She is now 75 and has FTD with aphasia. It is not that I don't want to keep her healthy but I am concerned with what to do should it come back positive. I don't think she would comply with the treatment and if she did it might be too rough for her. I would like to hear your opinions on this. I have full guardianship and can make whatever decision is necessary.
This was in response to a few atypical cells being found in fluid drained from around mom's lungs. The oncologist at the hospital she was in scheduled a bone marrow biopsy. Mom was 89, had CHF and Mild Cognitive Impairment. She was not going to agree to chemo or radiation or anything other than comfort. We didn't do the biopsy.
OldSailor, we know how much you love your wife. You are not being neglectful. You are being sensible and loving.
It was my choice for two reasons.
One - it always hurt.
Two - I have no intention of being poked or prodded. I will have nothing intrusive or invasive.
All I want is to be comfortable (as best they can) and still keep some dignity.
Hugs
Her PCP had suggested she go for a mammogram every other year, so this issue didn't come up last year. What's the point of an every-other-year mammogram? What would happen if cancer was detected? I know my mother wouldn't tolerate chemo or radiation. I don't know about surgery. I do know that I'm not going to be the nursemaid for afterwards...
Even getting the mammogram is going to require an assistant to help my mother with everything (go here, get changed, put your things in a locker, take the key, sit there, and then when it's all finished unlock your locker and go to a room to change, put your hospital smock there and exit over here). She won't hear/process/remember. I will not be her assistant for all of this. If the medical monopoly (of which the doctor is a part as well as the mammogram center) prescribes a mammogram, then that medical monopoly can provide someone to be her assistant through the process. I will plan to drop her at the door (well, see that she gets inside the mammogram center) and then go do something else so I will avoid being corralled into being her personal assistant for a procedure I do NOT feel is necessary.
I rolled mom in. I told the tech that I don't think it's possible to do a mammo on mom. She said that it's been done with other patients. Well, we tried and tried to get mom's breast in between those 2 plates. But she was not having it. She kept wiggling. In the end, the technician gave up.
Reading the above comments, I like what that wise geriatrician said. It makes sense. If you're not planning to go through the treatments, then it's best to not do the mammo.
Mammograms HURT.
How in the world would she handle any type of treatment if anything was found?
I believe there is a point at which various medical tests and procedures should taper off.
My own Mom was like that because her sister had passed from breast cancer over 45 years old, so my Mom was scared it would happen to her. So Mom kept having mammograms up into her late 90's. I know, totally ridiculous to go through all of that.
It was my Mom who insisted, even though her GYN said she no longer needed them. It wasn't easy, as it took two techs to handle my very frail, hard of hearing, fall risk Mom.
I had breast cancer but it was caught early, had major surgery, no chemo or radiation, but the daily pill I had to take for 5 years caused major, and I mean major side effects. I really believe with someone who had dementia, the surgery alone would put that person into the next phase of dementia, and those pills would make life miserable.
I would not get screening mammograms if I had FTD.
No.
You can ask whoever bathes her to run a discreet check, if you like. What to look/feel for is widely available on the internet.
I would never discourage anyone, particularly anyone with a relevant family history, from getting a mammogram if they will find it reassuring. But I have said before: I'm not sticking my t**s in a mangle to amuse anyone. I check regularly instead.
Knowing exactly what is involved in a mammogram, I can't imagine anyone with dementia being able to cooperate with it.
My intentions are to keep her as long and make as comfortable as possible. I have heard that people with these diseases will die from one of two things. Either the disease or no being able to tell us of other medical problems.
I don't want make things more complicated they are already.
Thank you all so very much for your comments. I do appreciate them.
Mammos are not fun. To get it right the first time is tricky. And you have to be able to follow directions. Like said, if you aren't going thru the treatment, why do it. I agree, to keep her calm and comfortable is now how it goes.
Can't believe ur Mom went thru all that in her mid 80s. Maybe treatments but I heard reconstruction is very painful. I had a friend say she would not do it again and she was fairly young.
When my mother is in the ER, I'm the one who has to get her urine sample. They would have me be the one to take her to the bathroom (she has to go a lot) once she's in one of the examining rooms, too. (I refused.)
Since my mother doesn't want me to be in the examining room during a regular doctor's visit, I'm thinking that should also apply to the ER. And I won't be signing any discharge papers, either.
There hasn't been an ER visit for more than a year, knock on wood! They never find anything, anyway, since she won't allow the tests that would give some information.
I also told discussed this with my 95 year old mother. If you ignore something, you don't know what you're dealing with. If you know, you can discuss options and concerns, you are doing it from facts. Fear is a horrid reason not to do something. I'm not afraid of facts.
But perhaps you aren't responding directly to his concern.
I *sort of* feel for public health specialists trying to explain the risks and benefits of screening programmes to an anxious audience who couldn't give a monkey's about population statistics and just want to know if screening will save them from a horrible death. But I'd feel a lot sorrier for them if they'd take the trouble to get better at explaining the statistics.
Perhaps part of the trouble is that in the context of your own health you want clear advice, and you're not best pleased to hear the experts saying "probably..."
Mum has good physical and mental health, lives independently, drives etc. She could pass for 60. She is very clear in her POA what she does and does not want regarding her healthcare.
members with litigious ($$$) expectations, can claim negligence. This can occur even if
the patient has a DNR/POLST claiming no more tests. Lighten up folks.
I don't disagree that it's a problem, but I don't see that it's anything to be very chirpy about either.
Would a mammogram that showed "something" change a course of treatment?
Chances are with or without treatment her lifespan would be about the same. So you are looking at QUALITY of life versus QUANTITY. I think quality is more important than quantity at this point.
Also to even do the test is not comfortable, it can be confusing. If you decide to schedule this for her when you make the appointment explain that they will need more time and patience.
Bottom line..short and to the point.. I would not bother with the test at all. Also not that you asked but also no to a colonoscopy and any other "invasive" test. There is no test that is worth the discomfort and confusion for a diagnosis if you would elect to not proceed with any treatment.
exists.
Since she is in worse condition this year I felt it necessary to ask for experienced advise. Our PCP is very understanding and supportive on these types of exams. We do watch her labs closely for things can be treated with meds. So far nothing invasive or that may require extensive treatments like most cancers.
I am more into quality of her life than quantity. comfort and good times for any memories she might have. We can almost always just hold hands and watch TV or try to talk.
But I really do appreciate all of the suggestions here. It helps reduce the confusion in making this decision.