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My dad didn't want his pacemaker battery replaced when he was given the option a few years ago. He's in an aged care facility now after my mum died of an aggressive brain tumour 3 years ago. They had been living independently. Dad had a fall and broke his hip and 9 months later broke his other hip.



He also has Parkinsons disease and some form of dementia to a certain degree. He wants to die.



He was admitted to hospital last week with a very high blood pressure. His blood pressure had typically been low. Does anyone know if the pacemaker not working could have caused that to happen?



Can anyone tell me what we can expect to see now that his pacemaker isn't working. What is his end of life going to look like? I know dad has atrial fibrillation that was being helped with the pacemaker and they said at the hospital that he was in AF while he was there. He's only been given medication for his blood pressure now. He's glad his pacemaker isn't working because he thinks he might die sooner. I'm not sure what to say to him!!

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Welcome, Sneaky.

Have you asked dad's cardiologist what the "end game" might look like with a fib and no pacemaker?

My mom's pulmonologist recommended not tapping my mom's lungs after the second go round and I asked him what death would look like if we discontinued treatment. He was quite descriptive and told us when to call in hospice, because air hunger would be involved and that would be very uncomfortable.

Talk to dad's docs upfront and ask if it's time for hospice or palliative care.
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Yes, the cardiologist can tell you what to expect for this, his patient. If your father is 100% dependent on his pacemaker (rare, indeed) then he could not live without it. But the likelihood is, that with the exception of perhaps needing to withdraw some medications that control to lower heart rate, etc., there MAY not be a whole lot of change for Dad without the pacemaker.

You should speak directly with the doctors who monitor your father's pacemaker as to what to expect given your father has chosen not to have the pacemaker. My husband has one for his atrial fib. Without it he would not be able to tolerate the levels of atenolol he takes for rate control without his heart rate going too low, so his dosage would be decreased which may cause his fib might become faster, and a bit more fluttery feeling.
As for myself; I chose not to have a pacemaker put in when I went into chronic atrial fib; that was several decades ago; I am now 81 this year, and still good to go.

No one can tell you for CERTAIN what will happen, but the likelihood is that Dad will not pass solely because there is no longer a fuctioning pacemaker unless your doctor can specify for you what deadly occurrence he/she fears/expects. Likely the doctor will tell you what COULD or MIGHT happen without the pacemaker.

I am assuming that your father understands that replacement of this battery is quite a simple procedure, not nearly as much of a procedure as the original placement with the leads into the heart. The pacemaker leads won't be changed. He would be in and out of the hospital in hours.

So do talk with your Dad's doctor. Every patient is as individual as his own thumbprint. Anything we can tell you is our "best guess". Expert advice is needed for medical, legal, financial issues. We can only tell you our own experiences.
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Kerrdl0413 Jun 2023
For most people your answer is good advice. I had a pacemaker insert inside my heart last month. It is suppose to last 5 to 8 years
depends on various factors. When it needs new battery I have to
have a full replacement which is still for most people only a day and
maybe one night stay. I seriously feel 10 years younger with the
pacemaker.
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Have you had your dad evaluated for hospice yet? I would look into that, if it were me. I don't blame him for not wanting to continue his fight. His life sounds pretty low quality. I can see those days for my mom in her future. It's difficult, no doubt. What to say to your dad? That's tough! Hmmm I can't think of a phrase but something vague and supportive. "I know you've had a hard time recently, haven't you? I feel so bad. I love you. What can I do to help?" Something in that vein?

Is he still in the hospital? Does he have a DNR? Do you have POA for healthcare? I would try to limit or eliminate trips to the hospital and focus on comfort care instead. Let nature take its course.

Sorry for the loss of your mom and now for this with your dad.
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I know with a classmate of mine, he was diagnosed with Parkinsons at least 25 years ago. His speech was effected early on, the last few years a walker. Dementia set in, and he became aggressive so his wife had to place him and he passed not long after.

I really don't think at this point the pacemaker means anything. You can die even when on a pacemaker. When the heart goes, it goes. I think your Dad is tired. He is ready to go. I would just get an order for Hospice to come to where he lives. Talk to the facility to see if its OK. Let him spend his final days comfortably. No doctors, no intervention. With hospice, he should go peacefully.
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FWIW, in his place I would vote for Hospice or Palliative Care ONLY. Comfort at EOL would be my goal. At 86 and with other physical issues, I would have agreed with his choice not to replace the pacemaker.
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Well, both a fib and high blood pressure are stroke risks. So that would be my guess.
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A friend of mine recently had his pacemaker changed. He is also diabetic and has high blood pressure.

He said he went to the doctor because he was feeling really tired, not all the time, just some of the time, and not consistent. He just felt off.

After his pacemaker was changed, he had a lot more energy and had that tell-tale feeling that showed that his pacemaker was working. That was 2 months ago. He is now starting dialysis treatment.

I have no opinion on what your Dad should do going forward.

I do know that recovering from a stroke is tiring and time consuming for all involved....and those are the "lucky" ones.
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My husband is 100% reliant on his pacemaker. It's set to keep his heart rate at 65 bpm or thereabouts. If the battery were to die, so would he. His heart rate would drop dramatically and he'd likely go into cardiac arrest in short order.

Only your dad's cardiologist can give you an idea of what his end of life scenario would look like based on dad's reliance on the pm. I'd get hospice on board one way or another.

Best of luck to you.
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A pacemaker not being there wouldn’t account for fluctuations in blood pressure.
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My husband has Parkinson's and afib. Never offered a pacemaker. Is on eloquis to help prevent stroke. Your father getting high blood pressure now not a worry. There are many 40 year olds with high blood pressure. Parkinson's can affect it at times and he can have high and low BP periodically. After his first broken hip he should have been required to have someone walk with him. I would definitely tell the facility to supervise him . He should be took to activities and taken to the bathroom on schedule. Someone needs to advocate for him. He shouldn't be walking by himself. A little sertraline or buspieone could help the mood with Parkinson's. Speak to the doctor. Can make a world of difference. He just needs a little help.. I care for Mom and husband and in facilities 15 years. Wore many hats in healthcare.
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Please confer with his PCP for guidance. There are multiple considerations, such as patient rights to say yes or no to care, and what documents are needed in such instances , EOL documents, POA documents etc etc.
Get PCP input and also confer with Elder Law Attorney for best guidance.
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Sneakyb: Perhaps you can get better answers to your questions from your father's cardiologist. Maybe it's time for hospice as without the pacemaker, his heart function will deteriorate.
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How many years does a pacemaker battery last? My mother had one implanted last July. Just curious about that.
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sbout 1o years ago my FIL battery was low.. he felt it.. blood wasn’t pumping very well… it freaked him out, saying doctors waiting for him to die .. why do this operation on an old person? Well they waited til the last drop of battery cell started to die, then they did the operation.. the stress alone thinking he wasn’t worth the effort of changing out the battery was very stressful.. wrll hecgot better from thst and then got esophageal cancer.. do that was fun.., NOT.
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