JOAN’S BLOG – TUESDAY/WEDNESDAY, SEPTEMBER 16/17, 2008 –
DIFFICULT MEDICAL DECISIONS – ANOTHER CAREGVIVER BURDEN

We have discussed on the Message Boards the personally challenging and complex decisions that we as caregivers must make at the end of our spouse’s life. Our particular discussions centered around whether or not to treat pneumonia in a Stage 7 Alzheimer patient, or let them slip away peacefully. This is a fairly common decision caregiver spouses must make. No one welcomes it, but it often has to be made.

However, I am finding more and more medical decisions having to be made by spouses - from the most basic to those involving life and death.

When AD entered our lives, I certainly expected to have to remind my husband to take his pills; to eventually have to fill his pill box to progressing to having to give him his pills. What I did not expect was to be put in charge of adjusting his medications. Because of fluctuating blood pressure, and a few seriously low blood pressure attacks, Sid’s primary care physician has put me in the driver’s seat regarding whether or not to give him a certain blood pressure pill on a certain day, depending upon his blood pressure readings after exercising. In addition, I am to monitor his medical condition, and if his reading is below a certain point, but he seems “okay”(as in not passing out), I should let him rest until the pressure rises. If the reading is low, but he does NOT seem “okay”(as in passing out), I should call 911. Yes, I realize it would be a major inconvenience to the doctor, and highly inefficient, if I had to call him every time there was a question as to whether or not to administer the pill or call 911, but somehow, this seems like a bit more responsibility than I am qualified to handle.

And yet………… I found myself choosing only one of the two drugs the psychiatrist prescribed for Sid. The anti-depressant solved the problem, so I didn’t see any need to add the anti-rage drug. That is just common sense, one could argue, but it is still a medical decision I chose to make on my own.

Then there is the situation in which my friend finds herself. Her 80 year-old husband, who is well into the middle stage of AD, has cancer. His only chance is chemotherapy.

Who wants to be put in the position of deciding whether to let your spouse, who is still able to enjoy life, socialize, talk, and relate to you, live or die? Should she let the cancer take its course to spare him the end stages of AD? He certainly is not capable of deciding. She felt she had to give him a chance, and is going ahead with treatment. Her decision is not the issue. The issue is carrying such a heavy decision making burden.

Alzheimer’s Disease forces us into situations we never thought we could handle, from doing the plumbing to coping with rages, but making daily medical decisions is not one I anticipated, nor one with which I am comfortable.

I know many of you have had to face end of life decisions, and many of you have refused invasive medical procedures for your spouses, but what about daily medication and treatment decisions? Have those been put in your hands, and are you comfortable with them? Please post comments under Message Board Topic: Medical Decisions.

©Copyright 2008 Joan Gershman

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