Mother is going to be 86. Last year she was at 25 efrg. Now she is at 14.She has moderate dementia and had a fall 6 weeks ago and has been in hospital and rehab since. Dementia has wiped out short term memory. And is worsening. No hope there. But she is in good spirits.
She is also not able to walk around without wheelchair. There's not alot of her left.
Dr's are going to ask about dialysis. I'm power of attorney and medical proxy.
We don't want her to go thru Dialysis as it's not going to fix the dementia. She was against it when she was more in control and lucid.
Opinions?
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I am so sorry for you and your Mom. How lucky she is to have you as a good advocate. My Mother-in-law (MIL) had dementia. It was a slow journey of misery for her and the family. To do dialysis, to prolong what? A life she is detached from? As her health proxy, you should be able to say no to dialysis. BUT, I would consult a lawyer to make sure that that is enough for you to be able to do that. I know health proxy can determine certain treatments or refuse, but not sure if your Mom had to claim it specifically before this. Does she have a DNR also?
I know how hard it is to watch someone you love slip slowly away. My MIL was a fisty woman; a little bit of a person. She was a War bride from Fance and married to my FIL 67 years. He was overwhelmed with trying to take care of her. We would come over to "sit" with her. She would be nasty as heck and then see me and instantly snap sort of back for a moment. I called her ma Petite Mere and it brought her back to France. It made her smile, which peeved her daughter, who she only fought with. Her last days, she used French mostly, and I was able to speak a bit with her. My French is very limited. But those moments were special for me. Even her last days, she would sit a glare at her kids, but me, she would smile. We were with her right up to the end.
Make sure to take care of yourself as well. Cherish the special times when she comes back.
Your mom trusted you to decide for her, based on her wishes, by giving you the POA. Please avoid judging or second guessing yourself. You know what she wanted and what is best for her. My thoughts are with you at this trying time.
I don't have anything to add to what Bassetmommer said. But I do agree with her. If you've talked to your mom and know what she wants, then go do it. The most important thing is to honor her wishes. I'm not quite as old as your mom, nor do I have dementia but I have instructed my proxy that if something happens and I need emergency dialysis to deny me that.
You will receive blessings from divine for taking care of her and your patience is commendable. In my opinion its good to follow her wishes as it will make her happy. As what I have heard of dialysis, its a very painful process and better to avoid it. I am an Indian and we have some therapies which many kidney patients follow and have got results. I will post the link here but not sure it will be helpful, you can consult them as well.biswaroop.com/ They also have ebooks and pdf on end of transplant. So you can choose to read it. I dont have any option to attach it here.
I am so sorry ! You are honoring her wishes and that speaks volumes for your commitment to your mom. Happy she is in great spirits. Sending lots of hugs and positive thoughts to you. 🙏🏾
I'm sorry to hear about your mum. We went through the same regarding dementia. It's heartbreaking. We were determined to do everything to help our mum. However there comes a point when you have to think about the day to day realities of your mums wellbeing. Can't believe I'm saying this but we were "lucky" as our mum died suddenly. So we didn't have to make end of life decisions. I am on haemodialysis and relatively young. It is hard going physically and mentally. I can't even imagine what it would be like for someone with dementia. There are a lot of elderly patients at our dialysis unit. Quite a few have passed since I have been there. The majority of them chose to stop dialysis and passed away peacefully. Knowing what I know now about dialysis and having a family member in your mums situation, I personally would not put them through it. I know it's a difficult one but as you stated, your mum when lucid did not want it. Sometimes the hardest decision can be the right one. This is only my point of view. Wishing you and your mum all the best. You are in my thoughts x
I am 83. I was diagnosed with stage 3 kidney disease in 2017. I stated then that, if I reached the point of needing dialysis, I did not want it. I will choose palliative care, and, if the need arises, I hope my daughter will respect my wishes.
i agree with Bassetmommer. . I am an 81 year old woman at stage 4. I have promised my husband of 61 years and children that I will TRY dialysis when the time comes , but NOT if I were to have dementia! I do NOT want a long happy life to be prolonged for thst! Honor her wishes! Best wishes!
I’m so sorry to hear this. Dementia is so horrible. I’ve watched family members go through it.
I don’t know why you would ever think of going against her wishes. Tell the doctors no.
You are free to refuse medical treatment of any kind and any time. It’s your right.
Have you ever seen anyone having dialysis? She’d have to be strapped down for hours or sedated I imagine so as not to dislodge tubes. . It would be beyond cruel.
We live and we will pass away. This is a hard to accept, but it is true. Often, mother nature is more gentle, understanding, and caring for us during that transition than modern meds and technology. I would see this as a golden opportunity to enjoy one's relationship with mom - to reminisce over old times, to complete bucket list items, to treat mom to things she cherishes. Of course, the decision belongs to you. You're an awesome and loving person for being there for your mom. May we all be so fortunate.
If mother communicates, walks and talks with the dementia and is not bedridden then let her have dialysis and keep her on Mother Earth longer. What she may have thought of dialysis in younger days may not be how she thinks as she aged.
Also no dialysis and end stage kidney disease is a lot of pain so if you don’t want her to have dialysis better be ready to give her strong pain killers and then morphine so the trajectory is no (or less) suffering and transitioning to the next life.
I’m sorry, but that is not correct. End stage kidney disease is not painful, nor is passing from kidney failure. It can be quite peaceful and quick.
Kidney failure is not kidney cancer - which can be painful. But, thankfully Hospice is absolutely wonderful with pain control and anxiety reduction.
I absolutely respect your opinion on end-of-life, but no one should be spreading misrepresentation.
I have seen people with Dementia screaming and crying getting their hemodialysis. They have been taken from their nursing homes to a new location with strangers and then they are strapped down and poked with a needle. They are scared. It was awful seeing that.
Some patients get sedated and some do not. Some patients from nursing homes came in looking almost comatose, either from meds or the end-stage of life, and were obviously peaceful.
Perhaps dialysis was the wish of the patient (even knowing what would happen to them in Dementia). Perhaps it was the wishes of their family for religious or personal reasons. But, dragging a scared person with Dementia from their bed to a completely different facility several times a week is certainly not an easy or light decision for anyone to make.
If anything, it is a reminder to all of us to make our wishes known in writing to loved ones and our PCP.
May you be at peace with whatever decision is right for you and your family. 🙏🏻
Sorry for your situation. I believe you are doing exactly what your Mom wanted and honoring her wishes, I think you are making a good choice. If that were my situation I would do the same as you.
I would say palliative hospice care when her numbers become lower.
There are many people who choose not to start or continue dialysis.
Depending on her symptoms, various meds can help with swelling. Often when the kidneys start to shut down, the patient ends up with multi-organ failure and/or congestive heart failure.
Her PCP or Nephrologist can refer you to Hospice services.
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