Not having medical procedures in old age

It's purely anecdotal, but of the elderly people I've seen who've had operations with GA, many of them have gone on to develop dementia or various forms of confusion a year or so later. Those who've had operations with an LA haven't.

I have found that families can be a real barrier to sensible decisions such as DNAR and what is and isn’t appropriate treatment.

You’re not the worst person at all for hoping something takes your mum out quickly.

My mum was diagnosed with lung cancer and died very soon afterwards from a medical emergency after a colonoscopy (they thought she might also have bowel cancer). I was so relieved when I was told the news that she had died! I had been completely dreading her being in pain for months. A long lingering decline is not what we want for our loved ones.

Chris Witty has talked about this before. I certainly saw the hospital throw more and more at my Mum. Six weeks before she died she was moved to cottage hospital (still big but no A and E) and they put her in a private room and I suspect at that point they knew she was going to die. I knew too but thought she has another 3 months based on nothing logical. She had some many tests and treatment.

My Dad has sensibly had a DNR put in place and had declined certain medication which would prolong his life but resulted in a poor waulity of life for him.

I had a very frank discussion with my mums Doctor and we have a 'Respect' Plan in place.
She is 76, with Alzheimer's, advanced COPD and weighs around 5.7 stone.
We have agreed that no lifesaving measures are to be out in place. No hospital stay unless for a broken bone. - I know being in hospital would terrify and confuse her.
She has on her paperwork, that she only wants home treatment, and to be allowed to die at home if possible.

There is no point in massive treatments. Its not going to save her, or improve her quality of life, it could only extend it and push her further down in terms of her Alzheimer's.
I have tortured myself by thinking i am the worst person in the world to hope something takes her out quickly.

She is dying. I just hope it happens soon so she dies still being 'mum' Still recognizing the people who love her, knowing how much we care. I dont want to have to watch everything being taken from her for her to die Scared in a strange place without feeling the comfort of the love from people she recognizes. I have come to terms that if that makes me a bad person, then so be it.

I think there are two issues here: deciding whether or not to have treatment before you get unwell and secondly prolonging life no matter what.

My thinking on the first is that I'd rather die of pneumonia, COVID, a heart attack etc in my 70s whilst fit and well and full of life BEFORE I might develop dementia. I'd rather die without having my life go downhill.

On the second issue, the medical profession seems to be obsessed with keeping people alive even when there is no quality of life. For example, CPR on or chemotherapy for someone with dementia. I believe this is wrong, not least that the treatment can worsen the dementia and cause the person more distress.

I actually think a lot of intervention in the elderly can shorten their lifespan rather than prolonging.

mil and fil both had serious conditions- one had a brain tumour, the other had an aortic aneurysm. Both opted to manage conservatively with medication and monitoring. Both are still here 15 years later and in good health (excepting those issues) in their 80/90’s.

on the other hand my sisters fil had a “lesion” on his liver. The NHS advised conservative management, the logic being he was in very good health, asymptomatic, and chances were if it was cancer he’d be unwell. His family insisted the nhs were choosing not to treat and took him private, where they diagnosed cancer without a biopsy and started chemo. He went from a fit and well man to dead from the chemo in 6 months.

sometimes the “cure” isn’t.

That's really sad about the work colleague with the 99 year old mother.

I hadn't heard of an advance directive before this thread but I'm definitely going to put one in place for myself. No way would I want to endure what this elderly mother is having to endure at the age of 99.

It's ridiculous sometimes

Thankfully the hospital were sensible when my mum had sepsis and stopped antibiotics
Then I sat watching her die like why does she have to go through the dying process when we wouldn't do this to an animal?
She's not going to recover, she's actively dying but yet it's illegal to help?

When it comes to people with no capacity and poor quality of life, there is often nobody who has both the understanding and the guts to say “enough”. Family don’t understand or feel they have to go with the recommendations for treatment or are a too heartbroken to make a decision, and there is no medic with the holistic insight of the patient or the time or the guts to say “you have the opportunity to allow your mum a natural death”.

I’m also the owner of a pretty strong advance decision.

I too have an advance directive in place. I have no children. So I would like the decisions made to be largely my own. I know that DH is unlikely to be able to refuse treatment on my behalf.

Like others, advance directive says no treatment if I have recognised dementia or suffer a brain injury; no anti-biotics for respiratory infections, and no cancer treatments unless I am fully informed and able to consent.

In my own head 75 is a good cut-off for things such as chemo/ invasive surgery etc. I have had chemo before; it’s debilitating and recovery is a long term thing.
Quality over quantity.

I think 75 is a bit early to give up on yourself! I can tell you the seventies are okay unless you suffer with ill health but come the eighties then things tend to go down hill. However if adjustments and expectations are made there is no reason to give up. However, once independence is totally lost then I don’t want to be here. I am 83.

I don't think 75, is too old to want to enjoy life but in my experience the next 10-15 years are often very cruel for people of this age and there is often a steep decline in health looming in the not too distant future. I have seen it time and time again where a relatively fit and healthy 75 year old becomes an elderly, confused and unwell 85 year old with an extremely poor quality of life. This often isn't helped by the fact that so many people lose their partners and friends over this time too and begin to struggle to live independently.

There literally comes a point where it is diminishing returns and some elderly people simply don't believe that life is worth living anymore when there is very little to look forward to and a lot to fear. My grandma is at this point and although I love her, I can totally understand why she feels the way she does and I imagine I would feel the same in her position. It wouldn't be fair to encourage her to endure medical procedures to prolong a life that she feels has pretty much already been successfully completed. Who would benefit from this? There should be a greater acceptance in this country that death isn't always the worst option for everyone all of the time.

@NattyTurtle59 my mum was dead at 72 from early onset dementia
Hence why I haven't waited until 75 to do an advanced directive
It's not just the dementia, I've seen people my age with brain injuries that I don't want to survive

My grandmother developed vascular dementia in her 70s. She has always been adamantly against any operations but when she broke her hip, her son pushed for an operation.
It was absolutely awful- she had a really bad response to the aneasthetic and it hastened her cognitive decline. Puls she was stuck in a hospital ward, without her regular carers and it was very busy which made her very anxious and aggressive.
My work colleague was still dragging her 99 year old mother to heart scans, even though her skin was like tissue paper and the blood tests were causing her real distress.

It's not that 75 is too old for anything at all. It's just that the decline between 75 and 85 is really striking. 75 is a point at which you might easily start having significant health issues which could lead to death if not treated. An age at which perhaps it starts to be harder to rehabilitate after surgery, radiotherapy, fractures etc.

Barbara Ehrenreich wrote about being 'old enough to die' at 70 and that she was refusing major intervention from that point (she was already a breast cancer survivor). She died at 81, six days after a stroke. Good on her.

Haven't read the full thread but is be surprised if it wasn't full of screams of ageism and that people are little better than murders wanting old people dead.
I don't think there's anything you can do about this to help this generation, the only thing we can do is make sure this treatment doesn't happen to us. Make sure family all know you DO NOT want this torture and get paperwork in place to prevent it.

I agree with this. A pacemaker isn't necessarily life saving but my goodness it can be life enhancing. Yes my 91 year old stepmum would probably have died before now if she hadn't had it done, but she regained her pep... she is out and about, not sat in a chair looking at telly.

Before the (minor) op, she wanted to die. Now she doesn't.

I agree with you @Orangesandlemons77

My in laws are in their late 80s and quite frankly they are miserable. My MIL is in a wheelchair and can't do anything for herself. My FIL has early dementia.

They are both constantly going to the doctors and then the hospital for procedures and they definitely have been kept alive by a huge amount of NHS intervention. This week for example my MIL has 2 hospital appointments, one is for a scan but she doesn't know why she's having a scan.

My poor SIL is the one living closest to them and she is at her wits end with having to be their main support system and keep driving them to appointments and sorting things out for them at the same time as holding down her job. In my heart, and all their children feel the same way, we wonder why the NHS is so determined to keep them alive when they have no quality of life.

Where do people get these ridiculous notions that 75 is too old to want to enjoy life? My neighbour is 76 and his wife not much younger and they still work full time in their own business, which involves physical labour. My friend is 80 and we go walking several evenings a week, for an hour to an hour and a half. Some of my friends are 71/72 and show no signs of slowing down.