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GM - Mom will need a new pacemaker battery in 2 yrs. She will be 95 yrs old at that time. I am her only caretaker for over 7 yrs now and it has not been a pleasant time for me. She is demanding and ungrateful and “lowers the boom” on me whenever she doesn’t get her way. I have tried to set up boundaries and even to try to get her volunteer help to take her out and visit with her. They never last.


The fact that she will be eligible for a new battery for her PM in 2 yrs gives me so much anxiety now! I couldn’t take her having more life in her than she has now. Sorry to sound so harsh! But it has been pure hell on and off these 7 yrs.


Does anyone have experience with this PM batteries for a 95 yr old person? She had AFib and CHF. It’s not as if she is at the hospice stage for anything. Maybe palliative care at the most. Her cardio took her off all unnessary medications for her heart like tikosyn and digoxin. She is still on Lasix, metoprolol and Eliquis. The pacemaker is for syncope.


I know things could change in 2 yrs, but she is very strong willed and she will want a new battery when the time comes. She does not have dementia.

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Wow maybe our mums are related as I have one exactly like yours. She is 97 and I have lived, cared for her last 5 yrs . I'm burnt out just as you are and can't believe my mum is still living. Was good to read your story,was as if you were describing mine
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Don't discuss changes, such as the grocery plan, just do it! She might not like it, but what choice does she really have? It isn't like she can do anything about it other than complain (tune that out!)

Absolutely draw those lines and stay away as much as possible. If her mind is still intact, eventually maybe that will sink in (the why.) If not, well, that's her problem.

Bringing another along is a wise choice! I know our mother would behave differently in front of others - can't air that dirty laundry with non-family members!!! You may have to enlist several others in those visits, so she doesn't become used to that one person and start acting on a familiar basis with them around!

No experience with PMs, but as at least one other said why worry about something that is two years away? No idea what could happen in those two years, so no point in worrying about it now. Even then, if she has it done and it prolongs her life, if you set and maintain boundaries, the impact should be less on you. As for NH, doctors should determine if/when that is needed. Meanwhile, let her sit at home, alone, doing whatever it is she does and only go/visit when regular scheduled necessities are provided.
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nymima Feb 2019
TY for your response. We are still in winter here and she is not looking to get out too much thank goodness. So I am using it for some “vacation” time away from her. On another note she told me yesterday that she doesn’t want to go to anymore doctor appts. She claims there is nothing they do for her (she has the afib and chf and some other conditions going on). So not sure what prompted that, but of course I would get her medical attention if she needed it.
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At age 95, it is unlikely that your aunt will live very much longer, if that is any help. I would think that if she wants a new battery, that is her decision. You certainly cannot prevent that.

As for how she treats you, you do not have to put up with it. I recommend you check out some of Laura Schlessinger's books on dealing with toxic family members. People fall into patterns of accepting abuse and that is never right. Praying that you find some relief and the strength to stop accepting your aunt's abuse.
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Bumping up. Not my specialty.
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The batteries can keep elderly people going for a long time.
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My grandmother went steadily downhill after that final battery replacement, falling, multiple small strokes, platter sized bruises and eventually bedridden. Before that she had batteries and PM's replaced for decades and did well. I was furious when my mother had a doctor replace it at that age and at the cost of Grandmother's quality of life. It's interesting to see comments here about it helping QOL and preventing falls. That wasn't our experience after she turned 90.

I'd definitely try to get your mother accessed. My mother had all her friends and doctors fooled until it was too late for her to acclimate at a continuum of care facility. Those that don't acclimate get dealt with last if at all. Getting her affairs together left me bedridden, so I understand you don't need to be destroying your life for your mother's. Mine was travelling the world at my age until she turned 80. I'll be lucky to see 65. It's not selfish to want your life to be less stressful while you still can!

Some states have geriatric nurses that access the elderly's mental status. Mom thought they had just come for tea!
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bigsun Feb 2019
Thank you
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I don’t know about pacemaker replacement but I was told my client couldn’t have heart surgery because he was over 85.

I agree with another about calling out a person who is being mean. Especially if they don’t have dementia so they know what they’re doing.

I believe in standing up to bullies. I first check my mind, attitude, and presentation before I speak. I politely and simply state what I find unacceptable and why. Sometimes i say it in such a way that it comes out like a mother to a child, with a bit of a tone of shaming acknowledgement, because when they are way out of line you need to correct them. Doing it like that, lovingly and firmly, helps me not feel like a bad person honestly. And then I walk away. I’ve had a client sit stubbornly 1, almost 2 hours until they decided to cooperate. And for myself it was worth it. The moment I got cooperation, I acted like the past was in the past, and I moved on. Nice, polite, friendly, acting in a behavior that I wanted them to join me in. And sometimes that meant we didn’t talk much for the rest of the day - It’s OK!! We’re human! There’s only so much we can take/do. Relationships can be difficult no matter what the circumstances are. We need to remember that so we don’t add more of a burden to it than what it already is.

Somehow, it does feel like with our parents we don’t have the right to do that, but when you become adults, and the parent is miss-behaving, they are taking advantage of that inherent respect they get because they are your parent and that’s when it becomes abuse and that you do not have to tolerate. You’re an adult now too.

And if she was nasty again, I politely drew the line again. Nasty behavior may raise its head again every so often, so you repeat so they learn. Someone needing help doesn’t negate the responsibility of both parties treating each other with respect.

Both sides need to learn to let go of the child parent relationship in that sense.

Seems to be a common theme in this forum. I just want to encourage everybody we have the right to stand up for ourselves but be respectful to yourself and to them for good consciousness sake. Good luck. my heart goes out to you.
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All I know about pacemakers is that my husband's grandmother outlived THREE of them. I'm sure she must have had the batteries changed in her 90s, because she lived to 106. But I'm sure it depends on the individual, so you should definitely discuss this with her cardiologist and probably also her PCP.
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nymima Feb 2019
Oh my - If my mother lives to 106, There’s no way I can care for her. She will have to look into other means of care. This is why I’m already having anxiety if she agrees to the battery change in 2 yrs It will be too much for me knowing she could go another few years after that. She is not in that great of health - heart-wise, and that scares me because she will be more frail. But she is afraid of death. So I suspect she will go for the opportunity.
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My Mom had CHF and a pacemaker. CHF qualifies for palliative care. My sister and I requested a private meeting with her PC physician to discuss the matter in order to get her into the program. He/she is the one who will approve it. The only relief this may give you is eliminating doctor visits. Her nurse dealt with everything from infection to pain with the doctor who oversaw the program. We got a lot of supplies from the program as well, including a hospital bed, oxygen, wheelchair, ointments. There is a team that will look after her, including a social worker and pastor/priest, and someone to help her bathe. The social worker also checked on my sister and me who took turns caring for her at her home 24/7. We vented a lot with the social worker. She was able to suggest helpful books as well as videos on YouTube. Please look up Teepa Snow, and watch some of her videos. You are likely dealing with some dementia. Knowing this may help you.

Please do your homework when searching for a palliative care program. They are listed as hospice companies because they will transition her from palliative care to hospice when the time comes. Insist on having the same nurse each time, which will lessen the confusion for your Mom. One thing two of my friends are dealing with where they live in Maine and Florida respectively is a shortage in palliative care. They just don't have the staff to support the program so my friends' mothers are not able to get palliative care even though they qualify. I hope you don't have to deal with that. We had no problems where I live in Alabama.

I know how rough it can be with a difficult parent. My sister and I both went on an anti-depressant. Hang in there!
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nymima Feb 2019
Thank you for valuable information. I will ask her PCP about this. I don’t know what we have available in NYS.
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Depends how often the pacemaker is used..the only thing a pacer can do is correct missing beats at set rate. It is *impossible* to say "it has only 2 years life left" because they last a lot longer when it's not used much. Besides, Medicare will not approve a pacer change until it has reached near end of battery life. Your cardiologist should have explained that to you. Pacermaker change outs are out- patient procedure. Sure if you mom is still walking, talking and functioning I'd do it when the time comes. If she is bed bound and dying, you may want to consider other options like hospice care. If you have not done so already, you may instead want to focus on estate planning and POA by seeing an eldercare attorney. Also discuss, if you have not done so, advanced directives and living wills; a chaplain or nurse can talk to you about that.
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A friend of mine told her dad when he began to get mean, "if you’re going to be like this, then I don’t think I can do this any longer" and he actually came to his senses and stopped being mean. I know it’s a long shot but you might try it. Truly, you do not owe her anything if she’s treating you so badly. Seven years is a long time and I’m sure it’s impacted your health. So what if she doesn’t like the new grocery routine...no one said she had to. She’s a grown up and can determine her attitude...you are not responsible for her liking anything.
As far as your worry over her PM battery...that’s 2 years out. Worry is counterproductive because you have no idea what could happen in 2 years. Don’t let the anxiety of that projection steal your joy.
What can you do to bring joy into your life? Start planning that out and let mom know what it’s like not to have you in her life constantly. You don’t owe her your retirement. In other words ask yourself "what is enough?" What would she do if you keeled over tomorrow? She’d carry on somehow. Take care of you for your own family and self preservation. Take back your powerthat you’ve let her have.
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nymima Feb 2019
Yes - I agree. I have been getting back to my crafts and painting little by little. I don’t feel guilt if I don’t sit with her or take her out just to get her out of her house. I tried to set that up with a volunteer, but she goes a few times and then I never see the volunteer again. She always has an excuse. I think she is telling them she doesn’t feel good or something. It’s been a long 7 yrs. I know I did my best.
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Allow Mom's Doctor to help Determine about Mom's Batteries, If she is Lucky enough to Reach 95.
Yes, Family can be very Difficult, My sister who is Now my Dad's Caregiver, Is still a little Younger than your Mom, But is More of a Straw Boss since Becoming his Own at Home Boss, Since Mom Passed away.
Just a little Advice, If you ever feel she needs a Nursing Facility, Become her Guardian and go to Court.
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Thank you for your Frank responses
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If it is at all possible to get your mother into a senior center or adult day care program I would go for it. Being social and having someone else besides the immediate family to focus on a few hours a day can make a lot of things easier. In our area transportation to these programs is provided.
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I’m so sorry you have to put up with your mom’s nasty behavior. I’m glad she is living next door, instead of under your roof. I know it’s still hard though.

Your story reminds me of a woman I know. Her husband was her whole world. When he died she was able to live alone. Her son thought it would be a good idea to move in with him, his wife and children.

This woman was excited to go thinking she wouldn’t be lonely but said to me that she most likely would be asked to leave after awhile.

When I asked her why she said that she told me that she would interfere in the raising of their children, how they spent money, just everything in their lives. Guess what? Her daughter in law hated her and told her son that his mother had to go!

She knew fully well that she was a busybody. She thinks it’s caring in her distorted way. Her daughter in law is overweight and she constantly told her that she was fat! She thought her criticism would help her to lose weight. She told her that she was a lousy housekeeper and cook. She criticized how she worked in her garden and so her daughter in law told her she would let her have her own garden to tend to, which she did but she still told her daughter in law what flowers to plant. It got crazy! She wanted the walls repainted in her favorite colors. On and on it went. She interfered terribly with their children by undermining the parents.

So now she lives in the upstairs condo above her daughter. Her daughter does everything for her and all she does is complain! Sounds like you are in the same situation. Hope you get relief soon.
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nymima Feb 2019
I’m amazed the son and DIL put up with her for as long as they did. At least my mother lives next door and I can get away when I need to. I’ve tried taking her to senior programs and getting her visits from volunteers, but nothing ever sticks. I don’t fuss over that however. If she would rather not have anyone besides me, then she will have to have me when I have time. That’s all. I have no guilt. I’m just tired after 7 yrs. And tired of her finding fault. I hope I get relief soon too. You can see my panic if the PM was going to give new life to her. I hate to admit that, but truth be told, I will be ready for the nursing home before her! Lol Thank you for your response.
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NYmima - I am so sorry for your situation. Some elderly seem just live to torture their children. And the better their children take care of them, the longer they live to keep on giving hell to their families. A lot of the blame has to be placed with our medical advances that help prolong their lives without any quality. I hope you will see the end of this caregiving journey soon, and your mother goes to her maker. Death is not the end. Our souls will survive. So, it's a beginning of a spiritual journey.
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nymima Jan 2019
So true so true. She is afraid of death. She has no real quantity of life, but she hangs on for dear life. We have discussed what awaits us on the other side, but as much as she wants to see everyone again, she won’t let go. All friends and family gone. She is the only one left. And I am burnt out. Just an odd place to be in life - for me and her.
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NY;  I think you're wrong about the cognitive piece.  Anxiety was the ONLY symptom of my mother's Mild Cognitive Impairment, which morphed into Vascular Dementia after years of heart issues and a stroke.

I wasn't suggesting a Geri Psych for cognition, though.  I was suggesting a Geri Psych for meds for anxiety and depression.

The fact that she doesn't "get" that she can only stay in her home because of your help is prima facie evidence that her thinking skills have declined.
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nymima Jan 2019
Yes - I totally agree. But she will never take the medication and would be really upset that I would even think of setting her up for an appointment. I did mention to her that I thought she had anxiety, but she looked at me in disbelief. She will never believe it. So I think of new ways to deal with what ever I think she is stressing about. It works for a while. She has afib and she always thinks new medication increases her afib. In fact, a good medication would probably decrease her episodes.
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I wouldn't say "you'll have to go to a NH or AL"; she may end up needing to go there anyway.

I would simply state that you're no longer going to participate in her care if she doesn't agree to see a geriatric psychiatrist and get treatment for what ails her.  You leave it up to her to figure out how she's going to get cared for.

She's strong willed and competent; she doesn't need you.
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In reference to the PM. It does not keep the heart going when it finally just gives out. My daughter, RN, says you can hear the PM continuing to click trying to restart the heart.
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Rabanette Feb 2019
That's sad.
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I believe in a little threat but be sure your ready to back it up. Like Barb said if she doesn't take her meds...oh well Mom then you are going to have to go to LTC. If Mom is 95 then u have to be 70? You are a Senior too. Tell her you no longer can put up with her nastiness and you don't have to put up with it. If she doesn't like living with you, then you will gladly look for a really nice Nursing home. If she can afford it, an AL.
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NY, I just read one of your previous posts; your mother refuses to take medication for her anxiety?

If your mother is of sound mind (and it sounds like she is) you have every right (and obligation to yourself) to say "sorry mom, if you won't take meds, I can no longer care for you".

And mean it.   Can you do that?
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nymima Jan 2019
I think I’m gearing up to tell her that. It’s a tough situation for someone who hates meds. She has afib and is petrified it will bring on her afib. In reality, it may decrease her episodes.
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I know your question is about the pacemaker battery, but what I am reading is that you are burnt out. 7 years is a very long time.

Does Mum live at home with you? When is the last time you had respite? What help is available to you in the community? Do you have any personal support, family, friends, therapist, religious leader? Have you spoken to your doctor about being burnt out an needing help?

Setting boundaries is important, but it is not easy and hard today with out some sort of back up. Even if the back up is the therapeutic fib. But more importantly the support of a counselor or therapist to help you stick to you guns. There will be backlash and it may feel easier to 'give in', but in the long run it is so worth standing your ground.
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nymima Jan 2019
She lives next door. Still able to warm meals for herself (from meals on wheels or leftovers from us) and she has a housekeeper who helps with things like changing her bed and doing some wash occasionally. My mother can still walk with the aid of a cane and if you were to meet her, she would come across as a very friendly and nice person.

If she had to go to a NH, it would be on Medicaid. She lives on my father’s SS. The NH’s around here for Medicaid are terrible. I would have to take her kicking and screaming. She avoids hospital visits when she is in afib because she’s afraid they will send her to a NH like she did with my dad when he kept falling. Unrealistic thinking, but she is very phobic about NHs.

She doesnt have any cognitive disability, so a psychiatrist would probably deem her fine mentally.

I am currently taking some time to myself as we just had a blow up and she accused me of being nasty with her for no reason. This is not true. Actually, I was explaining a new way of handling her grocery shopping so she wouldn’t have me running every other day and she didn’t like the switch-up. I am so tired of having to deal with childish behavior and her telling my daughter that I am mean. My daughter reminds her that because of me, she is able to stay in her home and be independent. Then she looks startled as if she never thought about that before.

We always had a difficult relationship, but she had no one after my dad died. So here she is for 7 yrs now and life has never been the same. She is not that fragile and she has more energy than I do at times. My daughter lives close by and helps when she can, but she is a single parent and works a lot. In fact we have my grandson a few times a week - which we love.

A recent visit with the cardiologist determined a new PM in 2 yrs. I almost had a heart attack myself to think I would still be dealing with this - and maybe worse in 2 yrs if she has a battery replacement. I know she is losing some of her life as she knew it, but I’ve tried taking her to the senior groups around here and she doesn’t like them. She does spend a lot of time on her own. If I had 20/20 hindsight, I would never have agreed to this.
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NY, have you considered having your mother seen by a geriatric psychiatrist for her nasty behavior?  Caregiving his hard enough with a grateful parent; have you considered placement in a nursing home?

CW is correct, the PM won't prolong her life.  Palliative care sounds like it's worth looking into.
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nymima Jan 2019
With who would I approach the subject of Palliative care? I’m not sure if she would qualify unless there are some hidden medical problems I don’t know about. She has chf, valve leakage, afib a lot of the time, squamous cell skin cancer that she treats for with a dermatologist, but no chemo or anything. She has macular degeneration and has terrible vision. I’m not sure about her kidneys. Her gfr is at 38% - but that is normal for a person 93 yrs old I think. But all that doesn’t seem to keep her down much. No real bad days.
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From what I've read the pacemaker won't keep her going if her body is ready to stop, but what it will do is prevent her becoming disabled (and harder to care for) due to a fall caused by her syncope.
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