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MSweeney, you do want to check what type of pacemaker this is, exactly. Some are combined with a defibrillator, and if that applies in your mother's case then you definitely need to ask her doctors to address the issue without delay.

I didn't ever have to have this difficult conversation with anyone, as things turned out; but if I had the first person I would have turned to would have been the cardiac physiologist who did my mother's routine monitoring and adjustment sessions. These people know all there is to know about the specific points you need to know; and because they're not doctors - responsible for the whole patient, if you see what I mean - they're very good at picking out and explaining the technical aspects dispassionately.

It may be, if your mother's pacemaker is a standard model with no bells or whistles, that it won't have any noticeable effect on her end-of-life process; I just don't know enough to say. But get advice simply to see if this is something that needs to be addressed or that you can safely let be.
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I have never seen a pacemaker turned off. Usually it is not going to keep someone alive if they have stopped eating and drinking. Some people have an automatic implantable defibrillator. Those are turned off because they will try to shock the dying heart.
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The day my father passed, they still refused to turn off his pacemaker.

Generally, the cardiologist will not turn it off until the very end. My mother passed on in the hospital recovery room but the nurse didn't/couldn't turn off the pacemaker and Mom breathed deeply 3 times after passing before I asked if it was the pacemaker. Then the nurse turned it off.

The pacemaker is not considered artificial respiration. The pacemaker doesn't keep the person alive, it only keeps the pace for the heart. Your mother will pass when her time comes, with or without the pacemaker. I would think you should leave it alone as without the pacemaker she could wind up having some awful chest pains and severe heart attacks.

Again, there is no way a pacemaker prolongs life - it only keeps pace for the heart.
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Ditto to all the advice about checking with your cardiologist first. I had those same questions, it was a bit confusing to understand how someone could still die naturally with a pacing device.

Dad had a combo pacemaker and defibrillator. His cardiologist advised against deactivating the pacing part, he said that just makes people feel worse physically. He strongly recommended we think about deactivating the defibrillator, he said it would make a difference between a very painful death and a peaceful death. We turned off the defibrillator part so that he would not get repeated shocks if his heart stopped. Dad’s heart stopped on its own, he still had the pacing part of his device active.

Debbie1955
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Yes. I had my fathers pacemaker turned off while in the hospital. It was easy to do and it gave me peace knowing he wouldn’t be shocked while in such s fragile state .
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It may vary by the reasons for the pacemaker, but we were told that the pacemaker did not extend life, but it made life more comfortable by ensuring a regular pace. My husband had both a pacemaker and a defibrillator. A defibrillator's purpose is definitely to extend life. My husband insisted on having his defibrillator removed when he developed dementia. He wanted no life-extending procedures. He was OK with continuing with the pacemaker. So the next time the pacemaker needed a battery replacement the heart surgeon removed the defibrillator. He said he wouldn't open hubby up just to shut off the defibrillator but since opening was necessary anyway, he would do it then.

I think the primary questions should be whether the pacemaker is actually prolonging life in this case.
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Thanks for your responses. She actually has a pacemaker check next week and that was why I started thinking about it. I definitely have some questions for him.
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How much battery life does the pacemaker have? When it’s interrogated how much more life does it project that it has and what’s the percentage of time she’s using it? Perhaps if it’s getting close to end of battery life it could be that it’s not replaced. This is something we may be looking at with my dad
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My aunt, 81, has late stage Parkinson’s and dementia. She is on hospice. She recently had her pacemaker replaced as her cardiologist advised her family that her death would be very unpleasant if they allowed the pacemaker to just stop. In my aunts case her heart would stop without the pacemaker.
Check with your mom’s cardiologist.
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I read her NY Times article and it was very good. I may see if our library has the book. Thank you.
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I read a book called 'Knocking On Heavens Door" which was all about this.
I recall that the doctors gave teh wife a hard time
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No, it hasn't. Ironically the breast cancer is probably the least of her problems. It's hormone fed and very slow growing.

I'm not sure she would be uncomfortable if the pacemaker was deactivated. She wasn't uncomfortable before she got it, just tired.
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That's an interesting question. My father had a pacemaker, but we never even thought of considering disconnecting the lead(s). In retrospect, I don't think I would have asked that, b/c it was hard enough for him to breathe as he declined and his vital organs were shutting down. I think the respiratory issue was significant enough, and causing obvious distress, that turning off the pacer might have aggravated his discomfort.

Has your mother's cancer metastasized?
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Thanks for your reply and I'm sorry for your loss.

My mom really has no quality of life and I know that if she had her faculties she would not want to go on like this. It's breaking my heart.
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When my mom, who had dementia and CHF got a pacemaker, we asked specifically if we would be able to have it deactivated if it appeared to be what was extending her life past a time when she had any quality of life. We were told that deactivating was not an issue.

As it happened , mom died of respiratory failure, so in the end, we did not have to do anything about the pacemaker.
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