I remember reading an etiquette article decades ago regarding a widow continuing to use Mrs. James Smith. At that time, Mrs. Mary Smith usually denoted a divorced woman. I am paraphrasing, but the author suggested that the widow had already lost her spouse, she didn’t have to lose his name as well.
Perhaps some of these conventions are generational. My aunt lived to be 90 and was widowed in her 50s; her mail was always addressed to Mrs. James Smith.
The “Mrs. John Adams,” deal has stymied us on getting some (probably small, but we don’t know) funds back from the state where my grandmother lived. The funds reverted to the state when the insurance company couldn’t find her – not that they looked very hard, imo – and the state will not take evidence that “Mrs. John Adams” is the same person as Mary Adams, despite a marriage certificate and other documents. They want some official document showing that Mary Adams resided at 123 Pine Street, and as far as I can tell, she had everything – including the phone – listed under the “Mrs. John Adams” name. Minor frustration, but I’ve given up on it at this point.
Eyeamom, no it’s not, but I’m sure glad it’s here.
Glad you had such a great vacation away from all that!
Well, my relatives are all going nuts because one of my other relatives didn’t tell anyone that he was advised to have a pacemaker implanted and instead went off on a vacation 10,000 miles away. He’s scheduled to return tomorrow and I got a very aggitated call from another relative that as soon as the guy comes back “home,” he has to be rushed to the hospital.
I threw cold water on that idea and said that the older relative is perfectly competent, as far as any of us knows and it’s up to HIM to decide what he does and doesn’t want and when. In any case, you can’t just show up at the hospital and demand to have a pacemaker installed. I further pointed out that NO ONE is supposed to even know this person’s medical issues and definitely not airing it about. The relative was upset with me and hung up. I agreed that we should DELICATELY encourage this person to get the appropriate medical care that he has had recommended to him, WHATEVER that may be, and get a 2nd opinion if he chooses.
ARGH!
My sister took my mom to the cardiologist yesterday as a follow up to her recent stay in the hospital. She’s still in rehab, but is being released tomorrow. She has made a remarkable recovery. I seriously didn’t think she’d survive this last go round with chf, flu & pneumonia. She literally would just fall over and sleep face first on the couch, couldn’t lift her legs to lay down, couldn’t move. Now she’s up and walking, they take her to her apartment where they have her making her own eggs, to the laundry to wash her clothes, etc. She’s doing more for herself than she has in a long time. But she actually prefers to be waited on. She’s getting back to her feisty complaining self.
As they were leaving the exam room the dr spoke briefly with my sister. He told her - your mom is a sick woman, she needs a valve replacement but I wouldn’t dream of doing it given her age and health. She could have another year.
Our reaction was - first of all, no kidding, we see what kind of shape she’s in, my second thought is no one has an expiration date stamped on their forehead, but honestly - what is there really to do? She just needs to move forward the best she can. Whether it’s 6 months, a year or 6 years. She’s 80 and in poor health, nothing would surprise me. So I’m not sure what the dr was trying to impress on my sister. He did ask if my mom’s paperwork in order. Which I wish he didn’t say to her. It doesn’t take a rocket scientist to figure that statement out. Why worry my mom or make her afraid when she’s actually made big strides.
My mom did gleefully tell me she lost another 7 lbs and is now down to 110. As if she’s doing it through diet and exercise and not just deteriorating. She was 137 in the fall.
Eyemamom - I think the Dr. was doing the right thing. He was letting your sister know that your mom could die at anytime in the next year. I know it’s obvious to you and your family, but to many, they have no idea that their loved one can’t be kept alive indefinitely with modern medicine. The Dr. was making it clear that there are limits to what medicine can do, which surprisingly, many people don’t know.
I agree with GT. I think that he was also letting your sister know that if desired, there are more medical interventions that could be done but that it would probably not increase her life span much if at all.
So often when someone is nearing the end of their life, the family refuses to really see it and so want every medical intervention possible. What they fail to realize is that these procedures don’t always increase life in a meaningful way.
I watched this happen with my FIL. His last year and a half was filled with medical interventions that really made him pretty miserable. Yes, they extended his life, but at what cost?!
I have read Drs comment that they perform medical interventions for elderly patients that they would not do on their own parents. But the children want it for their parents, so it happens. I think your mom’s doc was simply steering the family away from medical procedures that might not really be helpful to your mom in the long run.
@eyeamom, glad you got your vacation and the world didn’t stop spinning while you looked away from your Mom. Glad to hear that it is going well in the care, too. Hard journey to get there so good to have good results. I have mixed feelings about the Dr. comments. although agree with bookreader.
I am struggling with a semi-similar thing, although from the opposite view point. Mom’s cardiologist retired and there are none taking patients in her small town. I got her one with a clinic 75 miles away. But for what point? They do her pacemaker checks right there in the hospital beside her. I don’t see much added value for this trip, although I am going to take her and try (again) for a reduction in her statins. But I don’t see what other value it has for my Mom, she has her pacemaker, her filter, her stent, and her heart is strong as a stallion according to one surgeon.
I think it is rough for the doctors, someone like you can see the obvious, my BIL’s family is blind to their Dad’s issues. Last year he had valve replacement and I commented I did not think that would go well and was seriously chastised for my negative attitude, well, it went horribly. He was released home not rehab due to insurance issues, he refused to participate in all post-op recommendations (even just the breathing exercises), it exacerbated mild dementia, his family does not even see that he has, such that he could not remember to be careful about his chest. He was put into rehab when he got so frail he could not walk, wife & kids exhausted.
After rehab, he felt much better, recalled none of the horror of the prior months and began smoking and drinking again. The surgery was not only a waste of money, but it was a painful use of that time. He is going to die sooner rather than later, he is not willing to not smoke and drink (all day), his family is very much in denial, they need to hear the bad news from the doctor repeatedly and, still, it is not sinking in.
The doctors are partially at fault here. If the procedure was not going to make a positive difference in this person’s life (and it sounds like it was destined to fail from the start) then they should not have suggested, nor consented to do it.
@esobay - at some point you have to let common sense prevail. How many doctors appointments and driving and tests and etc do you put someone through when it ultimately isn’t going to really make a difference? I know I’m going back to my cat that we put to sleep here - but the vet actually told us - you don’t need to bring him back in until you are putting him down. We’ll talk by phone and I’ll just prescribe as needed, it’s too difficult for the old guy and he should just be made comfortable.
I don’t know what I want to know when I ask this, but I’d like to know the trajectory of someone who needs a valve replacement and has congestive heart failure. If a doctor is saying it could be a year - how do you treat someone like that to keep them comfortable? I know my mom well enough that giving her some kind of timeline would not do her any good. Now that I’m thinking about it - she had told us this same dr told her he wanted to see her celebrate her 80th birthday. She pretty much thought she’d be dead by then. She’s now 8 months past that.
This is why you want to talk to a palliative medicine specialist. That’s their job: how do you make someone have the best quality of their remaining life?
Fang has it exactly right about palliative care. Once the doctor tells you – and once you can see it – then it’s time to stop aggressive care for medical conditions, and re-orient to quality of life care. Easier said than done, for sure, especially if there are family members who aren’t yet ready to make that adjustment. My dad probably lived a month longer than he should have, because one brother (who hadn’t seen Dad in 6 months), just couldn’t accept for a time that the situation was really that dire and that it was time to let go.
If it’s time for your family to start down that road, I gotta tell you from experience that this thread is the best resource in the world, for care options, for advice on dealing with whatever difficulty you might encounter, and for support.
Hugs.
Cardinal Fang: The doctors are partially at fault here. If the procedure was not going to make a positive difference in this person’s life (and it sounds like it was destined to fail from the start) then they should not have suggested, nor consented to do it.
I have to say that I disagree. We don’t have enough information here to make such a blanket statement.
In eyeamom’s case, the family/the patient may have said ‘he will stop drinking and smoking and he will do rehab’ so in that case, the surgery may have been warrented. They may have been in denial about his smoking/drinking/level of compliance. And denial is so very common.
I think that a dr should say what all the options are. THey are not god and they can not know all the factors. They can only give their educated best guess. We don’t want doctors making decisions for us. Well, I do not. I want to know all the facts (from my doctor and possibly other sources as well) and then will make a decision.
No, doctors aren’t gods. But I think some people (in general) need to understand that, as much as we may wish our elders could stay forever, humans aren’t built to. I don’t always think it’s fair to prolong the quantity of years when there is little quality for the actual person. Medical intervention isn’t always truly for “the best,” for the patient.
Palliative can be a great gift.
Best wishes, all.
All here say, of course, as I heard it 2nd hand, but IIR, the doctor initially did not want to do the surgery, said it was too risky, shocked them all by saying Dad may die in the OR, but also that he may not make it until the end of the year. I don’t know why he decided to do it, but when the doctor came out of the OR, he conveyed that it was worse than he thought & he wished he had not done the surgery as the guy had taken such lousy care of his body that his internal organs showed hard living & wear & tear.
The Dad is still alive, but the second half of 2014 was brutal on the family.
I don’t know what the answer is, a doctor really cannot grasp the full scope of ones true condition, especially the chronic stuff, some people perk up and down play the negatives, others dwell in the negative, the doctor can only go by the physical measurements a and what they are told. There can be a great many negative factors afflicting quality of life whilst someone still pursues the quantity of life!
Did the dad want the surgery and was he considered competent to make the decision?
He wanted them to “do everything” & I think he is on that borderline where he can appear mostly competent, yet behind the scenes it is obvious he is losing it. A dear friend of mine had a Mom falling into worse and worse dementia, but when I visited them 1-2 times a year, she could pass for normal, it can be tough to spot when someone is on the downhill slide and when the medical people don’t really know the true baseline.
My mom is being released today from rehab. When she went to the cardiologist she bumped into the running board of my sisters car and reopened a wound on her leg. She gets to go back to her new apartment for the first time since we moved her in. They will send someone to change her bandage, send up pt and ot, etc. However, my other sister feels like this would be the perfect time to take mom to Florida to drop her off to see her longtime friend who lives alone, with no end date in mind.
My opinion is give mom time to get settled in her new place and into a routine, get the leg healed and keep up with all this therapy they’re offering right now. Not to mention, this friend cannot be expected to deal with all of my mom’s issues. I’ve voiced my concerns and have been shot down. I don’t even think mom could sit in those uncomfortable plane seats for 3 hours. I don’t get why not a month from now, why does it have to be right now?
I’m letting it go. I did ask that they ask the rehab place their opinion on this trip right now. If they think it’s fine then I’m fine too.
Eyemamom, Wow, you are so much right on this. Travelling at this time is a terrible idea due to all the reasons you stated.