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joneatra9275 Asked October 2013

How to get grandma treated for cancer?

My grandma was diagnosed with cancer month ago. She needs hysterectomy. She is 81 and has dementia. She fights doctor at each visit and says no. She doesn't remember visits. They refuse to treat her. Grandpa wont get power of attorney over her. What can I do?

vstefans Oct 2013
There was a recent post on a medical site about a 103 year old who had cancer surgery that bought her 3 more years of quality time until she died of something unrelated. Every case is an individual one, not just decided by age or stage of dementia. It is not really fair for someone to have to be making all their own - especially difficult - medical decisions if they have dementia and can't even understand conseqences of choices beyond immediate comfort or discomfort. A big question would be if your and grandpa's decision be any different than hers, given her quality of life? The answer might well be yes, dying of cancer can involve a lot of pain and suffering, though hospice can help. Having a medical POA or guardianship would let someone help make the best decisions possible for her, and prevent someone stepping in and deciding to either do everything or do nothing when that would not be what any of you wanted. Just deciding that you will do everything to keep her comfortable as long as the health care providers in her situation are all on barod and can be trusted to stick with that plan.

jeannegibbs Oct 2013
joneatra9275, do you know what her attitudes were before she developed dementia? Does she have an advance health care directive? Grandpa must know her attitudes and beliefs ... does he think she would have wanted treatment before she had dementia? What about your parents?

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joneatra9275 Oct 2013
The problem is she is not of sound mind to make medical decisions. She does nnot understand she has cancer

jeannegibbs Oct 2013
I agree with gladimhere, consider ALL effects surgery could have. Also consider what Grandma's general attitudes were regarding cancer, chemo, surgery, etc. before dementia set in.

A few years ago I was with my mother (now 93) at a doctor visit. The geriatrician said, "I see that while you were in transitional care recovering from a broken arm you had various tests done. Something is showing up in your pelvic area and that doctor thinks you should follow up with further tests. Would you like for me to arrange that for you?"

My mother replied, "No. I don't want to know what it is. If it is cancer I will not have chemo or surgery, so what is the point of knowing?" The doctor agreed that many older people felt that way and that it was entirely my mother's decision. "I do need to point out to you, though, that if it is cancer, treatment may be able to prolong your life." My mother replied that she had had a good long life already, and if it was her time, so be it. The doctor replied, "I will respect your decision. If you change your mind at any time, just call the office and I will schedule tests for you."

My mother is not usually that assertive, especially with authority figures like doctors, so I knew she was firm in her beliefs.

Even if Grandpa had POA over your grandmother, he would not be able to force her to have surgery or to accept treatment. That is not a POA's role.

This is a heart-breaking situation for you. I am very sorry for your pain. I don't honestly know what you can do (let alone what you should do).

gladimhere Oct 2013
Strange, went through this with my mom, she too was 81. She had the surgery as an outpatient, developed an infection, was then admitted to the hospital for what became a two week stay. We thought we were going to lose her. I now wonder why do they stop doing pap smears on women when they get old? Maybe doesn't develop in older women as much? It was after the surgery that nearly everyone noticed significant changes in her memory.

Now, though I wonder if the anesthesia from the surgery may have resulted in some of the memory loss. She lost all of her hair, it did grow back. It makes one wonder if it would have been better to let nature take its course. The early stages of memory loss were very hard on her emotionally. Google chemo brain for information on the effect of chemo on the brain.

Moms husband had a hip replacement at age 83, we also saw effects of anesthesia on his memory which cleared up after a month or so. Any sort of surgery and the effects of anesthesia on their older brains can be significant. There is a chance that the dementia will get worse with the surgery. Ask these questions of her doctor. All possible effects on her should be considered.

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