Answering your questions about dealing with post-stroke memory loss and the prospects of deciding to have a feeding tube inserted.
Q: My mother is repeating herself and forgetting what I told her. She had a small stroke years ago. Now the doctor is telling me that my mother has vascular dementia. Will medication help my mother? I worry that my mother will not remember to take the medications, about the side effects, and wonder what the benefits are.
A: Vascular dementia is a disease that will progressively evolve. Vascular dementia presents itself with problems in remembering past events, poor judgment, difficulties with reasoning, mood or behavior changes, and difficulty following instructions. Your mother is at higher risk of having a second stroke.
There are medications that help with memory loss that is common to Alzheimer's and dementia. Some side effects can include nausea, vomiting, diarrhea, insomnia, fatigue and muscle cramping.
Medications do not stop or reverse the disease, but rather slow down the disease process. Some families choose not to take medications but instead allow the disease to progress and not prolong the disease process.
Some families think that quality of life not length of life is most important. This is something that needs to be discussed with your mother (if she is still able to express her thoughts), with other siblings, and with your mother's physician.
Q: My father is in the hospital and he has difficulty swallowing. The doctor suggested a feeding tube. My father always told me he did not want to be kept alive by machines; is a feeding tube something he would want? My father is confused and unable to tell me his opinion on the feeding tube.
A: A feeding tube is a tube inserted into the stomach allowing nutrition into the body. A ventilator is a machine that allows someone to be kept alive who cannot breathe on their own. Most people think of a ventilator when they make comments about not wanting to be kept alive by machines. Without the feeding tube your father will not get the nutrition his body needs to be kept alive.
There is no right or wrong answer. For every person and every situation the decision varies and you must make the decision with the information you have at the time. When making the decision, think about your father; who he is now, who he was in the past, and his other diagnoses. Is the expectation that the feeding tube would be temporary or permanent?
Most of all, think of your father's quality of life. If your father has ever made comments about what he defines as living and what he defines as not living, then all of that needs to be considered when you make this decision.
If a feeding tube is something your father would want then you must consent. However if after thinking about your father and his comments to you, you believe it is something he would not want, then you must decide no feeding tube.
It is very difficult to make this decision, which is why it is so important for families to have these kinds of discussions before a crisis. During a crisis emotion takes over and that can affect all decisions.
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 SeniorSavvy@ElderCareResources.com or ElderCare Resources Inc., 29 Gano Road, Marlborough, MA 01752.