Surgery for Stage 6 Alzheimer Woman - 86 yrs old

[Anonymous]

OP here. Thank you for your insights. She just had bloodwork done to look for cancer “markers” or something of the sort. Mass is around 7cm in diameter. I have Durable Medical Power of Attorney-Advance Directive and Advance Medical Directive.

Years ago, when she was of sound mind, she would, jokingly say, “If go cray cray, just push me off a cliff!” Her advance directive says not to use artificial life prolonging measures. I am just not sure if surgery would qualify as such. Chemo, dialysis, etc… are a differenty story. If she does go through the surgery, and it is, in fact, cancer, I would not want her to go through chemo anyway!

Doctor was also saying she needs a colonoscopy. My poor mother weighs 83 lbs!!!! She would not be able to go through the colonoscopy prep!!! It seems as though this doctor was just going through a checklist!!

[Anonymous]

Let her pass in peace. Not suer what stage 6 is but I'm assuming like PP said its very severe and she has no quality of life. Most people wouldn't want to live with that type of dementia. Its horrible and its very difficult to make those decisions but its far better to not do the surgery when she cannot even express pain to get help/mediation.

[Anonymous]

Anonymous wrote:OP here. Thank you for your insights. She just had bloodwork done to look for cancer “markers” or something of the sort. Mass is around 7cm in diameter. I have Durable Medical Power of Attorney-Advance Directive and Advance Medical Directive.

Years ago, when she was of sound mind, she would, jokingly say, “If go cray cray, just push me off a cliff!” Her advance directive says not to use artificial life prolonging measures. I am just not sure if surgery would qualify as such. Chemo, dialysis, etc… are a differenty story. If she does go through the surgery, and it is, in fact, cancer, I would not want her to go through chemo anyway!

Doctor was also saying she needs a colonoscopy. My poor mother weighs 83 lbs!!!! She would not be able to go through the colonoscopy prep!!! It seems as though this doctor was just going through a checklist!!

You have your answer... time to let her pass. She wouldn't want the surgery or even colonoscopy.

[Anonymous]

Does he think the mass might be ovarian cancer? Have you asked him what his plan would be post-surgery if the mass does turn out to be cancerous? I also agree, colonscopy also sounds pointless. How does he propose getting an Alzheimer’s patient through the prep in the first place? I’m sorry op, it’s a lot to feel like your facing alone. Does she have other doctors involved in her care that you could talk to? Is there a gerentologist?

[Anonymous]

OP here. She’s with Kaiser. No gerentontogist. She has been calm and easygoing these past two years. Stays home, watches TV. She can feed herself, sort of dress herself. Needs some help with toilet and bathing. Does not remember her DOB, names of her siblings and closest friends. She does not cook, but can make her bed.

I really haven’t taken her to the doctor much these past months. She does not do well in the cold. Her regular doctor just retired. She was fabulous. I hope her next doctors consider her quality of life. I will look into palliative care.

[Anonymous]

She would never be able to handle post-operative care. I’m so sorry OP but I would not go ahead with the surgery.

[Anonymous]

Dear OP,

Please don’t put your mother through surgery. She will not understand what is going on and will try to pull all the tubes out which means that they will restrain her in the hospital. The hospital is awful for people with dementia. They never get back to the level they were at when they went into the hospital. Reach out to hospice. They are absolutely amazing and your mother will never have to get near a hospital again. Good luck.

[Anonymous]

Anonymous wrote:OP here. Thank you for your insights. She just had bloodwork done to look for cancer “markers” or something of the sort. Mass is around 7cm in diameter. I have Durable Medical Power of Attorney-Advance Directive and Advance Medical Directive.

Years ago, when she was of sound mind, she would, jokingly say, “If go cray cray, just push me off a cliff!” Her advance directive says not to use artificial life prolonging measures. I am just not sure if surgery would qualify as such. Chemo, dialysis, etc… are a differenty story. If she does go through the surgery, and it is, in fact, cancer, I would not want her to go through chemo anyway!

Doctor was also saying she needs a colonoscopy. My poor mother weighs 83 lbs!!!! She would not be able to go through the colonoscopy prep!!! It seems as though this doctor was just going through a checklist!!

If she has diagnosed dementia and is only 83 pounds, she may qualify for hospice. Has she always been small or has the weight loss been recent?

I would also decline the colonoscopy. Ridiculous at that age.

[Anonymous]

OP here. She has always been small and thin, but not to the degree she is now. Doctors have never suggested hospice due to her weight. She has another appt next week. I assume the blood work results should be back by then. We will take it step by step. I will ask about hospice. Ugh, so many variables to think about!

[Anonymous]

No doctor should recommend a colonoscopy for an 86-year-old! They usually don't do them for patients who've reached 80, let alone 86. And your mother weighs only 86 lbs!! Her doctor must be nuts! She needs to be seen by someone else ASAP.

[Anonymous]

My mom has Alzheimer's too, no way would I do surgery in this situation.

I did let mom have a basal cell carcinoma removed, but that was because it would have just disfigured her and made her miserable. Even that recovery was rough because she wouldn't keep bandage on

[Anonymous]

I’m sorry, Op. that is a really tough situation.

I do not think you should have your mom do the surgery. It sounds like it wouldn’t have been something she wanted. And it sounds kind of pointless to figure out if it’s cancer if you’re not planning to treat the cancer anyway. I also don’t think it sounds like she should get a colonoscopy either. Maybe try to find a new doctor, and look into palliative care/hospice options.

My MIL has late stage dementia and she absolutely would not want to go through all these medical procedures when it will not improve her quality of life at this point.

[Anonymous]

OP, the words you need to say are: she will decline treatment "AGAINST MEDICAL ADVICE". There is a paper. They will have you sign.

Until you do this, they may keep asking you because they can not refuse to treat your Mom: because of her age, because of her dementia. They are covering themselves, legally. Some docs are more adamant about this than others.

[Anonymous]

We were in the same position with my MIL age 84, dementia, COPD, bowel cancer. Heavy smoker.
Daughter/ Sister consented to surgery resulting in colostomy bag. MIL never did recover — dementia went full on she couldn’t breathe. It was a nightmare. Afterwards I looked it up and asked DH. Did the doctor ever tell you she had a 97% chance of not surviving the surgery?
After a few nightmare weeks of her heart stopping and being shocked back to “life” she was finally moved to another hospital where she was allowed to die in peace. Awful. Truly terrible.

[Anonymous]

Anonymous wrote:OP, the words you need to say are: she will decline treatment "AGAINST MEDICAL ADVICE". There is a paper. They will have you sign.

Until you do this, they may keep asking you because they can not refuse to treat your Mom: because of her age, because of her dementia. They are covering themselves, legally. Some docs are more adamant about this than others.

Best advice yet.