Mother in-law is almost 80 and in stage 4 kidney failure due to long term use of a particular blood pressure and pain medications. She has scheduled knee replacement surgery. Today, we met with her kidney doctor. He made it clear that she is immune compromised and has great risk for infection. He made it clear her kidneys will continue to decline. She said she doesn't care about these issues and is determined to have the surgery. I think she is setting herself up for more health issues. I would appreciate feedback.
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As long as the kidney doctor approves it she can go ahead with the knee replacement. Unless surgeon will do it without the kidney docs blessing.
How active is mom?
How much pain is she in on a daily basis that can not be controlled by medication?
Will she be able to take medication for pain after surgery?
Will she be able to participate in rehab?
Is she pretty strong now? With the surgery she will have limited use of the knee to bear weight so upper body strength as well as strength in the other leg/knee will be needed.
Is the surgeon fully aware of her kidney failure? What does the anesthesiologist have to say about it?
And I guess lastly
Ask her all the questions that are on a POLST form.
Would she want CPR? (does not always work and will break ribs and crack sternum)
Medical intervention:
Primary goal sustaining life
Selective treatment
Comfort Focused
Medically administered nutrition:
Long term
Trial period
None
Intubation:
Yes (this would probably be included with Full treatment during intervention)
No
And make sure she has her POA for health and finances in order (if they are not) and make sure medical POA is aware of her wishes.
Personally if it were my mom or if it were me I would opt not to have knee replacement.
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I do not know how far along her kidney failure was at the time, but my late aunt, while in her late 80s had a knee replacement and did fine.
I know she already had kidney issues, had for years. Hers was Tylenol overuse. She died at 93 after a fall on her way to dialysis. She had only been on dialysis for about a year, so she had several years with a replaced knee. The same knee had been replaced many years prior and had worn out. So she did have an idea of what it entailed.
A difficult decision perhaps on encouraging/discouraging your MIL. She is lucky to have you helping her gather all the pertinent details.
My aunt was one who made her own decisions and wasn’t looking for our opinions. Her husband died less than a year later.
Hopefully you or DH has her POA and she has all her affairs in order. AND that you are not setting yourself up to be primary caregiver whichever decision she makes.
Let us know how this goes. We learn from each other. Good luck!