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Mom with pneumonia, diabetes and coronary artery disease. Husband with early onset Alzheizmer's. I am so very tired, physically and emotionally. Stress is causing my diabetes to be out of control. I am under my doctor's care. We are currently trying to make the decision whether or not for Mom to have a quadruple bypass operation, or to let her live our her life with Congestive Heart Failure. She is 83. Her doctors have left the decision up to us (Mom, me and my siblings). She still has a sharp mind but at her age and with the diabetes not under control, I don't think surgery is the right answer for her. Any experiences or thoughts on this subject for me?

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First of all, let your sharp minded Mother and siblings make the choices for your Mom's care and treatment, you have health issues of your own and a husband with Early Onset Alzheimer's, stress will exacerbate your health issues, get with your doctor about meds to help you deal with anxiety that won't have negative affects on your diabetes, you can't take care of anyone until you take care of yourself...you first, then your husband...by that time Mom and the siblings, along with recommendations from her doctor, should have HER health issues settled. Don't bite off more than you can chew...YOU don't have to share every burden in your family, I've learned that the hard way, husband with Alzheimer's, 2 children going through marital problems, grandchildren with....well, you get the picture, I support my family in their needs, I don't have the time or energy make THEIR needs my own. God bless...
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Is yor Mom's doctor able to explain her options to her? You mentioned that her mind is still good, and your Mom's own feelings are most important. It sounds like the doctor is communicating with you and your siblings as well, so the family sounds very concerned, loving, intact. You can help your Mom sort through her thoughts and feelings about this, because in my opinion, a serious surgery at age 83 would frighten me. My mother in law lived for 15 years with congestive heart failure and she was almost 200 pounds. She was very sensible, and lived to be 100 (was also type II diabetic). Her opinion was that if she didn't overwork her body, if she put her legs up (we got her a wonderful recliner), she would die happy. Being able to talk with her adult-to-adult really made a difference and we knew she was solid in her decision. Toward the end, the blood thinner she took was also releasing the clots in her legs, so it was medicine and poison at the same time, but she knew and made reasonable decisions after a lot of discussion, thinking, soul searching. Her taking charge like that relieved my husband and I more than we ever knew. Having to be in a position to make decisions on others' behalf, or to take the lead because another is more passive, is the worst kind of exhaustion. It would seem that trying as best you can to get into her shoes and be the best advocate you can for her happiness, quality of life, safety -- is the best anyone could do. Even though you may be strong for your Mom, it is possible there is a sense that the undercurrents of stress are felt by her and others. Should your Mom decline, need more help, etc., you yourself need to protect her by protecting your own stress levels. Now my husband (81), a very active man physically and intellectually, is opting to forego back surgery because he recently had a few TIA strokes and has been diagnosed with moderate grey matter damage (vascular dementia). Thus far things haven't changed much, but we are definitely facing his mortality. My Mom had aortal artery surgery at age 82, it changed her life so much she spent the rest of it in depression and as an invalid. I suspect there is no firm predictor of surgical outcome, but there is no doubt it is a very, very large assault on a frailing body. Nursing someone is extremely exhausting and often frightening when you are alone with issues that come up in the middle of the night. The longer I live, the more I respect my mother's words: "You have to respect and bow to mother nature." She said that with a smile not long before she died. I hope that you, your Mom and family can have relaxed and blessed conversations together. My thoughts and regards to you and them.
(11)
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personally I would not put your mother through surgery at her age, just have the doctors make her comfortable so she is not in pain, i would also look to put her into a skilled nursing facility so you can take care of yourself, I just had to do this with my mom as my health is also failing, will keep you all in my prayers
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I just want to add to what 50s Child said so well. My mother also lived with congestive heart failure and made it to age 100. She had a great cardio team and was able to use a scale called a "cardiocom." She weighed herself on it daily and answered a few yes or no questions on it. The data was reported to her doctor's office and if they saw she was gaining fluid they would adjust her meds accordingly. They were able to keep everything under control very well and she was still living in assisted living, participating actively in the community there and walking under her own power when she passed away. Surgery is not always necessary. Please take care of yourself and unburden your stress if you can. It is not a crime to take breaks from the stress of caregiving and is essential for you. Hugs and prayers coming your way.
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When Mom's hip prosthesis deteriorated, a local surgeon wanted to operate but the primary care doctor said elderly people don't come through general anesthetic very well.

I researched this and found many cases of elderly people with normal faculties becoming mentally incompetent after surgery. Even with a spinal and/or local anesthetics, such serious surgery is a huge risk for someone your mother's age.

And, speaking of risk, it seems from what you say that you aren't physically or mentally able to be anyone's caregiver. Sorry to be so blunt, but are you waiting for a coma to rescue you from these circumstances?

Sending prayers for resolutions to your problems, all parties blessed.
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My Mom has Congestive Heart Failure, Diabetes, her memory is not real good. She is 77 years old. I took her to Florida for a vacation. Drove down from Vermont. I had to cut the 6 month condo lease to come home after 4 months. Her balance had her falling quite often and was admitted in the hospital in FLorida. The conclusion was fluid on the brain. To shorten the story it was not done as the risk v.s. living with it , it was decided to not operate. This operation was not a "High Risk" by doctor's in Florida but in Vermont they thought it was better to get her walking in physical therapy. It has helped and I think that it the right thing to do. It's not all about she will live longer, it's about looking outside the box and realizing what will be, will be. I have strong faith and feel it was the right thing to leave it alone. Operating with diabetes is a risk. My Dad passed 2 years ago, and it has been a nightmare as he controlled everything and Mom can not handle decisions. I am taking on all the responsibilities. I have 2 half brothers who would rather not do anything, except take money from her. Since we came back from Florida a total of 4 months, Mom has done okay, She suffers from deep depression and that is the main issue. I have been sick doe 4 months straight with 3 different illnesses that has compromised my life and health,. Mom is in assisted living but the stress has taken it's toll. My sweet dog that I love has kidney failure too! I am burnt out and I have to take care of myself, It is difficult as I have been taking care of Mom for years, But I know I will not be around,or ill all the time. So, take care of yourself, reach out for any help to relieve your stress. It's hard to do but I have admitted finally that I am burnt out and need to have my life, I love Mom but in assisted living they can take care of her and she has the option to join activities with people her age, I can be a Daughter and visit but refrain from turning it into a Caregiver situation, Not only is it better for me but I know it is what is needed for Mom. I still have a lot to see to as I am POA, and her home is not sold. She has so much paperwork that I have to do. But I now go for walks again with my dog, clean my home, visit with friends and family, I feel somewhat better, it will take sometime and I am sure I will have Mom on my mind all the time. But I do meditation and stay in the "now" and it has improved my health. Take care of yourself!!! It is not being selfish, You need to relieve yourself of the stress and trust me it will be okay. Prayers for you and all your family, and feel we have a lot in common. You are a Wonderful Daughter, enjoy Mom but also enjoy your life,,,Hugs:)
(3)
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STOP. TAKE A DEEP BREATHE. NOW DO WHAT YOU HAVE TO DO TO TAKE CARE OF YOURSELF.

I hate to admit this but I was suicidal for months because of dealing with so much (as well all are) and living with someone who is slowly dying. With help from family I have come out of it knowing:
1st: You deserve as much love and care as you are giving.
2nd: You have to be healthy to truly be of help to others.
3rd: Let go & Let God (if you believe) or Let go; you are not in control of your mom's or your husband's journeys. (whether you believe in a higher being or not)
4th: You are in control of your own journey.
People who are used to giving all of their lives (like ourselves) can easily loose their identities. Don't loose yours. Find yourself again and find the joy of being you in a world with so much to give.
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"And, speaking of risk, it seems from what you say that you aren't physically or mentally able to be anyone's caregiver. Sorry to be so blunt, but are you waiting for a coma to rescue you from these circumstances?"

I think these are common thoughts and feelings shared by a lot of caregivers in similar circumstances. The struggles we deal with, the sanity lost, the way it wears us down, amplifies depression and constantly tests our resolve to keep things together.

I wouldn't judge anyone who would see their loved ones passing as a mixed blessing. My own viewpoint is that I want my father to live as long as he's able to, happily. But I wouldn't lie to myself or anyone that I haven't thought things like how less stressful it would be or how I could get back to my life instead of the sacrifice I made that none of my other family members understand or are willing to accept the burden.

So for us caregivers, I empathize. It doesn't mean we're incapable of being an adequate caregiver because we have those feelings, it just makes us human. And the best way to deal with them is to be constructive and honest with ourselves about the situation we've been thrust in. I love my father with all of my heart. I fight the thoughts for him and for myself and my daughter.

Jonathan
(4)
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I have lived with variations of these dilemmas (my stepfather wanted all aggressive medical intervention to extend his life, so we did that and got him stents, which were experimental at the time. He lived with congestive heart failure for about 10 years after that), and agree that if your mother is sharp she can make her own decisions. If she has not outlined her medical care wishes this is the time to make it all clear. And if you can get some help and some rest, and perhaps find a way to slightly alleviate or manage your stress (mindfulness meditation, exercise, biofeedback, therapy) it will help you a bit. Love yourself as much as you love your family, and ask your siblings to help.
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My mother will be 83 in January. Back in 2005, she had to have a section of her colon removed. The area that they stitched back together is not healthy now, and is subject to frequent bleeds. Her GI doc recommends another resection. So we went to the surgeon that originally did it, and he recommended that it be done with the minimally invasive approach. He said it would be much easier on her. Oh, but he doesn't do that. He recommended the best person that does. We went to him. He flat out told us, even minimally invasive surgeries on 83 year olds are still dangerous. They might not make it. He recommends no surgery.
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My 88-year-old father has had TWO supposedly routine surgeries since April 2012. Both times his 3 to 4-day stay ended up 2 to 3 WEEKS. The main culprit both times was the his body's reaction to the anesthesia used. So I would recommend getting a 2nd opinion before proceeding with major surgery for an 83-year-old. It might be better to manage the congestive heart failure.
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If you choose not to do the surgery, please feel comfortable contacting me. My grandmother is 93 yrs old, she was on 6 different medications(and diabetic) ,kidneys failing and constant infections. She came to live with me 2 years ago, October 8th 2011. Since that date, I have changed her diet and not only does she not take insulin shots anymore, but she is now down to 5 mg of glipizide, and 112mg of levothyroxine,which sometimes fluctuates to 75 mg. Her cholesterol is now LOWER than when she was on the cholesterol lowering drugs! I have her cholesterol at 175 now! All from doing NOTHING different EXCEPT changing her diet. She used to be on meds for her kidneys,not anymore. I know she is going to continue to decline as we all will, but I feel like the quality of her life has changed enough that we will continue to do what we are doing. Her doctor told me he was "impressed".
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I have similar observations with changing my mom's diet. By the advice of her diabetic nurse-counselor, I have put mom on a carb restricted diet (or carb budget as the nurse called it). I am starting to see lower blood sugars during the day and especially in the morning. My mom absolutely argues with me every step of the way, though. She hates budgeting her eating and we fight constantly. Talk about worn out. I feel like I would just like to move her to an assisted living facility. I wish she could afford it. That aside, the changed diet has been touted by many. do it if you can.
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Since she still has all her wits about her, it is her decision to make about surgery. At 83 yrs. she could live a long life yet, even with diabetes. Don't discount the greatest generation's ability to live. They went through much more difficult situations than a little diabetes and heart condition which can be greatly improved with surgery. I am speaking as a nurse who has an 87 yr. old who is currently putting caulking around our windows and works hard six days a week (even with dementia). God didn't give you anything you couldn't handle, so buck up and just handle it. That's what the rest of us do...
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Slow down, stop, take a deep breath, let it slowly, counting backwards from 10. I suggest that you learn to do some meditation exercises daily. If you don't know how, then Google can help you. You desperately need to take care of yourself. If mom is strong in mind, then let her decide. I recommend to NOT do surgery but then I am not there and I am not a dr. Just my opinion. At her age, I would not put her body through it. Sending you my love.
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I'm not sure this is your decision, as you say your mom has her wits about you. So you might just want to "let go". But if you decide you need to be part of the decision process, make sure that your mom talks to an anethesiologist about what the anethisia for this surgery is like (it apparently causes cognitive loss in elders sometimes) and talk to a physiatrist about what the rehab looks like (it's hard work). Been there and done that with both my husband and his mom. After the surgery, she decided no rehab and starved herself to death. Probably some dementia involved...was that from the surgery? No way of telling what it uncovered.
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My mom is in the beginning stage of CHF. Her doctor says it could plateau or get worse. We all decided on a "DNR" scenario and are comfortable with that. Everyone, including Mom, agrees that it is better to enjoy what we have now instead of going to extreme measures. We are trying to meditate, walk, do PT, and live each day to the fullest. We take lots of pictures, my children call their grandmother, and we enjoy our cats--they love Mom. I know it is very hard to chill out--very hard! By thoughts are with you because I know what you are going through. One more suggestion--find a compassionate counselor for yourself. I did and it helps tremendously. All the best.
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Sorry to hear of your distress and angst. I don't envy your spot, but I do agree with those that say that really number one priority is yourself, and you know it. If your mother is of clear reasoning, it is her decision, period. Surgery is bad for anyone at any age, she needs clear and precise prognosis of options. You can support her and her decisions, but it is her decision. Perhaps it is time to take a look at your own options, I know I had to do so when I was getting quite sick from caregiving and knew I'd be dead before my time and my mother would still be around. The best outcome for you and your mom, I pray.
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Hi so sorry you have this to deal with. My friends mum at 76yrs had a triple bypass 5mths ago she suffered a stroke during the operation but was lucky not to have any paralysis BUT a changed woman my friend almost had a breakdown after looking after her for just 3wks. Her mum changed and went into a deep depression she wont wash or eat properly they I dont think they had a choice as she sufferes a heart attack 10yrs ago but this woman was very active very social etc...
My mum has HP HC and diabetes I personally would not want my mum to have this done now as she just wouldnt recover.she also has dementia. My neighbour had a triple bypass at 84 and as she had no previous health problems lived to be 89 and recovered well? I guess it depends on how bad their health is to begin with?
I have too had to make a decision to step back now as ive got chest pains and am having tests done I know now that my health is getting worse and I need mum to go into care I think we will all get to that stage when enough is enough and we really need to look after ourselves now. Stress is not good for diabetes so you really need to watch this and take care of yourself!
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daughter52, we are on a high-carb,low protein low fat all you can eat,no restriction lifestyle. My grandmother has been allowed to carb-up, eat sugar as much as she can pack away (as long as it is low /no fat) and the results are better for us than lo carb. She supplements with iron and vit D because she rarely eats meat.
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Thank you to all who have responded. I truly appreciate your input. I am actively taking control of my diabetes and diabetic retinopathy. My husband, who is still able to enjoy life and I are going on a 2 week vacation just after Thanksgiving. Leaving Mom's care to my sister. God bless you all and may the Lord be with you in your care taking journey.
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Good for you! Enjoy that vacation.
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My husband has dementia but what is really the villan is his hearing, I read that Medicare will pay for an implant and 1/2 of the second, does anyone have 1st hand knowledge of this and what it takes to qualify. He is 68 and seems confused but I think it is mostly his hearing and it makes him anti-social.
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My mother has congestive heart failure, and at age 94, the doctors are only keeping her comfortable with medications. No CPR will be done if Mom gets worse. Surgery is too much of a risk for her at this point; again, only comfort is the issue. One family member is her POA and medical care directive option for her legal decisions.
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Just remember (as you seem like a very caring person), you can only take care of others if you are healthy. If you always put your health and well-being second, eventually it will take it's toll. Seek assistance when possible. I hope you enjoy time away with your husband. Sounds like it will be just what you need!
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With my exp. my dad had surgery at i believe 79-80 on his back all surgeons want to do is operate however it caused his dementia to worsen he never really walked again was placed in a facility 6 weeks before he passed , my mother was his primary caregiver. operations at that age i would never consider again. I have seen it with many of the elderly and the outcome is going to be what it is to be, my dad had open heart surgery in his 60 and was so worth it you need to all sit down as a loving family and consider the pros and cons of what needs to take place .. surgery on the elderly is VERY DIFFICULT recovery process and also very much a strain on loved ones..
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Yep I have to say that being a caregiver for your parents is the hardest job I have ever had. I am a very artistic person and sculpting is my background.It involves a lot of heavy lifting of rocks, granite, marble.,also heaven equipment.not to mention dealing with clients and art shows.. Really? This was a piece of cake compaired to the daily ritual of caregiving aging patents.I have been doing this for 4 years now, my Dad has passed, I had to give up my work, home, friends, and social life to continue caregiving my Mom, as know one else in the family would or wanted to take the time, Ofcourse they thank me all the time for being their for her ...Well of course ,I love her . But she has gotten herself ( and Me now ) into a negative ,just don't give a shit anymore attitude. I , for along time when my Dad passed tried to get her to do the creative things she used to do , but she just wasn't interested, even going to church, or having friends over, she just slides back to the negative, I joke with her and keep her up on current going ons ,but all she wants to do is DIE and go be with my dad. That is tough to deal with day after day....She is basically healthy, except for some dementia, she can not drive or cook... That is too dangerous now, also I have had to do the checking account and bill paying... The point is that now she has gotten stressed about living so long and doesn't understand why God won't take her , that she has come down with the shingles.....oh man...yeah.. Believe me , eat very well, lots of fruit vegetables, fish chicken, the health list can go on.... But when a person is not happy to be alive without there mate ( 70yrs. Married) and you try your best to help ..and come down with shingles...and I am getting tired out ....I have to wash, and change ,her depends, pooping is a BLAST litterly! Family and friends ask how is she doing... Well what about ME..... I have been doing this for along time with no time off... Come on family come by befor mom has passed! And if you are all looking for any inheritance ... Good Luck... It 's all mine , I worked for it ...you never cared to come by or visit....
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Wow, 2woods, I am so sorry. It is amazing how many other people are in situations that sound just like mine. I know exactly how you feel how that inheritance thing. I have four brothers who have already taken anything of any value from mom when dad died. They were living with me. When dad passed away, my siblings talked mom into going back to her house, promising to take care of her. Two months later, she was pleading to come back and this was after they already had most everything including her money. Now they hardly ever even come to see her or call her. I don't get anything for taking care of her. Not a dime. And the only thing that was my inheritance (her jewelery) was stolen by one of them. Grrrrr. Think when she is gone, I will do her funeral and wait to see how long before they find out. Not really, it makes you feel that way. It's been about 6yrs for me now. God bless you, you are a special person and I'm praying for you. Lots of hugs (((((( ))))))) to you.
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In his early 80s day's doctors wanted him to have a bypass. Dad refused. My entire family came down on me because I, was the only one he listened to and I needed to talk sense into him.

While in the hospital, I bumped into a friend visiting family, we shared stories,her dad had been a doctor and had passed away on the operating table for a heart operation. Most surgeries are successful, but I took this as a sign.

So when the family insisted that I was the only one dad listened to, I decided I needed to listen to dad and not talk him into something against his wishes. He lived till 93.

Try to figure out what is in her gut and follow that. There is no right and wrong. Whatever you choose commit to it, you will never know "what if".

My personal gut reaction, would be no surgery.

Best of luck.
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Bypass will make the surgeon richer. Nothing more. Diabetes will complicate healing. My MIL had cataract surgery at 84, which aggravated her glaucoma and blew a hole in the retina. Then she insisted on having retina repair surgery and ended up with a cerebral hemorrhage. Don't do it.
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