'm so sorry you have gone through this. It's interesting you weren't "prodded" to not do the procedure, by the hospital.

Prayers to you and your dad.
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I would seek to have private care givers come in to assist with his adl. Adult daily living skills find what his allotted hours are approved from his insurance and go from there they can direct you to companys and such to best fit your needs.
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Your Father may not be as alert now as he was previously. Im sure you made the correct decision based on the facts at that time. Take it one day at a time and remember he has had a long life and prepare to let him go.
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OMG, you poor thing. You made one of the hardest decisions a human can make. My mom told me her and my papa's medical directives stated no measures to keep them alive, but when he was dying, and the paramedics asked her what she wanted them to do, she said; "save his life." he died that night anyway, but she felt guilty for going against his wishes. I feel for you. It's really the worst choice to have to make. ((HUGS)) I hope you'll find peace, and know you did your best, in a terrible time.
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Unfortunately, there is no right or wrong choice here. You do what you feel is best at the time. My husband was in the last stage of dementia - did not know anyone, could not walk, was incontinent, had trouble eating and swallowing even liquids. I signed a DNR as his health care proxy, but when his pulse started to get higher and higher, the physical therapist wanted him to go to the emergency room. I decided with the advice of his doctor to do nothing except call hospice. He lapsed into a coma and died a few days later. I feel at peace with that decision and I know he is in a better place. I feel grief, but no guilt. I'll pray that God will guide you when the next emergency comes up.
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Sweet Abby. I'm so sorry to read about this very, very tough decision. It sounds like any decision you would have made would have been made with love and compassion. That is what really matters...

Personally I believe none of us can do more than God. He determines the number of days one will live regardless of the decisions we make. When I struggle to figure out the right thing to do, that's when I find peace knowing everything is as it should be.

His design for each of us is perfect. I do not have the power to disrupt the universe. I only have the power to love.

I pray you find peace in knowing you are a loving, compassionate daughter...and that you are greatly loved as well. I will say a prayer for you and your dad.
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sp19690 Sep 2022
I have to disagree with his design for each of us being perfect. I don't believe god would ever think that putting a child knowingly in an abusive hone is a perfevt design. The human mind just like to body can be diseased and defective.

Surely god didn't intentionally make people defective in theit brains which results in many if the evil that people to to other people and animals.

Plus i hardly think a person rotting away with cancer is a perfect design. Imagine when we didn't have alk the medical advancements like pain pills and antibiotics and pills for mental illness how much more people suffered.
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The Wise Facilitator at one of my Support Groups always told us "Don't Should on yourself"
I have told people if they make a decision based upon the information that they have at the moment and you think it is the right thing to do based on that then that is all that you can ask of yourself.
20 20 hindsight is a wonderful thing but we don't have the capacity to go back in time to change things.
Use this opportunity to talk to him and ask what he wants done in the future.
If he wants no intervention Hospice would be a great way to go forward. You would get support from great people, you would get help with supplies and equipment and truly great medical care. Not curative but Hospice will provide care a Nurse will come weekly if medications are needed they will be provided, if other problems arise they will be addressed.
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You made the right decision out of love and compassion.
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You made a decision under extreme circumstances and you can’t look back. I can relate because my father in law 93 also had pneumonia in june and wasn’t expected to survive but is alive and in a nursing home now. He was found unconscious on the floor where he had been for at least a day maybe two. I hated him being alone at home but his 3 children let him be since he’s only mildly cognitively impaired. Be comforted knowing someone is there for him now 24/7.
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The problem here, IMHO, is that there was nothing set in place, which meant you had to make this awful, heart wrenching decision. You did the best for the situation at the time.
Moving forward, I agree, you need to decide, with your father, what he wants to do. No one wants to get old, incontinent, fall out of bed, be in danger of imminent death. No one! Your father also doesn't want you to have to take care of him, 24 hours a day.
When everyone involved is calm, go have that conversation. You can sign a DNR and/or POA. You can have a clergy member come in, or a social worker, someone who can help mediate if you are not able or feel that you need an objective voice in the room.
Then, next time something happens, and it will happen, you'll be prepared with the proper legal documentation and the knowledge that you are doing exactly what your father wanted you to do.
Also, since he is sharp mentally, he may rally and you may find a place that he likes well enough. You can have weekly visits, have lunch, take him for a walk, read a book, whatever, and enjoy the time together, without also having to be his nurse.
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Helenn Sep 2022
More often than weekly visits I hope !!!
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Abby,
You made the right decision in the moment and allowed your dear father time to close out his life on his own time. The cardioversion was a very minimally invasive measure and I'd have done the same.
I've worked in Hospice, 5 years as an RN and I can tell you with certainty that your Dad will make his exit when he's ready to; you've only given him the time he needed with loved ones. When he's ready, he'll leave this earthy toil.
I was on the other side of a decision with my Dad and had to call an end to life support with his 19 day CoVid battle after being placed on a vent in ICU. I feel like I'll never be settled with having made that call, even though I know clearly that I was following his wishes.
The choice to never start life support may one day come to you and you'll know not to go down that road and to allow him a peaceful journey whenever that time may come.
Make the most of your remaining time with your Dad and maybe consider talking with him about your decision in that moment. He may surprise you.
Our parents are such treasures and it's so very hard to say goodbye. Just love him and hold his dear hands in mutual comfort or exchange your customary expressions of love and affection with every chance you get.
Funny how much I miss my dear Dad's care worn hands.
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Abby,
You made the right decision in the moment and allowed your dear father time to close out his life on his own time. The cardioversion was a very minimally invasive measure and I'd have done the same.
I've worked in Hospice, 5 years as an RN and I can tell you with certainty that your Dad will make his exit when he's ready to; you've only given him the time he needed with loved ones. When he's ready, he'll leave this earthy toil.
I was on the other side of a decision with my Dad and had to call an end to life support with his 19 day CoVid battle after being placed on a vent in ICU. I feel like I'll never be settled with having made that call, even though I know clearly that I was following his wishes.
The choice to never start life support may one day come to you and you'll know not to go down that road and to allow him a peaceful journey whenever that time may come.
Make the most of your remaining time with your Dad and maybe consider talking with him about your decision in that moment. He may surprise you.
Our parents are such treasures and it's so very hard to say goodbye. Just love him and hold his dear hands in mutual comfort or exchange your customary expressions of love and affection with every chance you get.
Funny how much I miss my dear Dad's care worn hands.
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Abby,
You made the right decision in the moment and allowed your dear father time to close out his life on his own time. The cardioversion was a very minimally invasive measure and I'd have done the same.
I've worked in Hospice, 5 years as an RN and I can tell you with certainty that your Dad will make his exit when he's ready to; you've only given him the time he needed with loved ones. When he's ready, he'll leave this earthy toil.
I was on the other side of a decision with my Dad and had to call an end to life support with his 19 day CoVid battle after being placed on a vent in ICU. I feel like I'll never be settled with having made that call, even though I know clearly that I was following his wishes.
The choice to never start life support may one day come to you and you'll know not to go down that road and to allow him a peaceful journey whenever that time may come.
Make the most of your remaining time with your Dad and maybe consider talking with him about your decision in that moment. He may surprise you.
Our parents are such treasures and it's so very hard to say goodbye. Just love him and hold his dear hands in mutual comfort or exchange your customary expressions of love and affection with every chance you get.
Funny how much I miss my dear Dad's care worn hands.
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Abby,
You made the right decision in the moment and allowed your dear father time to close out his life on his own time. The cardioversion was a very minimally invasive measure and I'd have done the same.
I've worked in Hospice, 5 years as an RN and I can tell you with certainty that your Dad will make his exit when he's ready to; you've only given him the time he needed with loved ones. When he's ready, he'll leave this earthy toil.
I was on the other side of a decision with my Dad and had to call an end to life support with his 19 day CoVid battle after being placed on a vent in ICU. I feel like I'll never be settled with having made that call, even though I know clearly that I was following his wishes.
The choice to never start life support may one day come to you and you'll know not to go down that road and to allow him a peaceful journey whenever that time may come.
Make the most of your remaining time with your Dad and maybe consider talking with him about your decision in that moment. He may surprise you.
Our parents are such treasures and it's so very hard to say goodbye. Just love him and hold his dear hands in mutual comfort or exchange your customary expressions of love and affection with every chance you get.
Funny how much I miss my dear Dad's care worn hands.
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Abby,
You made the right decision in the moment and allowed your dear father time to close out his life on his own time. The cardioversion was a very minimally invasive measure and I'd have done the same.
I've worked in Hospice, 5 years as an RN and I can tell you with certainty that your Dad will make his exit when he's ready to; you've only given him the time needed with loved ones. When he's ready, he'll leave this earthy toil.
I was on the other side of a decision with my Dad and had to call an end to life support with his 19 day CoVid battle after being placed on a vent in ICU. I feel like I'll never be settled with having made that call, even though I know clearly that I was following his wishes.
The choice to never start life support may one day come to you and you know not to go down that road and to allow him a peaceful journey whenever that time may come.
Make the most of your remaining time with your Dad and maybe consider talking with him about your decision in that moment. He may surprise you.
Our parents are such treasures and it's so very hard to say goodbye. Just love him and hold his dear hands in mutual comfort or exchange your customary expressions of love with every chance you get and be grateful for the time you have with him.
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I'd suggest finding out about how hospice care could provide support to him..and you, and other family members and friends.
Try not to look backwards, you can't change the past.
You do have an opportunity now to talk with him about his preferences.
Many states allow a patient and provider to make out medical orders for life sustaining treatment. Or physician orders for same. This allows the person and their HCP and their medical provider to talk about specifics of end of life care....if there is one in place and his status is DNR, no not intubate, etc. then that is clear to everyone.
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Call hospice imo.
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If I had been in your shoes, I would have done the same because if I had made the decision to let my dad die; Lordy, that is the guilt that would be very difficult for me to live with. You don't want them to suffer so if your dad need critical care/around clock care 24/7 then you must decide to move him to another home or facility to ensure all of his care/needs are met daily. We as caregiver do the best we can. My dad is 88 and mom is 83 living at home (their wishes is being honored for now) with elderly/disabled brother there too. It's hard but I say do your best and the best must be enough! Wish you blessings in your decisions for your dad.🙏
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You made the best choice that you felt was right.
We, caregivers, will most definitely be facing making choices that are hard and how can we, assuming most are not doctors or even have any medical knowledge be sure of anything.
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Since his thought processes are sharp, you saved his life. Good call! Now use this time to talk with him about the quality of life he wants in these later years... and about advanced directives: DNR, organ donation, iv hydration, tube feedings... Then, get those desires in writing,
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PeggySue2020 Sep 2022
Organ donation for someone who’s 93?
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You're in a 'damned if you do/damned if you don't' situation Abby. Either way, you're going to feel badly here. If you didn't approve the 'cardioversion', you'd have felt terrible guilt in allowing nature to take its course. Now that you approved this procedure, whatever it is, you're feeling guilty for prolonging dad's life which will now be in a Skilled Nursing Facility. Either way, you lose.

Dad's mind is intact, ask him what HE WANTS moving forward, which should have been made known all along. When others leave decisions in their children's hands, we make choices based on what WE feel to be the best decisions FOR them. That's how it works.

Ultimately, dad is 93 and in poor health. When his number is up, it's up. With or without a 'cardioversion', his heart WILL stop beating when it's tired and finished beating. That's not to sound callous or cold, just to say, we all have a certain amount of heartbeats here on earth, and that's it. Even if you wound up extending his life for a while, that's all you did: extend his life for a while. He can now choose to sign a DNR and make other decisions that will not prolong his life any further. He's free to make his own choices now, and after you speak to him, you'll have a better idea of what he wants his final days on earth to look like.

FWIW, it's no better to have a parent with dementia to watch go through an end of life journey, that's for sure! I wouldn't wish that on anyone, ever, under any circumstances. You are better off with dad having his mind intact and finding out his end of life wishes than you are having him incoherent with advanced dementia and having to make ALL of his decisions for him. That's no cake walk, trust me. His life in a SNF may not 'break his heart' the way you think it will. It may be a great weight lifted off of him to have others caring for him in such an environment, w/o having to rely on his daughters to change his incontinence briefs.

Wishing you the best of luck with all you have on your plate. Extend yourself some grace now and realize that you're doing the best you can under extremely stressful circumstances. There are no 'bad decisions' when a daughter is making them based on love. Remember that.
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sp19690 Sep 2022
I agree but sometimes even when a person's number is up medical interventions prolongs life past a persons expiration date.

Hopefully dad is willing to talk about further interventions going forward.
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Whatever choice you made, you made from love. Even if it feels like you did the wrong thing at times, you did it because you love him, and you were stressed and made the best choice you could at the time. Sometimes our best isn't the same from one day to the next, sometimes our 100% varies too. (I stole that pearl from The Four Agreements)
When the time comes again, maybe you'll choose differently because you love him? Cut yourself some slack, you did the best you could and did it with love.
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Thanks sp19690, I thought I read it wrong.

Is Dad capable of making his own decisions? You say nothing in the your profile about Dementia. Did he understand what was going to happen?

We do what we feel is right in the moment. It seemed even if this has not happened, Dad would have needed more care than you could have given him. Just be there for him now. Visit and take him outside while the weather is nice. Bring him his favorite things to eat. Enjoy the time you have.
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