Q: My mother has always told me that, medically, she wants everything done for her and not to give up. I am my mother's health-care proxy. Q: My father was diagnosed with Parkinson's disease a number of years ago. Q: When I visited my parents over the holiday vacation, I noticed that my mother was repeating the same questions and continually wearing the same clothes.
Q: My mother has always told me that, medically, she wants everything done for her and not to give up. I am my mother's health-care proxy.
She was recently hospitalized and I agreed to a feeding tube for her because she said she would want a feeding tube to keep living. She went into cardiac arrest and was resuscitated, then placed on a ventilator. The doctors feel my mother has a poor prognosis and may never come off the ventilator.
They suggested that I remove the ventilator and let my mother die. I refused because I know my mother's wishes. The nurses have spoken with me about my mother's condition and I continue to stay steadfast on keeping my mother alive.
What will happen to my mother, and where will she go if she needs a ventilator and cannot stay at the hospital?
A: First of all, you did exactly what your mother wanted and followed her wishes. This is why she chose you as her health-care agent. She knew you would make decisions based on what she wanted.
In Massachusetts, there are chronic-care hospitals that are able to provide the necessary care for anyone on a ventilator. Chronic-care hospitals have the staffing and the ability to provide care to your mother. It is possible that at a chronic-care hospital, your mother may be able to be weaned off the ventilator.
Q: My father was diagnosed with Parkinson's disease a number of years ago. As the disease has progressed, it has affected his speech. Sometimes he cannot express his thoughts, and this frustrates him. Can you comment on this?
A: Parkinson's disease affects speech as well as walking and the ability to care for oneself. If you are noticing even more changes in your father's ability to express himself, then consider contacting his primary care physician for a speech therapist evaluation.
A speech therapist is able to work with your father. With Parkinson's disease, there are often changes with pitch range, intonation, reduced emphasis on words or syllables, longer pauses between words and a softer voice. Sometimes, what the patient was trying to say is forgotten from the beginning of the sentence to the end of the sentence.
Often, people will limit their communication with other people because of embarrassment. A speech therapist will provide your father with exercises, techniques and skills and will continue to play a key role as his disease continues to progress.
Q: When I visited my parents over the holiday vacation, I noticed that my mother was repeating the same questions and continually wearing the same clothes.
I asked my father about this and he said my mother is fine. He would not acknowledge the changes in my mother. My father is taking over more of the household chores and said he wants to help his wife.
What can I do if my father is refusing to see that there is a potential problem?
A: Our advice is to contact your mother's physician and provide him or her with the information you noticed on your visit. Put together a note and fax it to the physician reminding the doctor that the information you are providing is confidential because your father would be very upset if he knew that you wrote a note.
The physician will not be able to talk with you because of privacy laws, however, on your mother's next visit, her physician will be aware and focus in on your comments.
Your father is probably nervous and in denial that there is memory loss problems. Approach him again with support and extra TLC. Remind your father that you will always be there to help if there is problem. Many parents do not want to burden their children.
ElderCare Resource Services is a partnership of geriatric nurses and social workers that helps families to investigate, assess and recommend medical and non-medical care and resources for seniors.
Send questions to ElderCare Resources Inc., 29 Gano Road, Marlborough, MA 01752, or call them at 508-879-7008.