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Swollen legs, ankles, itchy abdomen. Diagnosed with CHF, dementia, arterial stenosis. Pace maker working. How much care needed?

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Cardiologist, Interventional
Practicing since : 1995
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92 yr old female. CHF diagnosis. Arterial Stenosis since childhood. Pacemaker still working. Swollen ankles and legs more on left side. Itchy red/blue legs. Itchy abdomen. Moderate dementia. In hospice now. How much care does she need? She wants no medication and internist agrees. She wants pace maker turned off. /doctors wont do it. How long will she live?
Posted Sun, 28 Apr 2013 in Hypertension and Heart Disease
 
 
Answered by Dr. (Prof.) Subroto Mandal 18 hours later
Hello and welcome to XXXXXXX

As she is 92 years old and pacemaker is working, in this situation she needs more care. In my opinion, with better care she may live more.

It is difficult for a doctor to say how long she will live.

Hope I have answered your query.

SUBROTO
Above answer was peer-reviewed by
 
Follow-up: Swollen legs, ankles, itchy abdomen. Diagnosed with CHF, dementia, arterial stenosis. Pace maker working. How much care needed? 2 hours later
What do you mean "more care?" She does not want medication and wants her pacemaker turned off. There is no more I can think of to do for her. She has women with her at noon and in the evening. Is it true a Dr will not turn pacemaker off? What is the itchy legs and abdomen? She wants to die. She is a dear lady and we are out of ideas.
 
 
Answered by Dr. (Prof.) Subroto Mandal 3 hours later
Hello,

It is not legal to turn off pacemaker at the request of patient. The law of the state of most countries do not permit that.

Therefore according to me, she needs better care both from her treating doctors and her family/relatives and friends supporting her. I am sure you and all her family related to her are doing just the same.

As you told that she has mild dementia. This means she can't take right decision for herself also. Oour target should be to provide her with optimum therapy to take of the symptoms, to provide her good quality of life and good family support.

Hence, my opinion, we should do better for her and not what she wants.

Let me know if you need clarifications.

Good luck . . .

SUBROTO
Above answer was peer-reviewed by
 
Follow-up: Swollen legs, ankles, itchy abdomen. Diagnosed with CHF, dementia, arterial stenosis. Pace maker working. How much care needed? 21 hours later
why would her swollen ankles and abdomen be itchy. What should we do about that. She refuses all meds which we cannot make her swallow. She does have companion and hospice care all day long.I guess we are doing all we can.
 
 
Answered by Dr. (Prof.) Subroto Mandal 3 hours later
Hello and welcome again,

Swelling and itching may be due to heart related or some time due to anemia or lack of protein. It usually happens with elderly.

I think you are doing well.

Hope I have answered your query

Take care.


DR SUBROTO
Above answer was peer-reviewed by
 
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