Took my hb to the nephrologist this aft at request of gp because his kidney function was problematic. Dr. says it's borderline and we'll look at it in a year, and better than a year ago. Hb has no pain, bp good, wt good, etc. Mind???? the dr. said he would not do dialysis on a patient with "memory problems." (He never mentioned Alzheimer's or acknowledged my husband's vascular dementia--just kept using the term "memory problems.") Said he had a couple times, and the last one the patient didn't know where he was or what was happening and was very uncooperative. Family was pushing for it. Arguing, etc. He seems to think if a "memory patient" would require dialysis, one might as well let it take its course. I had already thought about pros and cons if that were necessary in our case (it's not now), and hb & I came to the same conclusion. BUT any thoughts from readers
We are approaching my DH's care from the standpoint that there will be no testing unless there is an event to be resolved. There is no point in testing for a condition, if he is unable to comply with the treatment required if the results say he has it. Injuries will be treated. Long before VaD was Dxd, we had talked about extraordinary measures, respirators, etc. and DH was clear that he wants no part of them. We have a DNR in place. In my mind it wold be a blessing if he were spared the full roide with Dementia. Being VaD, he could have Heart Attack or major Stroke at any time. With the combination of Learning Disabilities, Mental Illness and well progressed VaD, what sense would it make to "bring him back"? If he were to develop a Cancer or Kidney failure, it's doubtful he would understand and be able to comply with treatments, and how would they really benefit him, by prolonging an even more impaired life? Palliative care, is the way we'll go.
Carol-in time of relative good health it is easy to sign a DNR in the hope that it will not be needed. When the time comes to actually execute it the decision is terrifying.
Dialysis takes hours of just sitting while the blood is being cleansed. It is hard for a child and otherwise 'normal' adult. I can't imagine how difficult it would be to get an AD person to sit with hoses hooked up and blood going out one tube and coming back in the other. I would think it could be terrifying. The exception would be a spouse that just sits quietly oblivious to his surroundings. Personally, unless they are in the just the early stages, I would not put them through it. We had a bil and do have a friend who does it and he is always exhausted afterwords.
Zibby, I basically stand with carosi. The only tests my husband gets are blood tests to control his medications. The only doctor he sees is the family doctor. I can't imagine my husband being able to sit for hours having procedures done.
There is also one awful fact. If you treat some of these diseases you are giving up the "easy" death that nature intended them to have.
Well, I was never confronted with having to make any of these decisions with my husband, but I do know that when he was still able to walk and move around he would never have been able to sit for dialysis. Heck, he wouldn't even sit in a chair to eat....he paced......Hard decisions made easier by circumstances, perhaps?