Frustrated with my Mom's Doctor - Why do they put elderly people through so much?

[EllenFrasier]

Here's the background: My Mom is 85 and has had two surgeries on her eye. The first one was 4 years ago for a melanoma on her eye. The second one was last February for melanoma on her eyelid. She cannot see out of that eye at all now. She also has glaucoma in that eye as a result of the surgery, and thinning of the cornea. She had a blister on her eye which caused some leakage, but they glued it (yes glue) and it has healed under the glue and the glue has since fallen out. She cannot wear a contact lens on her eye because of scar tissue it won't stay in. Her eye looks fairly normal and she still has an eyelid, etc. but cannot see anything out of that eye.

Her latest Dr. is the one for her cornea. He is suggesting that she has surgery to build up the cornea so she does not lose the eye. My view on this is that she cannot see anyway, why risk having the surgery at her age. Why not just let her eye go on as it is and if the cornea thins to the point that there is a perforation, then the eye might need to be removed. That may or may not happen.

She has been struggling with this eye for over four years. Constantly watering, sticking her, bothering her. After the surgery on her eyelid, they removed the glands that are under there so her eye is constantly dry and her lid rubs against it. She is never comfortable with that eye. Sometimes I think they made a mistake 4 years ago in not removing the eye.

I suppose the final decision is hers, but I don't want her to have surgery for this if she can avoid it. I think Dr.s sometimes get things muddled up with elderly people. Risking someone's life to have surgery for an eye they cannot and will not ever see out of does not make sense to me.

 

[C.Ann]

Here's the background: My Mom is 85 and has had two surgeries on her eye. The first one was 4 years ago for a melanoma on her eye. The second one was last February for melanoma on her eyelid. She cannot see out of that eye at all now. She also has glaucoma in that eye as a result of the surgery, and thinning of the cornea. She had a blister on her eye which caused some leakage, but they glued it (yes glue) and it has healed under the glue and the glue has since fallen out. She cannot wear a contact lens on her eye because of scar tissue it won't stay in. Her eye looks fairly normal and she still has an eyelid, etc. but cannot see anything out of that eye.

Her latest Dr. is the one for her cornea. He is suggesting that she has surgery to build up the cornea so she does not lose the eye. My view on this is that she cannot see anyway, why risk having the surgery at her age. Why not just let her eye go on as it is and if the cornea thins to the point that there is a perforation, then the eye might need to be removed. That may or may not happen.

She has been struggling with this eye for over four years. Constantly watering, sticking her, bothering her. After the surgery on her eyelid, they removed the glands that are under there so her eye is constantly dry and her lid rubs against it. She is never comfortable with that eye. Sometimes I think they made a mistake 4 years ago in not removing the eye.

I suppose the final decision is hers, but I don't want her to have surgery for this if she can avoid it. I think Dr.s sometimes get things muddled up with elderly people. Risking someone's life to have surgery for an eye they cannot and will not ever see out of does not make sense to me.

Your poor mom.. I can see your point, but on the other hand, what are the benefits of going ahead and having the eye removed now?

It sounds like she has a lot of discomfort with the eye still being there - or did I read that wrong?

Would the main risk be the anesthesia?

How does your mom feel about this?

I feel so bad for her.. Being able to "see" (for me) comes in second only to being able to "breathe"..

 

[daughtersrus]

Here's the background: My Mom is 85 and has had two surgeries on her eye. The first one was 4 years ago for a melanoma on her eye. The second one was last February for melanoma on her eyelid. She cannot see out of that eye at all now. She also has glaucoma in that eye as a result of the surgery, and thinning of the cornea. She had a blister on her eye which caused some leakage, but they glued it (yes glue) and it has healed under the glue and the glue has since fallen out. She cannot wear a contact lens on her eye because of scar tissue it won't stay in. Her eye looks fairly normal and she still has an eyelid, etc. but cannot see anything out of that eye.

Her latest Dr. is the one for her cornea. He is suggesting that she has surgery to build up the cornea so she does not lose the eye. My view on this is that she cannot see anyway, why risk having the surgery at her age. Why not just let her eye go on as it is and if the cornea thins to the point that there is a perforation, then the eye might need to be removed. That may or may not happen.

She has been struggling with this eye for over four years. Constantly watering, sticking her, bothering her. After the surgery on her eyelid, they removed the glands that are under there so her eye is constantly dry and her lid rubs against it. She is never comfortable with that eye. Sometimes I think they made a mistake 4 years ago in not removing the eye.

I suppose the final decision is hers, but I don't want her to have surgery for this if she can avoid it. I think Dr.s sometimes get things muddled up with elderly people. Risking someone's life to have surgery for an eye they cannot and will not ever see out of does not make sense to me.

Why are the doctors saying that the eye may need to be removed? Is her body rejecting it?

My DD had cataract surgery 14 years ago when she was 2yo. Due to medical negligence(long story), she developed a strep-pneumococcus infection inside one eye. The bacteria continued to grow because the incision had healed and as a result, she lost the vision in the eye but not the eye. The way that I describe it is that she has no iris or pupil. It kind of looks like Lake Michigan water.

She wears a scleral shell prosthesis to cover the damaged eyed but her Ped Neuro-Ophthalmologist (not the one that did the cataract surgery) said that they will not remove her eye unless her body starts rejecting it. Honestly, I'm not sure what that means. It does water more often than her "good" eye but we were told that it's more sensitive to allergies, colds... so that is to be expected.

If your mom needs to have the eye removed, the will most likely refer her to an ocularist for a prosthesis. If you're in the Chicago area, I can recommend a good one. One that she made for my DD was so good that if fooled a Ped Neuro Fellow at one of our major teaching hospitals here.

It is your mom's decision so the best thing that you can do for her is to support her with whatever decision she makes.

 

[Octoberbride03]

I think sometimes Drs fail to see the "Forest for the trees" with Seniors. I had a great aunt who passed away last year. The last couple years of her life were filled with leg and feet problems. And the answer was ALWAYS surgery. And eventually it when the first surgeries didn't work it was "let's take off the toes, you'll be in a wheelchair you don't walk much anyway. You'll be fine after that" When the toes were gone, it went on to half hte foot and "Maybe the leg to below the knee". I could have that backwards a little, but the sentiment is the same. She was around the 90 year old mark. The Drs really pushed it and she's like "how much time do i have left anyway?" So she eventually shut them down and said "enough" no more surgery, antibiotics only, and if the infection clears up than it does. She knew it wouldn't, but she also knew God was calling her home.

It really shouldn't just be about "living" it should be about enjoying the life you have. If you can have a talk with your mom to find out how she really feels about this mess then I suggest you do it. That's what my aunt did with her family. And it was hard but they all accepted her decision. Your mom has much different circumstance then my aunt, but still I don't think the thought process is that much different. You have to find out what she REALLY WANTS, and go from there.

 

[shortbun]

In reading your post, it reminds me of how very strong my mother was right to the end of her life. She made good choices and turned down many procedures. I think the best thing you can do for your mother is to tell her it's HER decision, not the doctor's. When the doctors wanted to do exploratory surgery on my dying grandmother, my mother said no. It was the right thing as my grandmother died the next day. Imagine putting her through surgery just to find out what was killing her. She was 90. Some people forget that doctors are human beings and put them on some undeserved pedestal, thus giving them enormous power. My doctor is my advisor and she's good at what she does. I evaluate all the information she gives me, do more research, ask questions and make my decisions from there.

 

[Jennasis]

What exactly are you frustrated with the doctor over? Trying to save her eye? Seems like he is trying to do something good. Most people, I would think, would like to keep their eyes, even if they were blind, just for aesthetic reasons.

Talk to your mom and see what she would like to do, then discuss her wishes with the doctor.

 

[akcire]

Op--

I totally understand. My husband's grandmother lived with us the last 5 years of her life. She had late stage Alzheimer's--10 times a day it was "who are you, why am I here". So her quality of life was limited. At her 97 year old check up, her primary doctor decided she may be getting diabetes and we needed to check her blood sugar 3 times a day. Now she was just under 5 feet tall and weighed 90 pounds. Were not talking diabetic like she was passing out, were talking the pre-diabetes spectrum. Husband checked her blood one time--with her tissue thin skin she cried, she never got her blood sugar tested at home again.

Fast forward two years, she is now 99 and we found her passed out in the bathroom. Called 911, by the time paramedics show up she is fine. Take her to hospital to find out what is going on. Nice ER Dr (who is shocked at "the good condition our old person") hooks her up for an EKG. They find a previously undiagnosed heart murmur, which she has probably had all her life. He calls for a cardiology consult.

Cardiologist tells us she needs surgery--now she is 99 with alzheimer so severe she does not know her name. Husband (her legal guardian) says to what end will this surgery improve her quality of life? She has no breathing problem, stamina issues, heck we don't even know if this murmur caused her to pass out--the first time in the 5+ years she lived with us. No kidding the doctor tells my husband not to worry--she has good insurance (she had private and medicare) and it will not cost us anything. This was not about money, but was about cutting her in half to fix something that may not really help her. Not to mention tying up the surgeon for someone who was 99, when at the same time a 40 year old could have an MI and need his services. Shockingly we declined the surgery and grandma lived another 2 years.

Ok here is the best part. They wanted to keep her over night for observation, no problem. So they take her upstairs and put her in a room. Now she is confused, and they put her in a foley vest to keep her in bed. Well she is so little and sneaky she keeps slipping out of the foley vest. At 4 am that morning they call us, because she is lost and they can't find her. They tried to blame us, but we did warn them about the Alzheimer's and that she could probably get out of the vest, I had suggested either put someone in the room with her or lock the door. Nursing staff told us we did not need to worry (she was getting a sedative) and to go home.

So we go back to the hospital, the whole hospital is looking for her, and there are 3 police cars outside, presumably searching. I tell them she is somewhere with food. About 90 minutes later, while walking with a security guard I find her in an employee break room 3 floors down eating a birthday cake. We get her cleaned up-she was full of frosting, tell them we found her, and take her home. (I was really glad they had observed her).

The funniest part, we never got a bill and no one ever followed up, it was like she had never been there. I think they were afraid we'd sue. I like to think, it was like a trip to an amusement park for her lots of new places & food, she was roaming all night long. (We didn't freak out because she never went outside without her purse--so I was pretty confident she hadn't left the building--we had her purse at home). You should have seen the look of utter relief on the face of the hospital attorney and the CEO who had also been called in at 4 am.

So I guess, other than to let you chuckle at the antics of grandma, the point I was making is just because the doctors can do something, does not necessarily mean it should be done for everyone. If a 40 year old had the same heart issue, surgery is probably the right option; but at 99?? I find that in many ways health care is like other industries, and we must be an advocate for ourselves and our family. I can't say if the eye surgery is right for your mom, but if you have doubts I would probably at least seek a second opinion.

 

[ols386]

What exactly are you frustrated with the doctor over? Trying to save her eye? Seems like he is trying to do something good. Most people, I would think, would like to keep their eyes, even if they were blind, just for aesthetic reasons.

Talk to your mom and see what she would like to do, then discuss her wishes with the doctor.

I agree with this.

It doesn't sound like the dr. is forcing it, maybe just offering a suggestion. The final decision should be your mother's, if she is indeed capable of making that decision. If not, then I think you (along with other loved ones) could help in the decision-making process.

My best wishes for her.

 

[MushyMushy]

I went through this with my mother the summer before she died. What you need to do is find out what she wants and make sure you are very clear on this. It's well within her rights to decline any of this treatment. After that it's up to you or some other representative to make sure her wishes are being met.

The doctor is just doing his job. It was the same with my mom, but we had to be firm and tell her doc she didn't want any more. He was more than fine with it, but he had to hear that from us, otherwise he would have continued treating her the best way he could.

 

[clarabelle]

They system rewards doctors for being aggressive
and patients sometimes do too.
As previous posters said -discuss this with your mom and make her wishes loud and clear to her physician

 

[Wishing on a star]

Risking someone's life to have surgery for an eye they cannot and will not ever see out of does not make sense to me.

I agree with this....
If there is no true health benefit, then it would be 'unnecessary surgery'.
And, this could be considered Medicare/Insurance fraud. (always follow the money)

If the eye is causing her ongoing discomfort and is affecting her quality of life. She will never see out of it again... then I agree with the OP.

OP, are they even asking your mother what her wishes are????
Are they 'pushing' this surgery on her?
Have they all but refused to just remove the eye that she is losing?

I think those are the important questions.

 

[akhenaten]

the point I was making is just because the doctors can do something, does not necessarily mean it should be done for everyone. If a 40 year old had the same heart issue, surgery is probably the right option; but at 99?? I find that in many ways health care is like other industries, and we must be an advocate for ourselves and our family. I can't say if the eye surgery is right for your mom, but if you have doubts I would probably at least seek a second opinion.

I agree!! (and what a story about grandma and the cake i would have loved to have seen the lawyer and exec's faces too..)

 

[Antonia]

I'm a nurse in a hospital . I've been a nurse 28 years. Every week I see unnecessary procedures done to elderly people. Most of the time, they are unable to make known their wishes and their families make the decisions for them. A lot of families are just clueless and go with whatever a doctor says he can do. Like I so often say to myself, just because a procedure can be done doesn't mean it should be - especially when the quality of life is severely diminished or gone. So many times agony is prolonged or the last days of a person's life are spent suffering needlessly. So wonderful to read here of people's families actually saying no - and grandma keeping on going!

 

[Imzadi]

What exactly are you frustrated with the doctor over? Trying to save her eye? Seems like he is trying to do something good. Most people, I would think, would like to keep their eyes, even if they were blind, just for aesthetic reasons.

Talk to your mom and see what she would like to do, then discuss her wishes with the doctor.

I agree with this.

My best wishes for her.

I agree with both above. I'd rather keep my own body parts as long as possible. That's like asking, why keep a breast or why keep ovaries if you are no longer using them.

Perhaps, the doctor is trying to strengthen the eye so she won't need to have it removed at age 90.

If there is no true health benefit, then it would be 'unnecessary surgery'.
And, this could be considered Medicare/Insurance fraud. (always follow the money)

On the other hand, I agree with this. If there really is no benefit, then I too, would be following the money. If Medicare/Insurance pays for it, then I would suspect the possibility of doctors lining their wallets at the elderies' expense. We live in a culture which does not honor or take care of the elderly, or care about their quality of life. To some doctors, they may have inadvertently found it to be a way to line their pockets. Somewhere along the way they convinced themselves it's of no harm, as it IS a benefit to the patients.

But, there is a BIG difference in something being a benefit versus also being unnecessary. Something can be a benefit AND be unnecessary. Unnecessary surgery is unnecessary surgery.

 

[LovableGluttons]

In our country's healthcare system, death is considered failure.....no matter the age.

It is also a money machine, each patient is an income.

It's business. The more patients you see, procedures you perform, the more money you make. The more you bring in creates income for someone else.

We each are responsible for advocating for ourselves and our loved ones.

Who would perform a hysterectomy on a 95 year old? How about chemo?

I am a hospice RN, I've seen plenty.

Prepare for the end of your life span through your life span. Don't put the burden of tough decisions on those you love. It's a very thoughtful gift for those you love.

 

[FINFAN]

Had to move my mom up from Fl 4 months ago after my dad passed away...and I have NEVER been to so many doctors, ER's, rehabs in my life! My mom does have issues , no doubt but for the life of me I see ZERO improvement in her health, matter of fact I only see decline pretty much because it is brutally hard for her to get in/out of a car, has scoliosis which makes a coat fitting difficult...in a nut shell going to the dr visits is counter productive for her. I think they saw new patient+ Medicar/BCBS= $JACKPOT$!
She lives in a retirement community where there is in house nursing/CNA if needed...they tell me all the time that my moms spirits are good until it is time to go to the doctor, again. Now that winter is here, I told all 9 of her various physicians that unlessit is mandatory, every 3 months is just fine for seeing her unless there is an issue. I think my mom feels if she does not do what the doctor says that she is not taking care of her health so she is unsure of what to do and these doctors who can can PLAINLY see that it is detrimental for her to travel ( and her residence does have a bus but not handicap accessible) just keep scheduling her. The few things that she woudl love to do, go to lunch, maybe a store...never happen becasue she is wiped out from the medical visits and all my time is spent doing that which allows zero time for any enjoyable things. I literally counted up the medical visits since August that I have taken her to, and my brother and sister have also taken her at times....68! THAT is nuts . Her condition is chronic, it is not going to improve, I agree needs to be managed, but not to the level of doing more harm than good.

 

[C.Ann]

I'm hoping the OP will pop back in here..

I agree that unnecessary surgery should not be performed (if Mom doesn't want it), but unless I read the original post wrong, it sounded like Mom was uncomfortable right now and the removal might relieve some of her current symptoms.. Did I read that wrong?

Whatever the case may be, the decision is Mom's - but she should not be pressured by a doctor to do something if she doesn't want to..

When my dad was in the hospital dying of colon cancer (we were told he had a few days at most to live), the same day of the evening he passed on a doctor came in and wanted to remove his gall bladder!!!! What the heck? I went through the roof.. Doctor left the room and later that evening my dad passed on - which was a blessing.. He was in such horrendous pain.. I cry every time I think about it..

OP: Good luck with your Mom - and I hope everything works out in a way that she will be comfortable for the remainder of her life..

 

[Imzadi]

I think my mom feels if she does not do what the doctor says that she is not taking care of her health so she is unsure of what to do and these doctors who can can PLAINLY see that it is detrimental for her to travel ( and her residence does have a bus but not handicap accessible) just keep scheduling her.

Your mom was raised during the era where people did not question elders and especially authority figures. If a doctor pr someone with a fancy title told them to do something, they did it.

You're really going to have to advocate on her behalf because she probably won't speak up on her own, for herself.

 

[EllenFrasier]

I'm hoping the OP will pop back in here..

I agree that unnecessary surgery should not be performed (if Mom doesn't want it), but unless I read the original post wrong, it sounded like Mom was uncomfortable right now and the removal might relieve some of her current symptoms.. Did I read that wrong?

Whatever the case may be, the decision is Mom's - but she should not be pressured by a doctor to do something if she doesn't want to..

When my dad was in the hospital dying of colon cancer (we were told he had a few days at most to live), the same day of the evening he passed on a doctor came in and wanted to remove his gall bladder!!!! What the heck? I went through the roof.. Doctor left the room and later that evening my dad passed on - which was a blessing.. He was in such horrendous pain.. I cry every time I think about it..

OP: Good luck with your Mom - and I hope everything works out in a way that she will be comfortable for the remainder of her life..

So sorry to hear about your Dad. My father died of colon cancer when I was 7 and they didn't have hospice or anything like that then.

With my mother, I am not objecting to any surgery that will make her more comfortable. This surgery they are proposing is not to remove her eye, but to remove scar tissue from her eye, insert a ring of some type and embriotic tissue. The tissue is supposed to be absorbed by her eye and then they remove the ring - so we're talking two surgeries here. One to insert the ring and one to remove it. She is 85 and I just think any surgery is riskier at that age. If it comes down to removing her eye some day, then that will need to be done to prevent infection from going through her system but we are not at that point yet.

And to the poster that said she is of a different generation, you are right! My mother speaks her mind all the time, but for some reason when it comes to Dr.'s, she's like "well he said I need to do" whatever it is they want her to have done....like she has to do it.

 

[Imzadi]

And to the poster that said she is of a different generation, you are right! My mother speaks her mind all the time, but for some reason when it comes to Dr.'s, she's like "well he said I need to do" whatever it is they want her to have done....like she has to do it.

Isn't that the wackiest thing? At that age, they've learned not to hold anything back anymore and just say whatever they think and feel. Then they get around an authority figure, and they get cowed, and become all docile to whatever the authority wants.