An Ethical Alzheimer’s Question

The question came up again last week when a caregiver faced the ultimate decision. “Should we put our mother through a surgery, knowing that it may save her life, but at the age of 88, it will only prolong her journey into Alzheimer’s. What should we do?”

The decision, of course, will ultimately rest with that family and the medical professionals, but it is a quandary that many of us face as our parents age without the ability to express what they want for their own bodies.

Doctors are trained to preserve life, to “do no harm.” And they are skilled in the various ways to test for disease, treat the symptoms and perform surgeries that prolong life.

But at some point, don’t we have to ask the hard questions? Is Alzheimer’s any type of quality life? Would our loved ones want to go through the pain of surgery, the rehab after surgery and still face an even longer period of time living within the shadows of Alzheimer’s?

My family faced this decision a year ago with Mom’s pacemaker surgery. Yes, her heart needed stimulation because she was passing out, bumping her head and experiencing all sorts of physical problems. Doctors determined she needed a pacemaker, and the decision was made quickly by those who care daily for Mom.

It was supposed to be an easy surgery, in and out in a couple of days. But complications set in, Mom’s mental status quickly deteriorated from confusion to dementia, and the end result was four days in the hospital with a transfer to nursing home care.

Would it not have caused less harm to let Mom’s brave heart just wear itself out and wing her to eternity where there is no pain, no surgeries and no Alzheimer’s?

As I stayed night with Mom in the hospital, she experienced a rare moment of lucid thought and communication. She asked, “What did they do to me?”

I explained about the pacemaker and the complications of a collapsed lung, the possibility of pneumonia. “Your heart needed to be fixed, Mom,” I said, glad for this moment between us but wishing we could be talking about something besides her difficult prognosis.

She raised up in bed, setting off monitors that blinked and brought nurses running. “If they would have asked me,” Mom declared, “I would have said ‘No.’”

When I arrived back in Kansas, the first thing I did was to instruct my son that absolutely no life-saving measures should be performed on me. “If I get Alzheimer’s like Grandma, and if I’m not able to take care of myself, the best way you can love me is to let me go.”

Then I wrote it down in my last wishes’ papers and finalized everything. Do no harm. Let me go.

In the third book of the Life at Cove Creek Series, Reverend G, Jacob and Chris will also face this decision. Writing about this serious topic in a fictional story was easy because I had lived through it with my mom. I knew what Reverend G would choose because I knew my own choice and what I felt was the sanest and kindest way to go.

When it comes to that decision, a life of further Alzheimer’s versus stepping into eternity – for me there is no debate. But each family has to make that choice.

What do you think? I’d be interested to know where you stand on this subject.

©2014 RJ Thesman – “Intermission for Reverend G” – http://amzn.to/1l4oGoo                                                            Finding Hope When Life Unravels