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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Is The Treatment For COPD Ad CHF In A 93 Years Old?

My Mom is 93 years old. She has been on a respirator for one week. She has a history of COPD, CHF and a whole list of other conditions. They took her off the respirator today and she has been able to sustain breathing, but we don t know for how long. The CCU Dr. is suggesting a tracheostomy (permanent) so they don t have to intubate and extubate her. It doesn t sound like she will ever be able to come home and will live whatever time she has left like this. I don t think it s the quality of life she would want in the end. Any thoughts/alternatives?
Tue, 1 Jul 2014
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Internal Medicine Specialist,  's  Response
The question is whether she would agree to being on a respirator again if it is the only thing to save her life. If you believe she would prefer to die rather than being reintubated if her breathing deteriorates, then there is no need to get the permanent tracheostomy. Does she have a living will that instructs on what to do in such situations? This would be helpful for following her final wishes. If she is still conscious, perhaps you could get her to communicate her wishes. I can't think of any alternatives to a permanent tracheostomy if long term ventilation is necessary. This must be a difficult situation for you both and I wish you the best outcome possible.
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What Is The Treatment For COPD Ad CHF In A 93 Years Old?

The question is whether she would agree to being on a respirator again if it is the only thing to save her life. If you believe she would prefer to die rather than being reintubated if her breathing deteriorates, then there is no need to get the permanent tracheostomy. Does she have a living will that instructs on what to do in such situations? This would be helpful for following her final wishes. If she is still conscious, perhaps you could get her to communicate her wishes. I can t think of any alternatives to a permanent tracheostomy if long term ventilation is necessary. This must be a difficult situation for you both and I wish you the best outcome possible.