Over this weekend, I have to make the hardest decision of my life.

I'm the legal guardian of the widow of a long time music partner. She's a 74 year old African American with a 69 IQ (about a first grader, mentally), age related dementia, many other medical issues, and the big one...Stage 5 renal failure. Her kidneys have shut down, and something needs to be done NOW!

The issue is the dementia and whether or not she can handle the pain, uncertainty, unfamiliarity, exhaustion and other often serious effects of dialisys.

She pulled the fistula (the place prepared for dialysis-a joined artery and vein)out twice when it was first installed and was in the emergency room twice.

She is shaking, weak, has cramps, etc. Her long-time Dr. says dialysis is the only option, and ignores the dementia factor, which is major. A team of experts from the University of Kentucky department of nephrology say that dementia and dialysis never mix. And, to make things worse, once dialysis starts, you often die within a week if it is discontinued.

I met this family in 1960, when I was 15. All are challenged, including my former music associate. At one time or other, I have helped all of them financially, to the tune of over $100,000.00. Neither son could qualify as guardian, because of legal/financial troubles. Neither wanted to, when they found out there was no compensation involved. Each child saw mom once last year, when I held a dinner for her and they showed up for a free meal.

The three living kids weren't even aware that mom was sick. I moved her from a condemned home where the Dr. said she would have died in three more weeks. That was 5 years ago.

This is biggest, most life-affecting decision I have ever had to make. Deciding to withhold treatment results in certain death within 6 months. Dialysis, in this case is brutal and not recommended by many experts.

Anyone been in or near this kind of situation?

What did you (or other responsible people) do?
What would you do here? Anyone currently getting dialysis?

As legal guardian, I have the final say.

I haven't slept for a week, and have a 30 hour film score session starting Sunday morning. The decision has to be done by Tuesday at noon.

Any/all input will be appreciated.

This is impossibly rough. I would appreciate, and really NEED your input.


Russ