I ask because my MIL health care proxy specifically states that if she has a terminal illness she doesn't want any extraordinary life preserving measures taken. She keeps becoming anemic for unknown, or unverified reason. With much resistance, she does receive iron infusions to rebuild her blood, which helps for a bit. Her PCP says if she or my husband do not want to pursue why this keeps happening, he has no objection, since she is suffering from a terminal illness. She does not want medical tests. She is 88. I think she now has what would be described as moderate dementia.

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I second Jeanne's opinion. Alzheimer's is a progressive disease that will result in death unless something else causes death first.

Your mother-in-law is 88 - likely quite frail in many ways. I don't expect that the iron infusions are considered extraordinary. The are supposed to keep her feeling better by controlling anemia. However, you may want to get a second opinion from a different doctor about how helpful the infusions are. There is nothing to be gained by putting her through more than absolutely necessary.

I, too, would skip as many tests as possible unless she is able to decide for herself. The aim is generally for the person to have as much quality in her life as possible without causing undue pain or harm.

Take care,
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Bluntly ask her if she is willing to die, and tell her that may be the outcome of refusing tests. She will likely say yes, and then think about it. If she feels the same way next week, then you have your answer. If you don't sugar-coat anything, and she gives you an answer, it will be clearer what you should do for her.

My father would have needed repair on his aortic aneurysm before cancer surgery, and chose not to have either surgery. The first one could have killed him. There were times when he probably wished he had taken that chance, because he got impatient waiting to die!
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Yes. Alzheimer's is a progressive disease and will result in death, if another cause does not come first. (For example, a person with Alzheimer's could die from a heart attack.)

Are the tests they want to do invasive? Would they be considered "extraordinary life preserving measures"?

Do you think that she understands the problem and the tests well enough at this point to make an informed decision? Or will your husband need to make the decision for her?

Personally, I think I would skip the medical tests and just treat the anemia as it comes up. But there is no "right" answer here.
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I feel if your quality of life has no chance of improving what's the use of tests and continuing treatments that don't cure anything. After watching my mom suffer for the past 3 1/2 years, if and when I ever get in her situation I pray I die. That's what she wanted too, but I guess the higer up feels differently.
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