What to expect when pacemaker quits

[ccironwood]

My Dad is in stage 5 vascular dementia. His pacemaker reports that he has 6 months batter life. Because of the prognosis, we have decided to not replace the pacemaker. He is 100% dependent on the pacemaker. What should I expect when the battery runs out? His doctor told me that it won't just quit at that time. They really don't know how long the pacemaker could last.  I'm worried about pain. I will be discussing this with his PCP and his cardiologist. I would just like some answers before then. Dad's health is not in crisis right now.

[LivingInHope]

Well, God is not aside in advances in medicine- since He is the One Who designed our complex bodies & when medical breakthroughs happen by learned people of medical science, it's His grace that causes them to discover those things.   We don't always get the breakthroughs when we might wish, but even when our bodies are diseased, life is precious in His sight.  

I can't imagine what ccironwood is going through, watching their father go through life now so changed, with advanced dementia.  I think the trial is for them, since their father's health is not in crisis- are they going to be strengthened and grow from this experience?  I think I'd be in breakdown mode for sure if I were in their emotionally hard, draining set of shoes, if I didn't have the Great Physician in my life to cast my cares on.    I pray ccironwood will not let the battery wear out.  

[ccironwood]

The pacemaker is a mechanical instrument. Had it not been for it's implementation, my Dad would be in God's hands right now. Would you have him go through the horror's of the latter stages of dementia. Clearly if you knew, you would have a change of opinion. The stage of dementia he is in in nonreversable. He will get worse, day by day.

Not changing the pacemaker is honoring my Dad's wishes for not taking extra measures to prolong his life.

Just like when my mother had cancer 20 years ago and there was no hope for a cure, we kept her free from pain and gently allowed her to home. That is all I will help my Dad do. Keep him pain free and not take extra ordinary measures to prolong things. That is his wishes.

[ireneo]

It sounds like you've already made up your mind as to what you want to do about the pacemaker. You know your Dad's wishes and will honor them. I think I misunderstood the question then. I was focused on your worry about pain. I thought you were hoping to keep his heart beating gently till his body shut down.

If his heart is paced 100%, then you need to find out more details from his cardio. Did he require the pacemaker because his rate was too slow, in the 30's and he was passing out? If so, then his rate will drop into the 30's again and perfusion to the brain will decrease and his dementia will probably increase to the point that he'll drift into a coma. No pain there.

If he needed the pacer because his SA or AV nodes were destroyed and his heart won't beat on its own, then his heart rate will probably drop off and he'll lose consciousness and that will be it.

Either way, I don't see where he'll suffer. If the doctor is worried about any pain or anxiety over the transition, I would think they could give your Dad some medications to ease that when the time comes to either turn off the pacer or when it's almost ready to stop. That would mean interrogating it often though to figure that out.

I hope you can get more info from his doctors and his time will be peaceful.  

[LivingInHope]

Was it your dad's decision to have the pacemaker put in?  If he decided that, was perhaps his wish not to recussitate if his heart stopped beating in spite of the pacemaker?  (This is what happened to my grandma- her heart ceased despite the pacemaker she chose to have put in many years previous.)    

I worked in a skilled nursing facility and saw and interacted some with patients with Alzheimer's in various stages.   And my grandfather had Alzheimer's.  As a child, he imagined me a dutch sailor with my then blonde hair.  Later, I watched him wolf down chocolates and he was drinking his gift of shaving cream (and family had to get him to stop).   He was obviously not as close to me as your father is, so I cannot say I understand the agony this is putting YOU through.  But God is able to be your strength in this tough time you are experiencing as you cry out to Him and He is able to carry your dad home without man's intervention of trying to hurry it along.  There is no way a functioning pacemaker can stop God from calling His child home in His perfect time.    

[ccironwood]

He made the decision in 1996. That was the decision he made then. Now that his circumstances have changed, HE has made the decision to NOT have the pacemaker replaced and leave the rest up to GOD. I respect and love my Dad. We have had this discussion many years ago and I accepted the commitment to follow his wishes.  A few months ago, this thought (of not replacing the battery) never crossed my mind. God is my strength. I know He is always with me as He is with all of us. My prayer is my communication with him, my intuition, is His communication with me.

[LivingInHope]

Obviously, our accountability to God is what counts in any decision.  Prov. 28:26 speaks to one's own intuition, but if you are God's child, I know His Holy Spirit will guide you as you seek His will and listen with your heart to God's Holy Word, living and active.    

So, what I hear you saying is your dad, early on in his illness decided not to get any future pacemaker replacements, but you recently had the idea of not replacing the battery in his current pacemaker.  Is that right?  Have you had the opportunity to get input yet from his PCP and cardiologist on the pain issue since your original post?