I don't know what to think

Discussion in 'I have a partner with dementia' started by jenniferjean, Jun 19, 2019.

  1. jenniferjean

    jenniferjean Registered User

    Apr 2, 2016
    345
    Female
    Basingstoke, Hampshire
    My husband has an aorta aneurysm which the hospital has been monitoring for quite a few years. Now it is at the stage where normally surgery, major surgery, would be recommended. It is 5.4 and it appears they wouldn't normally operate on less than that.

    However because of his alzheimers they now say that they have decided not to operate as they fear he would be unable to cope with the operation. I was advised that the chance of it rupturing is less than 1.5%, but if it did then that would be it - lights out. There is no discussion on this, the doctors have decided it's not advisable and he has been discharged.

    Part of me feels that maybe it is better if he is spared the operation, and yet part of me feels that it's as if having alzheimers means he's written off. I just don't know what to think.
     
  2. karaokePete

    karaokePete Registered User

    Jul 23, 2017
    4,773
    N Ireland
    That's a distressing situation and I hope that talking about it here will help you in some small way.

    It's a fact that surgery can have serious complications for a person with dementia and even accelerate the dementia. If I were in this position with my wife I think I would let something like this spare her the later stages of dementia - but I realise that this is easier said than done.

    It's horrible the positions dementia put's us in and I wish you the strength to deal with this.
     
  3. Rach1985

    Rach1985 Registered User

    Jun 9, 2019
    322
    I have to say I agree with @karaokePete on this one. It’s something me and my mum have discussed regarding my dad who has heart problems and we are going towards a DNR. He is only mild right now and we are hoping for a good few years still, but my mum works in a care home and she is of the opinion that if anything can spare him that then she will do it. That doesn’t mean it’s an easy decision and if it happened tomorrow I’m not so sure she would stick to the decision 100%
     
  4. maryjoan

    maryjoan Registered User

    Mar 25, 2017
    1,253
    Female
    South of the Border
    How old is your husband? My mother had an aortic aneurysm in her late 80's - no dementia - but they refused to operate because it is such a big op for a person of that age. It ruptured when she was 91 and they did operate to try and save her. She died because her heart gave up just as the op was finished.

    My OH has dementia, and he had major surgery just as his dementia was diagnosed - 6 hour surgery, after delirious illness of 5 weeks, and on the point of death. The surgery saved his life. But the dementia progressed because of the severe illness and the operation.

    However, my OH has Vascular dementia and this is known to be affected by ill health.

    I imagine the whole situation regarding his alzheimer's and his aneurysm has to be weighed up with regard to his age and general health. The situation is a lot different for someone with mild dementia in their 60's, to someone with severe dementia and poor health in their 80's - just how much can one human body successfully deal with and still survive??

    Not sure if all this is of any help - but I hope so
     
  5. jenniferjean

    jenniferjean Registered User

    Apr 2, 2016
    345
    Female
    Basingstoke, Hampshire
    I suppose I should have clarified these points originally. He is 72 and on the FAST scale I would put him at 6b. His short term memory is just about zero. I explained to him that the doctor had discharge him and he was glad. He said he didn't want the operation, but who can say if he understands that or the consequences.
     
  6. Duggies-girl

    Duggies-girl Registered User

    Sep 6, 2017
    1,452
    @jenniferjean I tend to agree with the doctors on this. My dad has oesophageal cancer and the operation was dismissed from day 1 of his diagnosis. His age and dementia were against him and he would likely not have recovered. The correct decision as he is still here and happy 14 months later having had no treatment.

    My mum had an aortic aneurysm and was also unfit for surgery (no dementia in mum's case) but she lived for a good number of years with it. I believe mum's measured over 7.5 which was risky but they still would not operate.

    I agree with above answers, weighing up the risks of surgery with the possible advancement of the dementia and also the age of the patient.

    I know how badly a bout of pneumonia affected dad and I would do anything possible to keep him from getting worse. Quality of life is far more important than quantity as far as I can see now.

    I would just be happy that the doctors have made the decision for you.
     
  7. Sirena

    Sirena Registered User

    Feb 27, 2018
    1,327
    Female
    I can understand why the doctors have made this decision. It's a serious op and recovery time can be lengthy. Given there is such a small chance of it rupturing they are probably think the risks of surgery outweigh the benefits. My FIL had the op when he was in his 70s (no dementia and otherwise fairly healthy) and he had a long and difficult recovery, including renal failure which is a known complication. I can't imagine anyone going through that if they also had dementia.
     
  8. jenniferjean

    jenniferjean Registered User

    Apr 2, 2016
    345
    Female
    Basingstoke, Hampshire
  9. Rach1985

    Rach1985 Registered User

    Jun 9, 2019
    322
    I doubt you are neglecting him. I imagine you have been doing your absolute best for him for a very long time and you are doing your best for him now
     
  10. Grahamstown

    Grahamstown Registered User

    Jan 12, 2018
    1,184
    East of England
    I have been thinking about your post and I have feelings too about whether I am doing the best for my husband. I keep coming back to the same conclusion, that the best thing for him is what gives him the most calm and tranquil life in the middle of the confusioned and disoriented world he lives in. I take a palliative approach, in the broadest sense of the word. Anything which would contribute to suffering and pain is to be avoided, in fact I would resist any treatment that would increase that, unless it was to alleviate symptoms. Do no harm if it won’t do any good is my motto, which at times makes me wonder if I am doing the right thing. I have to keep reminding myself that I am.
     

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