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I am caring for my mother Clementine, who is 88 years old, living in my home with age-related decline, alzheimer's / dementia, diabetes, and urinary tract infection.
Under NO circumstances would I have EVER chosen to extend my mother's life after she was diagnosed with dementia! Her quality of life was dreadful with dementia, and extending it would have been an act of cruelty in my opinion. To place a PEG feeding tube into the stomach of a demented 88 year old woman to extend her life in such a state would serve what purpose, exactly?? Ask yourself that question, and when you come up with the answer, then you'll have the answer to the question you posted.
As dementia, a terminal condition, advances, the elder can become unable to swallow, unable to speak, unable to understand language, unable to walk, get out of bed, go the bathroom on their own, etc., all ending up with death, ultimately, which can be a terribly ugly thing to witness.
Put your mother's best interest at the forefront of the matter, and you'll have your answer. And ask yourself if YOU would want your life extended if you were suffering from dementia, diabetes, UTI and age related decline.
A feeding tube to help get through a temporary illness might be reasonable, but if your mother is on a general decline and has reached he point of being unable to eat, a feeding tube would only be an invasive intrusion into the dying process and might actually cause her unnecessary discomfort in the dying process.
My mother had this procedure done following a stroke. Our family approved it after her doctors encouraged us with a great hope of recovery. Sadly, the recovery never came. In the circumstances of dementia, I’m pretty certain, as there is no chance of recovery, I would choose not to place the feeding tube. Once it’s placed, there becomes no good or simple way to decide to stop nutrition. No one becomes willing to “pull the plug” so to speak, it’s an impossible situation to be in
If it were my mom, and she couldn't eat on her own and I had medical power of attorney, I'd say no. Quality of life vs. length of life…quality always wins in my opinion.
The procedure is not the question here at this point. The anesthesia is exceptionally light for this procedure. My concern is the choice to place a peg tube. Only you understand your Mom's wishes for her end of life care. I personally, at 80, have for decades had specific PROHIBITION written into my advance directive that disallows such forced feedings. I have refused placement of NG (naso gastric) or PEG tubes for feeding, and have forbidden IV TPN (total parenteral nutrition). I have prohibited other things such as dialysis. If your Mother gave you indications that she wishes to live under ANY conditions, and with ANY and ALL heroic measures, then you are following the instructions she gave you. I am assuming you are medical POA. If your mother has expressed to you in the past that she would not like to continue to be forced to live in these circumstances, that she feels that we all die and that she is at peace and content with her life, would like to pass in peace and contentment, you may wish to explore hospice, and allow your Mom to pass as peacefully as she is able. As a nurse I can tell you that the placement of this tube, and the forced feeding of these nutritional substitutes for real food often mean diarrhea, bedsores, infection, and etc. They may prolong the quantity of life, but seldom help with any quality of life. Only you can make these decisions now for your Mom, after speaking with an honest and forthright doctor. I can only wish you the very best.
I wouldn't if the decision is yours, and assuming Mom cannot make her own decision. I have already refused in my advanced directive (I am 80) dialysis, placement of NG or PEG or IV for nutritional delivery. So that would make the decision easy, but I was a nurse, and I surely do know after many long years of lessons what I don't want in terms of torment for myself at the end of life. We all die. The question is, does Mom accept that? Do you? Is it time for end of life care and Hospice? I am sorry, but it sounds as tho the decision if yours. I know the anticipatory grief, but I doubt very much that placement of feeding tube will do anything but prolong pain, both mental and physical.
I was a party to the development of my recently deceased LO’s end of life choices and decisions.
She was an active Church goer, and everything in her decision making was shepherded by her lawyer and her long known clergy.
She firmly rejected this sort of sort of procedure, and I as her POA checked her final directives and additional documents as her illness progressed.
Until about 10 days before she died, she relished juices and nutritive beverages served with a straw. She progressively lost weight for the last 5 or 6 months of her life in spite of heroic efforts to encourage her to eat, and was finally described as having geriatric failure to thrive.
With your mother’s constellation of issues, it would seem potentially questionable at very least to subject her to any strenuous procedure(s) that would prolong life in any way.
My LO was enrolled in an on-site hospice program for about 18 months before her death, and both they and I agreed that she was peaceful and comfortable in spite of severe physical deterioration in her last 4 or 5 months.
We also agreed that no medications were needed as she came nearer to death.
If you have access to someone whom you trust to talk to, you might find comfort in a 2nd opinion. I took great consolation from conversations I had with some of my LO’s favorite clergy members.
This is mom's call. If she cannot understand how it works or how it's going to affect her life from now on, I would be hesitant to have it done.
88 is a good long life. The peg tube will allow her to be nourished, and will prolong her life. But it comes, as so many of these 'procedures' at a cost. Quality of life being the first and foremost.
Assuming you have DPOA? If you don't, you can't do a thing to help her with this, other than be a sounding board for her questions.
What is her mental status like? Does she have a good attitude and a true desire to live longer? Or is she terrified of the march of time and the ultimate death that awaits us all?
Is she still capable of making good decisions for herself? What are her wishes? If the answer is "no" to the first question, does she have a Living Will? What are her instructions there? If she doesn't have a living will with her advance medical directives, do you think you know what she would want? Is she the kind of person who would want every step to be taken to prolong her life? Or would she rather let nature take its course and be in hosptice-type care, where she is made comfortable, and doesn't want extreme measures to fix things that are wrong with her. All operations with anesthesia take their toll with senior citizens. And does she want to be fed through a peg tube the rest of her life? All the best to you both!
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
I am caring for my mother Clementine, who is 88 years old, living in my home with age-related decline, alzheimer's / dementia, diabetes, and urinary tract infection.
Under NO circumstances would I have EVER chosen to extend my mother's life after she was diagnosed with dementia! Her quality of life was dreadful with dementia, and extending it would have been an act of cruelty in my opinion. To place a PEG feeding tube into the stomach of a demented 88 year old woman to extend her life in such a state would serve what purpose, exactly?? Ask yourself that question, and when you come up with the answer, then you'll have the answer to the question you posted.
As dementia, a terminal condition, advances, the elder can become unable to swallow, unable to speak, unable to understand language, unable to walk, get out of bed, go the bathroom on their own, etc., all ending up with death, ultimately, which can be a terribly ugly thing to witness.
Put your mother's best interest at the forefront of the matter, and you'll have your answer. And ask yourself if YOU would want your life extended if you were suffering from dementia, diabetes, UTI and age related decline.
Best of luck with your decision.
The anesthesia is exceptionally light for this procedure.
My concern is the choice to place a peg tube.
Only you understand your Mom's wishes for her end of life care. I personally, at 80, have for decades had specific PROHIBITION written into my advance directive that disallows such forced feedings. I have refused placement of NG (naso gastric) or PEG tubes for feeding, and have forbidden IV TPN (total parenteral nutrition). I have prohibited other things such as dialysis.
If your Mother gave you indications that she wishes to live under ANY conditions, and with ANY and ALL heroic measures, then you are following the instructions she gave you.
I am assuming you are medical POA.
If your mother has expressed to you in the past that she would not like to continue to be forced to live in these circumstances, that she feels that we all die and that she is at peace and content with her life, would like to pass in peace and contentment, you may wish to explore hospice, and allow your Mom to pass as peacefully as she is able.
As a nurse I can tell you that the placement of this tube, and the forced feeding of these nutritional substitutes for real food often mean diarrhea, bedsores, infection, and etc. They may prolong the quantity of life, but seldom help with any quality of life.
Only you can make these decisions now for your Mom, after speaking with an honest and forthright doctor.
I can only wish you the very best.
I have already refused in my advanced directive (I am 80) dialysis, placement of NG or PEG or IV for nutritional delivery. So that would make the decision easy, but I was a nurse, and I surely do know after many long years of lessons what I don't want in terms of torment for myself at the end of life.
We all die. The question is, does Mom accept that? Do you? Is it time for end of life care and Hospice? I am sorry, but it sounds as tho the decision if yours. I know the anticipatory grief, but I doubt very much that placement of feeding tube will do anything but prolong pain, both mental and physical.
She was an active Church goer, and everything in her decision making was shepherded by her lawyer and her long known clergy.
She firmly rejected this sort of sort of procedure, and I as her POA checked her final directives and additional documents as her illness progressed.
Until about 10 days before she died, she relished juices and nutritive beverages served with a straw. She progressively lost weight for the last 5 or 6 months of her life in spite of heroic efforts to encourage her to eat, and was finally described as having geriatric failure to thrive.
With your mother’s constellation of issues, it would seem potentially questionable at very least to subject her to any strenuous procedure(s) that would prolong life in any way.
My LO was enrolled in an on-site hospice program for about 18 months before her death, and both they and I agreed that she was peaceful and comfortable in spite of severe physical deterioration in her last 4 or 5 months.
We also agreed that no medications were needed as she came nearer to death.
If you have access to someone whom you trust to talk to, you might find comfort in a 2nd opinion. I took great consolation from conversations I had with some of my LO’s favorite clergy members.
Hoping you are able to access the help you need.
88 is a good long life. The peg tube will allow her to be nourished, and will prolong her life. But it comes, as so many of these 'procedures' at a cost. Quality of life being the first and foremost.
Assuming you have DPOA? If you don't, you can't do a thing to help her with this, other than be a sounding board for her questions.
What is her mental status like? Does she have a good attitude and a true desire to live longer? Or is she terrified of the march of time and the ultimate death that awaits us all?
It is just easier with it, in the event someone in the family wants to raise a stink.
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