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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We ALL SAID “He’ll DIE (it will break his heart, it will kill him) if we have to (seek residential care, put him away, stick him in a nursing home, abandon him)”.
But the FACT IS, many elderly who are physically disabled or suffer dementia or are fall risks or are embarrassed by being cared for by family etc etc, actually learn to love their caregivers, enjoy pleasant surroundings in residential settings, and realize a renewed appreciation for their “new” lives.
I was the “noble daughter” until my own health began to crumble, and my young family came to miss a full time mom.
And as it happened, I DIDN’T “abandon” my mom. I had more quality time with her, and more interaction with her, than I had when she clung to the cozy little home where she’d lived before the fall down her steep steps almost killed her.
Elder life is not for sissies, BUT ELDER CARE isn’t for sissies either. You quickly learn that you have no “good” choices, and maybe ALL the choices STINK, but with LOVE and as much current information as you can pull together, YOU, AS CAREGIVER, SOLDIER ON.
You LOVE your dad, you made a choice with potentially no good outcomes using your love for him and in the heat of an emergency, all the information that was available to you.
And you know what? You couldn’t have done ANYTHING DIFFERENTLY. Continue to base YOUR DECISION MAKING on your love for him, the facts at your disposal, and his SAFETY and WELL-BEING and PEACE and COMFORT.
If you are doing that, you can’t do anything more. Hopes and Blessings…..
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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.
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.
Hopefully dad is willing to talk about further interventions going forward.
What did you dad want to do in this case? Did he tell you?
I know what I would choose for myself if I were in dad's situation.
At 92, my mom, with dementia, already living in a NH started having erratic and low heart rate. Cardio told us that a pacemaker was jot an "extraordinary measure" which mom's DNR and other documents said should be refused. My POA brother ended up asking mom did she want the device and she said yes, clearly after some thought.
I was left thinking that mom, 20 years earlier had always told me that she DIDN’T want to live like that, i.e., debilitated, old, in a home.
I think you did the right thing. (((HUGS)))
And how do you ask someone with dementia what they want? Shouldn't moms directive made before the dementia have been what was honored not the decision of a demented elder?
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.
Please don't feel guilty. Think of it as the other "G" word: grief. So many on this forum have been in your shoes -- or are about to be. Blessings to you and may you gain peace in your heart.
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.
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.