The philosophical discussions about how we medically treat our seniors have always been of interest to me from the time I was in my Twenties. I had the good fortune to live with my Grandmother (my Mothers Mom) during the last year or so of her life, while I was in college, and experienced an early lesson about aging.

Grandma was such a wonderful woman and she lived her old age with grace and humor. She was also the first exposure I had to someone letting me know their wishes privately about no life extending heroics, so I could advocate for her if she were not able to articulate her own choices.

Fortunately I have a family who was in tune to my Grandmother and she was never put through more than she requested. Grandma died at home surrounded by each of her children and I was blessed to have been there as well. She passed away with dignity, respect and in a room full of love.

I think of Grandma often when I am dealing with my own Mother. My Grandma had a very mild memory issue and would repeat herself often but never got to the place my Mother has with her dementia. Grandma was able to be consistent in articulating her wishes for her healthcare up until the very end.

But with Mom it is different in that we have to balance what we knew her wishes to be in the past and what she is expressing in her confused state of mind. As a family we want to give her the choice of change, but how do we know if she is able to comprehend the consequences or understand the ramification of a changed healthcare choice?

As an example, an argument was made to me from a healthcare provider to not give Mom the dementia drugs because there is no way it can reverse what has occurred, no definitive science that it works for everyone (crap shoot) and it delays the inevitable, so why put them in the holding pattern of dementia….what quality of life are you keeping them around for?

Sounds brutal but it made sense to me. Especially for someone like my Mother who my whole life would comment that her biggest fear was that when she got old she would lose her mind and she would not want to live that way. Yet when you ask her now does she enjoy her life and should we do all we can to help her keep her brain healthy she will say yes! So we put her on the drug regime and when I hand her the pills for her to take she will ask “What are these for?” I answer that they are for her brain and she always replies “Well then give me ten of them!” and pops them in her mouth happily.

In the end the rationale for our family was that my Mother is still able to function with some independence at home and so we would do whatever we could to help her remain in her home as long as was safely possible. We support that with caregivers, and for now my being with her, but there may come a day when this will not be possible and Mom will have to be moved.

It did give me pause when I thought about putting her in a holding pattern of sorts by putting Mom on drugs that may delay and as a result just prolong her decline. But as a family we thought we needed to give her every opportunity to stay at home and so here we are waiting for the next healthcare decision and hopefully a smooth place to land!