Surgery for Stage 6 Alzheimer Woman - 86 yrs old
![[Post New]](/jforum/templates/default/images/icon_minipost_new.gif){kind=icon}
Anonymous
| My mother was just diagnosed with a “mass” in her abdomen. I am her POA, only child. Dr says to remove mass and have it biopsied (sp?). Anybody here have experience with elderly parent going under general anesthesia? She is about stage 6 alzheimer. I feel so much weight on my shoulders making this call. I have heard of dementia patients having a terrible time with anesthesia. |
Anonymous
| There is no way in hell I'd subject my mother to surgery at that age/stage. |
Anonymous
| Is it typical to treat cancer in a patient with severe dementia? I would treat pain and symptoms, but this surgery seems cruel to me. |
Anonymous
| And I should add, she wouldn't want it. She always told me that if she couldn't consent to surgery due to that kind of decline, that I should not authorize it. |
Anonymous
So don’t do it. |
Anonymous
|
Is she still going out to eat with you? Helping you to clean up the kitchen after meals? Is she still doing some meal prep?
Is she walking a mile a day? Does she have a pet she cares for? Does she go to and enjoy religious services? Does she share a life with your Dad? Is she still getting joy out of life? Mom has had alzheimer's/dementia for about 18 years now. She is very, very late stage. My Mom was very, very active until 18 months ago. If she still was active and got joy out of life I'd proceed. Can you talk things over with other family members? Do you have a counselor? |
Anonymous
| I would ask the doctor what the treatment options would be if it was cancer. Then ask yourself and him if they are appropriate for an 86 year old. For what it is worth, my father had emergency surgery for an aneurysm at 80 and never recovered. His cognition and mobility declined greatly while recovering. Looking back we might have made a different choice. |
Anonymous
Does she have a signed medical plan? Do you have medical power of atty? |
Anonymous
|
My dad had dementia associated with Parkinsons, and had lots of falls and health issues at the end. When making health decisions for him I kept two things in mind: 1: will doing (whatever procedure) make him happier and more comfortable now? and 2: would Dad 10 years ago have told me to do it, given his current state, or not?
The dad of 10 years ago always said he never wanted to live with immobility, dementia, and paranoia. But the dad who was alive in that minute still wanted to live. So it wasn't simple, because my dad didn't want to die until a few months before he actually did. But most procedures were not going to make him more comfortable or happier, so we declined. We did decline some cancer treatment, actually - he had cancerous skin lesions, and we just let them be. |
Anonymous
Are you OP? Then that's your answer. With that said, cannot tell you what's best, but here's our story. My father was put under aneasthesia at age 87 for a colonoscopy because of bleeding. When my parents said this was the plan, I told them it made no sense. They are looking for cancer, which at his age, should not be treated. They should just treat the symptomes. They did it anyway, he woke up from the anesthesia in a delirium and stayed that way for 18 months until he died, living in the skilled nursing unit of their senior community. A few days before he died, the doctor called my older sister, who was their POA--my mom had mild dementia at the time, but had just fallen and was herself not cognitively well, triggering my sister's POA--telling her that he would die if he wasn't taken to the hospital for a transfusion. Shockingly, she told the doctor to take him. The doctor called me and gently implied he didn't agree with her decision and could I do anything? I called my sister and not as gently said: have you also lost your mind? Our father has spent 18 months believing he is living in an Amish community, being persecuted for a heinous crime--and that's when he's not in a near catatonic state. She relented and my father quietly died a few days later. While going through his paperwork, after all this, the nurse on his floor found his advance directives, which very clearly stated "no lifesaving measures, including transfusions." TL/DR: your answer may be there as well. What does her advance directive say? What does she want? And anesthesia for the elderly and especially those with dementia is very risky. |
Anonymous
There are no right answers or easy decisions and it absolutely sucks to be the sole person in the position of making it. I am in a similar situation with my mom who needs a heart valve replacement and we ultimately decided not to do it. It's an excruciating mental shift to move to a mindset of refusing medical procedures that would prolong life. In our case, it is our mother's wish, through her words in better times and living will, not to have interventions at this diminished cognitive stage as well. It also helped us to talk through the decision with her internist and get her feedback. My heart goes out to you. |
Anonymous
| Contact a social worker or patient advocate to put you in immediate touch with hospice to at least learn about hospice care. |
Anonymous
|
You can do palliative care even if she’s not ready for hospice.
The thing is that doctors, especially surgeons, aren’t often the best people to talk about this with. So reaching out to hospice might help even if she’s not ready. |
Anonymous
| This is insane. I am from the UK and they would never do this there. You need to think about what you would want for yourself under these circumstances. It is inhumane to take such measures when there is no prospect of any quality of life. |
Anonymous
|
“Stage 6: Severe Mental Decline/Moderately Severe Dementia Quality of life: Severe impact. Your loved one will not remember much or any of the past and may not recognize you and other family and friends. He or she may have trouble making healthcare decisions.”
I would not allow the surgery. Especially since you said it would go against her wishes. As other pps have said, palliative care from here on out. |