What does your mother want to do? If she is so confused she can't answer this does she have a good quality of life that she might want to extend with major heart surgery at her age? If she has a DNR has she ever discussed with you to what extent she wants medical intervention of other sorts in her final years? It really seems like her opinion would be the most important one in a decision like this. In my experience with aging parents and in laws, I found elderly people have quite a different opinion on their mortality than younger folks such as their children.

Someone needs to talk to, in depth, with the cardiologist and the heart surgeon.
Is the heart blockages causing the heart to work at only 50% or is if from muscle damage that has already occurred.
Does she have cardiomyopathy?
Long anesthesia time in someone elderly can be risky for a person whose mental status is already becoming impaired.
Quality of life is what her decision should be made upon.
I will be keeping her in my thoughts and prayers.
Please keep us updated.

Surgery and recovery HURTS. It will be an uncomfortable struggle for her to heal.

If your mother can't make an informed decision, and has a Do Not Resucitate order already in place, I'd think that decision is made, no matter how difficult it is for you.

If she can still make decisions for herself - well, it's all up to her.

My family is going through this with my grandmother. She's just turned 97, and is now in an assisted living facility. It's tough, because she hates living there, but she seriously could not live on her own, either.

She had a DNR in place when she fell in the assisted living place, but her life was not in danger, so they treated her for the broken hip - surgery and physical therapy. She's still pissed off (her own words) that they just didn't "let nature take it's course".

She's ready to die. Her husband died when she was 38, she's devoutly Catholic, she's never remarried, and all of her friends have died.

Some might think this selfish on her part. I don't. She feels done. She's done all she can in this life, and she wants to be released. She won't do anything to hurry it along, but she simply waits.

Certainly, do not neglect treatment for your mother! Do weigh, however, the pain and suffering of such treatments against the benefits.

Most importantly - it's her body, so it's HER decision.

If your mom is anything at all like mine (and considering she has a DNR order, I'm guessing she is), she wouldn't want to be put through a procedure like that at her age. You say she's confused, but I think you really need to sit down with her, and explain things, and see if she has any opinion one way or the other.

I personally would NOT have someone her age go through an operation like that. I'm surprised that her drs have even offered it as an option--most here won't operate on anyone that old because the risks of an operation are often far worse than the condition itself. I do have to admit, though, that my opinion is very colored by what happened to my FIL. He went into the hosptial for a simple test the day after Thanksgiving. They had him in surgery that afternoon--for an operation that was supposed to be simple and safe. He did well for about the first week, then he went slowly, slowly down hill. Three months later (he never came out of the hospital), he slipped away. Now understand, he was a strong, relatively healthy 80 old--who worked as a PLUMBER right up till the week he went into the hospital for the test.

The thing here is that I find people's attitudes toward life/death/surgery change greatly as they age. While at our ages, we can't imagine NOT doing everything possible to preserve life, a lot of times our older relatives are tired of living, they don't want to go through the hassle and pain of medical procedures. And I really think we have to respect their opinions on that. Of course, it does get a little stickier if the relative is not able to make decisions for themselves, and you haven't already discussed this sort of thing with them.

Before you make up your mind, though, I'd recommend getting out her DNR order and reading it. It may give you the information you need, to know what she wished when she was able to make her own decision on this sort of thing. I know my mom's was very well-written and gave very good direction on what she wanted.

I'm sorry you're all in this position--the decision is a difficult one, no matter which path you decide to take. The best to your family

Thanks everyone for your replies. She might be confused lately because of the loss of blood flow due to the decreased capacity. That and my Mom is following my brother's advice because he is the man and she has never liked making decisions.

I don't want to put her through the ordeal of an operation if it really won't help. But DB is being a control freak and not giving the rest of the family the name of the heart doctor or letting the rest of us see the report. We are all scattered in different states so depend on him for information.

I support whatever she wants. She lost her husband (my dad) of 48 years of marriage almost 21 years ago. She is ready to join him. I just hate to see her go. I don't mean to sound selfish, but it will be hard after having her around for 56 years to no longer having her here.
Clare

I wouldn't want to put someone her age through major heart surgery. It's hard on a much younger person. I can't imagine how much harder it would be for someone her age.

Linda

We all have to face this at some time with our aging parents.

I've already been there,and I "assisted" my Mother into going over.

It wasn't easy,far from it,but we had to "think of her" not ourselves and whether we put her thru hell just to hang onto her.

Call and talk to her docs,make it a conference call so DB cannot control the situation.
Talk to Mother,and then make the decision.

Its not easy,but she is not going to be here forever..you better get used to that now.

I can't imaging how your brother justifies his refusal to reveal the name of your mother's physician.

I agree with CarolÂyou really need to talk to that doctor.

I can tell you that my dad had heart bypass surgery when he was 86. His doctor told me that ordinarily they wouldn't consider the operation for someone his age, but in his case he would have died without it. Plus the doctor was impressed with how healthy he was other than his heart blockages.

My mom is nearly 80 but she would NOT want that. No way, no how. Hates hospitals, doesn't trust doctors, and is not a good patient.

As much as I will hate to lose my mom when the time comes, I wouldn't want to put her through it (the anxiety, the surgery, the recovery, the risk of it all).

Just my situation...not yours...best of luck with whatever you decide.

aptosca, your Mom is a doll- all dressed up with her make-up on, a nice hair-do & certainly doesn't look her age!

DH's doctors told me someone with inadequate heart function aren't always able to process thoughts like they did before severe cardio problems.

If there's anyway you & your Sis can make a trip to IL to see her Dr. (and her) & learn the whole truth of the situation, I would. I know there at times & circumstances where such is simply impossible, though.

I can & will pray for you, your Sister and your precious Mother.

Do let us know how you're doing.

Suzi

I'll be the dissenting voice here, Clare. My mom had a double bypass and valve replacement last Sept., and was completely on board with it. Other than osteoporosis and being a colon cancer survivor of 7 years, she was in very good health at age 86 and 10/12ths. She came through with flying colors and the surgery is very much considered a success. Her breathing improved only a little, which worried her, but all the docs who listened to her heart were very pleased. She is still living on her own, and her and our biggest concern is her very soft bones. Just picking up something a little heavy fractures some bone or another in her back. If it weren't for that, she'd be doing fantastic. As it is, she still lives on her own and gardens when it's possible. My sister is a couple miles away, which is a huge relief.

I guess it's up to you kids to decide whether she's "with it" enough to make the decision. Would it be possible to give her a blood transfusion just before you have the discussion with her? Yes, she's old. I and my sisters were so very grateful that our mom's insurance (Kaiser) allowed the surgery, because she very much wanted to have it.

Erin

There may be another angle here also. Do you and your brother get along well? There should not be any reason why he doesn't tell you the whole story, and ask your opinion. You need to know the facts so you can decide what you think is best. If DB chooses to go ahead with the surgery and Mom doesn't survive, or her life is compromised, how is that going to relate to your feelings with him? It would be a shame to lose Mom and your brother. The two of you need to talk.

Sue

with a little sluthing, you could probably call the hospital and get her doc's name...

I would go by what I thought my mom would want if she was in her right mind. I'm kinda surprised your sister who's a nurse would want to put your mom through this surgery. After seeing 80+ year olds go through h@ll, slow healing, infection, mental changes after surgery, stroke, etc...I would not try and talk my dad into surgery. In fact, he has had cancer, told me if it came back that he wouldn't treat it. The first round of chemo and radiation really took it's toll and he was in his 70s. I want him around forever but it's his life, not mine. He's the one who will have to suffer through it.

I just hope no one tries to guilt your mom into the surgery. I see that happen all the time, by doctors and family.

If my children put me through surgery at that age, I'd be very unhappy with them.

My father is 89-years-old and everytime they do a procedure on him, his health and mental accuity deteriorate a little bit more. I guess the medical establishment finds all this surgery interesting, but it's very hard on these old bodies. Healing time is unbelievably slow at this age and then there's more pills and more medicines and less quality of life and more hassle and more doctor's visits. I've observed that each hospitalization causes more and more deterioration of their quality of life.

After my father's last surgery (where they used general anesthesia), we had to take away his car keys and disable his vehicles and he lost his driver's license (due to accidents and incidents). If you ask him, his life really, reallly sucks.

Rose

A quick question. Do any of you kids have medical Power of Attorney? If she is a little confused, it may be a good idea for one of you to get a POA to help make decisions. Our mom when she was dying, and our brother now in an adult foster home gave DSis and I a POA.

Clare, a year and two months ago, I was in exactly the same

situation as you are facing now. My 91 year old father was

admitted and diagnosed with cardiomyopathy (heart not

working to capacity). His cardiologist spoke to us out in

the hall and said there's nothing he could do anymore. I

am an only child and was a complete wreck (I just retired

from 33 years of teaching). Dad was kept comfortable in

the hospital, and passed away after two weeks. I was happy

to have my father for 91 years. It was his time. I am

crying as I type this. I know exactly what you are going

through, and it hurts extremely much even after a year

later.

~Carol~

Please please please get together with your Mom's doctors and discuss this surgery with them. My Mom has bad lungs and was told 5 years ago she needed surgery. She ignored the doctors and is still going strong at 85.

I would not force my Mom to do anything against her wishes but that is the problem, what are her wishes. I know she will ask me when I phone her today, what do I think she should do. I don't have an answer because I feel like I don't have all the information.

She is a survivor and has survived breast cancer at 68, colon and skin answer after that. And she has had a broken pelvic and hip at different times and came back just as good as before. She survied a car acident that killed my dad 21 years ago. Her neck was broken and she was in a halo for 6 months. She also broke all the bones on her right side and had to go to thearpy for a year to learn to write and use her arm and leg again. She doesn't give up without a fight.

But maybe she is tired of fighting. I just don't know.
Clare

I'm close to 80 and no way would want to have heart surgery and the recovery period. I am "healthy" in that I haven't had a cold or the flu in years, can see ressonably well (no cataract surgery yet)and just found out I don't have cancer of the bladder, which the urologist thought was my problem even though no symptoms other than a little blood in the urine and some spots on my bladder. I use a walker and cannot stand long because of spinal stenosis and even though I wear hearing aids, understand nothing unless you are speaking directly to me, so when there are holiday gatherings I am pretty clueless as to what is going on. That is the hardest part of all. I would rather"go" from heart trouble than being in a nursing home for years with alzeheimer's, which happened to my mother.

I live with my oldest daughter and her husband and family.

Oh Clare, I hate this so much for you. My DH and I talked extensively about our wishes in this type of situation. He had severe coronary artery disease when I married him, so we felt it would be a short term marriage, but we were so in love.

He completed the DNR and medical POA a week before he passed, but I knew his wishes already.

Go be with your mom if at all possible.

Much love,

anette

Clare- I am so sorry that you are dealing with this especially since it's long distance. The POA and the DNR are important documents and I think all the siblings should have a copy. I'm responsible for my Father who moved in with us when my Mom died 3 years ago. He made out a new will and POA and DNR and I gave copies to both of my brothers. I didn't want any misunderstanding if something were to happen to Dad and I had to make important decisions.

You mentioned surgery but you didn't say what the doctor's opinion was, what the risk factors are or how much improvement might be achieved. I think you need more information before you try to help your Mom. Exactly what surgery has been proposed? If your brother is withholding information maybe you or your sister could visit and take her on one of her appointments. Maybe you would feel better if you were able to spend some time with your Mom now.

My Dad just had a pacemaker implanted. His heart was only pumping at 20% because the lower 2 chambers were not pumping in the proper rhythm. Plus his valves are worn out so half of the blood that was pumped out fell right back into the chamber. He has terrible circulation, can't walk without a walker, can only walk about 50 feet without resting, one carotid is completely blocked and the other only has 10% blood flow. He was so short of breath he couldn't dress himself. The pacemaker has made a huge difference - the shortness of breath is completely gone, his heart is in correct rhythm, his fingertips are no longer blue, he bathes and dresses himself, and his skin tone is pink again. He still can't walk far but that's because of peripheral artery disease. Mentally he is very alert, the procedure was short and fairly low risk. So it was an easy decision. However no one was in favor of more extensive surgery especially my Dad. And he is a 'ticking time bomb' but as he says 'who isn't at age 89?'

I hope everything works out for you.

chiming in to agree that you need to discuss with your mom & her doctor.

Brother refusing to give you the doctor's name is a huge red flag as to possible elder abuse:

one person, who isn't acting like he's acting in good faith, is in total control of his elderly mother's very life or death.

I'd get in the car & get to my mother pronto.

I have no advice, but want to offer a hug. (((((Clare)))))

My 87 y.o. mom is having heart problems and my dad and I butt heads about her care a lot. It's very frustrating and heartbreaking, so I can empathize with you.

The two of you look great together, I really hope you find a satisfactory solution to this, sweetie.

I relate substantially with Sylvia Texas ...

... I don't like the business of your brother being unwilling to give the Dr.'s name ... or let you see the medical report ... for what reason? Why shouldn't you talk to him/her?

She doesn't like making decisions, and he, a control freak, you say, is hoarding information.

If at all possible, I'd want to get directly involved.

Just my opinion, based on, necessarily, rather sketchy information.

Good wishes and some prayers for all of you as you move forward toward a decision ... I hope that it is the best one, given the circumstances.

ole joyful

My dad will be 84 in a few weeks. Last summer he was diagnosed with a really bad mitral valve leak and atrial fibrillation. A heart doctor wanted to do open heart surgery on him to correct the valve problem. Thank God we didn't let him do it. His regualar cardiologist talked to us and said that you can always find a surgeon that will operate on you (money issue), but he thinks my dad should concentrate on quality of life now, not quantity. I'm so glad that we didn't do the surgery. He still seems to be okay and gets around okay considering his problems.
I hope your mom will do okay. She is a beautiful lady and so are you.
Lu

Thanks everyone for your comments and support. I talked to her over the weekend and she is against the surgery. I feel it is her decision so I will not persuade her otherwise. I hope it is the right one.
Clare

Well, there's your answer, then. I hope that this brings you some peace as to her situation. Much love going out to you both. I still have my DM (at age 84) and I'm grateful for everyday that I have her.

Clare,
It is the right one for her and that is what counts.
I know this is a terribly difficult situation and I'm wishing you peace.
GardenSpice

I was/am thinking along the lines as Sylvia Texas & ole joyful re: the brother. Red flags!! When my folks (finally) got a POA each of us were given copies so there is no misunderstanding what they wanted. Still have my mom & even without asking, I/we know she hasn't changed her mind. I'm glad you've been able to talk to your mom & hear -from her - what HER wishes are. Hoping you & your sis will be able to work in a visit with her and see just how she's doing. And get the dr's name so you can call his office.
I know it's not easy.

In your original post you said that your sister mentioned unclogging the arteries and putting in stents, then anti clot medication. None of that requires major surgery. I had stents put in in 2001 and didn't even have to general anesthesia. They used sedation and a local so I was in lala land but I do remember seeing the inside of my heart when they were using the fiber optic thing to place the stents. My sister recently had stents put in and she was home in 3 days. So open heart surgery at your mom's age, I can see not wanting that but stents are an entirely different thing and could improve her quality of life.