Good evening All. My 93 yr old mother has decided not to get a new pace maker put in. The battery on her old PM is almost 10 yrs old and is running low. The life span of a PM battery is usually 10 yrs. She is on hospice now for 4 months for end stage congestive heart failure. She is still of sound mind, and it is her wish not to get a new PM. This is a new stage of my caretaking with her. I have been her caretaker for 8 yrs now, and up until a year ago, she was still fairly independent within her home. I believe her battery is running very low as they have a difficult time getting a reading on her blood pressure most times. She is still ambulatory with a walker, but she is pretty sedentary at this point.
I just don’t know what to expect if the battery is really running low. It is a whole new realm for me emotionally and medically and I would like to know if anyone has had any experience with this. Hospice is prepared to help of course.
Have you talked to your Mom's cardiologist about your concerns and asked him/her what the signs are of a pacemaker battery failing and how it will/might affect your Mom?
She signed a dnr when she first went on hospice. At that time, she couldn’t walk 2 feet without running out of breath. While she is a little better now due to comfort care, she says she has had a good life and she misses everyone who passed before her. She is not depressed. I just don’t know what to expect when the battery starts to really run down. Maybe it is and I just don’t recognize this. I wanted to find out if anyone had experience with this situation. I plan on continuing to let her make her own decision about it. If she wants to do it, I will accept her wishes and bring her to the doctor for assessment. If she gets the PM, she will be dropped from hospice as hospice sees this as treatment. But they can pick her up again if she declines further - even after the PM replacement.
Were I you, I would forget about the pacemaker. It is likely to go on more than a year more and if it does not it is unlikely to make any difference in her life. I would like you to speak to the doctor who put this in for her to reassure yourself if you are her POA. Please make an appointment if this is the case.
As to the life left in the battery are you her POA for health care. A quick trip to MD office will measure exactly how much life is left in the battery.
As to what happens if she doesn't have it. That depends. If she takes a lot of meds that slow her heart rate, atenolol, beta blockers, digoxin (which almost no one takes anymore) and etc. then her heart may slow so much that it cannot sustain her and she will slip away. More likely is that, unless she had a profoundly slow rate, she will go on. Syncope is difficult to assess as to what causes it and frankly it is usually low blood pressure from medications. My partner got his pacer to enable him to take meds he needed to slow his rapid atrial fib without slowing his heart to a stop because he had a slow beat anyway.
I would explain to her first how EASY this surgery is. I would ask her if she is WILLING to or WANTING to die. It would not be a terrible death as death goes.
I agree though, that a talk with her dr maybe good. My daughter has had patients die and you can hear the pacemaker clicking.
What does the cardiologist say about how the new battery or new wires or new pacemaker will affect your Mom's "end stage congestive heart failure"? Will a new battery make your Mom more comfortable the last days of her life? Why does your Mom not want a new pacemaker battery, does she think that it will prolong her life (and prolong her "misery and/or suffering")? Does she think that if she does not get a new pacemaker battery that she will die sooner?
You need to talk to your Mom's cardiologist and get more information about how her pacemaker is affecting her life currently and how a new pacemaker battery will affect her life in the future. If your Mom's heart is not responding to the pacemaker's electrical impulses like it should, then it might not help to have a new pacemaker battery inserted.
This is a difficult situation and I hope that you can assist your Mom to choose an option that will allow her to be comfortable during her remaining days. {{{Hugs}}} and Prayers
She doesn’t have a doctor now since May of this year. Just hospice doctor and nurses. She sees the nurses twice a week. The doctor assesses her from the nurses notes.
I will call hospice soon and have a talk with them, now that we all know she doesn’t want to get a new pacer. TY