82 Year old refusing pacemaker battery replacement

[Christina188]

My 82 year old mother has had a pacer since 1979.  She is do for another battery replacement, but wants to refuse the procedure. She is completely pacer dependent, we are told.

She is hemiplegic ( can't walk, stand, move her right side, or hold up head, and she cannot speak.  She lost her husband of 56 years last year, and has a DNR.    Her oxygen sat is in the mid 80s, and she is quite frail.  She still can eat and drink on her own, but needs help in all functions of daily living.

She stated she is not afraid to die, and life is too hard.  She feels the pacer is keeping her alive past her time.

What will her prognosis be ( including how  her death be like) is she does not replace the battery?  How can we keep her comfortable?

[Cleveland Clinic]

If she is indeed pacemaker dependent, and she has had a pacemaker for this long then most likely once the battery is fully depleted then she will no longer have a stable  ventricular escape rhythm. She may pass away from asystole in a few minutes, hours or days, one is unable to predict exactly when it will occur. If she is lucid and competent then she should be able to make the decision not to undergo the device change-out procedure. This is a relatively simple procedure which does not require anything but local anesthetic and is usually very well tolerated in the vast majority of patients.  What is her objection to the procedure? Is she mis informed regarding  how invasive this can be? Is she depressed following the loss of a loved one? This needs to be fully explored before a final decision can be made.

[Christina188]

Her objection is the pacer acts as artificial life support, which she does not want now that she is so paralyzed and frail.  She feels having a DNR means no artificial support, and the pacer is contrary to those wishes.  she doesn't want it turned off, just not replaced.

She actually is doing fairly well ( not really depressed) all considered, as she has lost so much more than just her husband.  She still enjoys other's company, movies, and a good game of bingo, loves to read, etc.  I think she is very lucid and competent to deny the procedure, but we don't know what that prognosis would be.  Your information was very helpful.