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She was recently diagnosed with a bowel obstruction and is refusing surgery. I do have an activated POA and can make all medical decisions for her. She is only 77 yrs old, with Alzheimer's/dementia. Should I honor her wishes? Or go against them. She fractured her femur in January and now has a hard time walking due to her refusing any physical therapy. When I attempt to get her moving, she gets very nasty and argumentative. She can barely move now, I can only imagine how it would be after abdominal surgery. She is very non-compliant. What do I do?
Another thing is she really isn't my grandmother, I just call her that. She lives with me due to her entire family abandoning her. I have been taking care of her for 3 years. I just recently started speaking to her daughter.
The doctor told me that if she is not going to have the surgery, she will be placed in Palliative Care.

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What does her daughter say about this? If this were my mother (the non-compliance and argumentativeness fits her to a tee) and knew she did not want surgery, I would have the doctor explain ALL the options (it's surgery or palliative care) and let her decide. If she decides against surgery, then move on to palliative care & let nature take it's course. JMO.
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As I get older and see what my mom is going through with the perils of the aging process, I appreciate more and more the need for us to "ignore" all of these life-sparing medical "procedures" when no REAL good comes from them. When it is obvious that the end of the road is near and that surgical procedures are only going to prolong the inevitable (vs. giving you a shot at actually LIVING a productive and happy life..of course that would be different!) I don't think we should be so quick to rush to the OR. Face it - modern (western) medicine is more concerned with profits than quality of life. It sounds like your Granny is one of the smart ones who is seeing through the smoke screen....good for her.
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Well she had the surgery today. For the past two days she couldn't make up her mind whether to have it or not. I finally put my foot down today and told her she had until this afternoon to maker her decision or I would. I told her if she didn't want surgery we would disconnect the NG tube and bring her home to die. Well within a half an hour the doctor called stating she decided to have the surgery!
The surgery went fine, they found 3 adhesion's in her small intestine and removed about one foot of the intestine. Her prognosis is good! Now we will see how her recovery goes. My husband and I made the decision that she will not be coming home, after rehab she will go to a CBRF...too much stress....Thanks for all your comments and well wishes....
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Thanks for all your support! I did speak with her daughter tonight and of course her knee jerk reaction was for her to have the surgery. I pointed out all the pro's and con's. Explained to her that there is a good chance she will not come back from this, as she is not the same since her surgery in January. I pointed out that if something should happen and she ends up in a wheelchair, in a nursing home, sitting in a corner drooling on herself, waiting for someone to clean her up, she would never forgive me. After point all these cons to her, she agreed that she should not have the surgery. I will be visiting granny tomorrow, I will keep you posted!
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I agree with purplesushi - if she doesn't want the surgery, then I suggest you don't push it. I'm sure granny realizes her life is only going to get worse as time goes on - so why prolong it as long as she's "going naturally" so to speak. It's a bummer - but everyone has that right. Please keep us informed - we care. Good luck!!
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Ugh - that really sucks! I would ask them to ask Granny what SHE wants to do - where SHE wants to live - who SHE wants to care for her. How many times have they called you in the 3 years you have been caring for her to ask how she's doing, etc? None? I don't know that I'd hold my tongue completely - I think I'd let them feel just a little bit sh*tty for ignoring her!
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I absolutely agree with purplesushi. Just because doctors CAN do something, doesn't mean they SHOULD. She is 77 years old. She has Alzheimers. She is in pain from the broken leg. She has a hard time walking. Sounds like she doesn't really want to go on, so why should someone else make that choice for her? SHE knows what her quality of life is, and apparently she's not afraid for this to end. What does she really have to look forward to?

My mom is 90. She has a myriad of health problems, as well as dementia. She is tired. She is done. She sleeps most of the time. She told me a long time ago that she doesn't want treatment if she is diagnosed with something life-threatening. She knows that there is a better place, and she's not afraid to go there. If your "grandmother" doesn't want treatment, and her daughter is on board, just say no and let her go.
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Just because modern medicine can keep people alive, does it mean it always should? If I knew the outcome, I would make the same choice as she is making. I would rather go out with my mind and some dignity.
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First of all ... big hugs and prayers to you for being a caregiver when no one else apparently would. I can't know the right answer for you, but I can give you some insight from my experience.

My mother is 84, in relatively good physical health, but has Alzheimer's and is progressively declining mentally. She is at the stage where she sometimes knows there's something wrong with her, but can't comprehend what is happening. She gets very scared, and sometimes lashes out in bouts of frustration and anger. It's all part of the disease. During more lucid moments, she will comment that she doesn't want to be like this anymore and doesn't understand why she can't go be with my dad (he passed away 7 years ago).

If Mom were to face a life-threatening illness, I don't think we (my siblings and I) would opt for extreme measures but rather look to comfort and quality of life. Mom has had some stints in the hospital and nursing home for a few not too serious falls, and her mental decline each time was markedly greater. I couldn't imagine putting her through any more than is necessary. And if I ever develop this awful disease, I would hope my daughter would do the same for me.

Give your granny all the hugs and love and comfort you can. And God bless you all.
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My mother expressed that she wanted to die more than once in her final years. She was tired of living, I guess, especially when she couldn't call the shots anymore. The final time it came about was when she turned yellow and the doc wanted to put in a stint to relieve the bile from her liver. She stated to us as a group, "Your just extending MY life!" It was rather a shock to hear that, but we gently disagreed and told her that it was her choice, but it might make her more comfortable. She chose to have the stint put in, and yet died two weeks later. We certainly did not know how long she had, and the doctor's best guess was 3-6 months. Of course, if we had crystal balls, we would have never suggested it. That was five years ago and I don't regret how it happened, because we did the best we could. 77 may be young, but Alzheimers is hard. Keep asking questions and letting her know the answers, but it's her call. We all wish we could keep out loved ones from crossing over, (or whatever you believe) but it's out of our hands.
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