Alzheimer's - now cancer, to treat or not to treat?

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My MIL is mid - late stage Alzheimer's. A suspicious spot showed up in a scan after a fall.....
Family all disagrees about whether to treat or not to treat.

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Tough choice. Modern medicine adds years to your life, unfortunately, mostly they can be some of your worst years.
Chemo is such a difficult thing to withstand, I would opt for pallative care for an elderly person with dementia.
I do not believe there is any right or wrong in this choice, whatever you decide as a family needs the support of all.
God Bless you and grant you all wisdom and strength in this journey.
L
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My mom had a spot on a scan a few years ago while she was in a rehab facility. When she was released and saw her own geriatrician that doctor asked if she should make an appointment for further diagnosis. My mother, who was then in earliest stage dementia and still "in her right mind" for this kind of decision, said No, she did not want to find out what that spot was. The doctor said she would respect that but had to point out that if the spot was cancer that treatment would be possible. My mother replied, "If it is cancer I will not have it treated. I have lived a good long life and if cancer is the way I'm going to go, so be it."

So I can understand even questioning whether more testing is a good idea. If you know MIL's attitude when she was in her right mind, and/or you have some written guidelines, and/or she is reasonable enough to give a rational opinion now, then I think her wishes must come first.

My mom, now in moderate dementia, was in ICU last week with an uti and also a GI bleed. The GI doctor urged us to have a scope done. Her primary care doc did not think that was a good idea. A partner in that practice told us if it was his mom he would not have a scope done. (We didn't.)

Even among medical professionals you are going to get different opinions of what should be done. Certainly family members may not agree among themselves. If MIL designated someone as her health care proxy (medical POA) then that is the person who ultimately needs to make the decision.

My heart goes out to you. This is not a position any of us want to be in, even if we've agreed to take the responsibility for decision-making. Whatever you decide, if you are acting in love that is the best you can do. Please do not look back at all the "what ifs." Do what you think best and move forward.
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What would be the benefit to treatment that for sure has negative side effects, in order to prolong a life in which quality declines daily? My 89 yr old mom with moderate dementia who still has some cognitive function and has lived a wonderful life, wants very much to die before she is in diapers, does not know her loved ones, and would require nursing home care if she progresses to advanced dementia. She is still pretty upbeat, but sees "the writing on the wall" and would be happy to know she was going to die before any of that happens, while she is still in her home with me as her caregiver. While spiritually our loved ones are still "in there somewhere", living until the Alzheimer's kills them is an awful ending for all involved, and avoiding that can preserve whatever is left of their sense of dignity, not to mention the extreme burden on caregivers.
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Dementia is NOT a normal stage of aging, it is a disease that destroys brain function.
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Your family thinks you're terrible because they don't see what you see on a daily basis.

They undoubtedly think that not treating your MIL will serve to hasten her death. That may or may not be true.

We should all remember that medical intervention can work miracles but it also can prolong the agony and devastation. Sometimes it's best to step back and let make your take its course.

My vote: palliative care if it comes to that.
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That was supposed to be: let Nature take its course.

BTW, you are the DIL and your husband has passed on. Maybe it's time for the bio-family to take charge of the in laws. Either by moving them into THEIR home or by locating them in a facility, either way becoming the true caretakers.

Maybe you aren't doing that because it isn't what you want, but it seems like it should be time for you to get back to your life, your children and grandchildren, no?
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How old is she, and what type of cancer? Has it been diagnosed? My father (95yr old) has late stage dementia and has late stage cancer (prostate and colon). His oncologist determined he would never survive chemo treatment, and used injection type chemo after surgery. After a few years of that, it no longer worked, and we went on a new pill - extremely expensive for a year. Now he's not on any cancer treatment, and is on hospice, but he's pretty strong even though he can't walk. I wouldn't doubt if he surpasses the limit time of being on hospice. If she's able to understand what is going on, and wants treatment - on the advice of her physician (oncologist) she should have a say about it I would think.
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I want palliative care as she lives with me and I am watching her deteriorate from the Alzheimers. Other family members think I'm terrible :(
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I would opt for palliative care. I would not criticize someone who made a different choice. This is extremely hard!

I take it she is your husband's mother? What is his attitude about this decision?
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You say a suspicious spot has shown up on a scan. Isn't a bit early to make a decision to treat or not? I would want to know more about the spot - have a full diagnosis before making any decisions. Then, I would also want to know what the docs involved recommend. You have a huge load having had your husband fight a hard battle with cancer and lose, and now having both in-laws needing some serious care living with you. There must be a story behind that. Why are their children not looking after them or why are they not in a facility? It seems to me this would get to be too much for you. I appreciate you are likely honouring the memory of your late husband by looking after his parents, but you have other responsibilities. Your profile shows you have a mother of 88 who surely needs some help or will do shortly, and also grandchildren, and full time work from home. I don't know how you cope with all of this and why you agreed to take in your in-laws considering their health and your situation.

Maybe it is time to re-evaluate it all and look for some other solutions to the care of your in laws, They are going to need more and more care. Very likely the family members not closely involved with the care of your in laws do not appreciate your mil's downhill journey. and the amount of work in caregiving both. Nor, likely, do they know as well as you do what a "really awful cancer battle" (your words) is. I suspect that your experience with your husband dying of cancer is colouring your view. That is not a criticism, but I don't see how it cannot colour your view and I suspect you dread going through it again - understandably.
After the diagnosis is complete can you and the family sit down together with some 3rd party - professional(s) - perhaps a social worker from a hospital or doctors office and look at this whole picture and make a plan of care for your in-laws that does not rest entirely on you. I really think this is going to get too hard for you quickly and there is no reason you should be shouldering this burden alone. You are already feeling cooped up and unable to see your grandbabies and it will only get worse.
To the decision re palliative care, if that is one choice according to the docs, I would support that, but understand that some family disagrees. And btw, who has financial and medical POA? I think it very important that efforts be made to allow everyone to have their say. and to get everyone on the same page, or at least a decent majority. Good luck and keep us updated. This is a very difficult situation. ((((((((((((((((((((hugs))))))))))))))))))))
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