Another Difficult Decision

Yesterday, my dad’s doctor called to discuss the results of his bone density scan.

The results showed that he’s at high risk for a hip fracture.

Then he shared two statistics that landed heavily on me.

For people living with dementia, roughly half will die from complications related to a hip fracture. Nearly one-third who fracture a hip will never return to their current living environment.

The conversation went silent.

It’s the only thing I remember hearing him say.

Then came the question.

What would you like to do?

On paper, the options seemed ordinary.

A pill once a week. Take it an hour before breakfast. Stay upright for an hour afterward because of the risk of reflux.

Simple enough.

Until you remember the person taking the pill has Alzheimer’s disease.

He lives in memory care. He likes to sleep in. He already struggles with reflux.

Suddenly, the “simple” option didn’t feel so simple.

The second option was an infusion once a year for three years. One hour in a chair. One hour of remaining relatively still.

Neither option promised certainty.

Both offered roughly the same reduction in fracture risk.

The third option was to do nothing.

The doctor began to explain why, given my dad’s Alzheimer’s disease, he could be persuaded that doing nothing was a reasonable choice.

I interrupted him.

“That’s not an option.”

As the words left my mouth, I realized I wasn’t just making a decision for my dad.

I was thinking about my mom.

What would happen if he fractured his hip and could no longer live with her?

They’ve already lost so much to dementia.

Words.

Memories.

Independence.

I wasn’t ready to let them lose their togetherness, too.

So I chose the infusion.

Will it matter?

I don’t know.

Was it the right decision?

I don’t know that either.

But perhaps this is one of caregiving’s quietest burdens.

Making decisions for those who no longer can.

Never knowing whether it’s the decision they would have made for themselves.

Never knowing whether you made the right one.

What I do know is this:

The weight we quietly accumulate as caregivers grows with every decision.