Alzheimer`s Disease/Amputations

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Question
My mother who does not have Alzheimer, but has some dementia from a recent stroke, developed a blood clot and needs an immediate amputation of her lower right leg.  Probably above knee do to knee replacement 17 year's ago.  Sever degenerative arthritis, left her mobility severely limited already, shoulder's are shot and arm strength minimal, left side even less functional since the stroke.  She is tired and ready to go home.  What I can't seem to find is if allowing the limb to infect and gangrene, just letting her die is a viable option?  Is it legal, could she be made comfortable enough with morphine? Could it be more pain and trauma free than undergoing the surgery with no hope of returning mobility? (and likely more ensuing complications with the diabetes)  I need help, and cannot find answers about non-treatment.  Have you perhaps any experience with patients opting out?

Answer
Hello Terri:  I'm so sorry that you're faced with this awful decision about your mother!  It must be heart-wrenching, and I can only offer you a suggestion.
The best person to talk to about this would be her primary physician.  I would ask him/her if it's possible to place her on hospice and let nature take it's course with her leg.  I'm sure they are aware of her condition, her prognosis, and hopefully even her wishes.  Being on hospice means they will only treat for pain or fractures, and they would make sure she is not in pain throughout the process.  
It would be much easier (legally) for you to make this decision if you are the durable healthcare power of attorney for her.  If you have siblings, I would ask them to be present with you when you talk to the doctor so he/she can see the entire family is united in this decision.
I wish you much luck Terri as you move forward to help your dear mother in her final journey.  Cindy  

Alzheimer`s Disease

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Cindy Keith, RN, BS, Certified Dementia Practitioner

Expertise

As a nurse and dementia consultant, I can answer most questions on all types of dementia. If I cannot answer your question, I will attempt to find someone who can. My passion is to help caregivers of people with dementia, which in turn helps all those wonderful elders with dementia live better lives. When caregivers are better educated, they are able to better care for themselves and their loved ones, so education is key to decreased stress levels and healthier, happier families.

Experience

I have worked as a nurse in various disciplines of nursing for over 20 years, most of which was with the elderly. I was a health care coordinator in a dementia dedicated assisted living facility for 4 years before I started my own business (M.I.N.D. in Memory Care) as a dementia consultant six years ago. As a dementia consultant, I help families nationwide through phone conference calls as they struggle to care for their loved ones with dementia.

Organizations
Alzheimer's Foundation of America Geriatric Interest Network Sigma Theta Tau International

Publications
Published "Love, Laughter, & Mayhem - Caregiver Survival Manual For Living With A Person With Dementia" which is a collection of stories about people with dementia I have known, loved and worked with. Every story has a lesson to teach and this book gently teaches family caregivers lessons about how to better care for their loved one, as well as themselves during their caregiving journey. Published "Love, Laughter, & Mayhem In Eldercare Facilities: The Master Key For Dementia Training" Created "Bringing Nurturing To Memory Care" staff dementia training video Created Ebook: "Hair Stylist's Helpful Tips For Working With People With Alzheimer's & Other Dementias"

Education/Credentials
Registered Nurse with Bachelor's degree in Nursing; Certified Dementia Practitioner; Author of 2 books and an ebook

Awards and Honors
Sigma Theta Tau National Honor Society of Nursing

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