Aggressive Care- Helpful or Hurtful?

http://well.blogs.nytimes.com/2009/10/19/the-wrong-care-for-dementia-patients/

I just found this article and it outlines what my instincts were about my mother's care. I have not subjected her to aggressive treatment for any number of ancilliary conditions because I have to ask myself if it would be her her benefit or because it would make me feel better.

For example, she is missing a tooth, an incisor. She dropped it out the window of the living facility she was previously at, but that is a different blog article. :) I took her to the dentist for a cleaning and to determine what we should do about the tooth. There are a couple of other issues with her teeth that are too boring to go into, but the bottom line is that she could get an implant, or a flapper. An implant requires the tooth next to the missing one to be pulled and a rod implanted into her upper jaw. The dentist asked me why I wanted to do it because it would cause her a lot of pain, she won't understand why she is in pain, and she is at risk for heart complications because she has a stent in her heart and an infection in her gums will not be a good thing. Plus, she will stop eating for several days due to the pain and she only weighs 90 pounds dripping wet. A flapper would likely be lost within a day and I worry about the choking hazard.

So I had to ask myself is it worth the suffering? She can eat just fine, and her teeth are very clean for a woman her age with dementia. We are very diligent about oral hygiene in the Diaz house :) I have decided that it is not worth the risks and the suffering. But there are people who do not agree with me. That's fine, I respect that. But I am with her everyday and when she is in pain from muscle aches in her legs it is very difficult for her to process that. She is mostly id now (had to get a Freudian reference in there at some point) and is like a child in pain. So why would I want to create more pain for her when it is not necessary? I appreciate the dentist forcing me to think about the reasons for subjecting her to that instead of just taking the money and doing it anyway. I hope that other doctors we come across during this process will be as honest with me about whether a treatment is for her benefit or for my conscience.

What similar decisions have you had to make about treatment vs. no treatment? Please share.

Sharon