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My mother has had diagnosed osteoporisis for a number of years, as did her mother. She has been on alendronate probably longer than she should. She is going into end-stage dementia and her mobility has really declined in the last few months; she's using a walker now but will probably be in a wheelchair soon. Her doctor has scheduled her for a bone density scan. My question is, what good might be achieved at this point? Has anyone else dealt with this one? I've already had to say no last year to a cardiologist who wanted her to do a stress test for a minor heart arrhythmia.


Thank you.

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I did read a while back that after a certain age medication does not help anymore.
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Reply to JoAnn29
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GLSDaisy, I think you've made a good assessment of the situation, as well as a good decision.   At this point it's kind of moot as to whether or not any anti-osteoporosis medicine needs to or can be helpful for someone at an advanced age when the cost could probably be more appropriately and usefully applied for her continued advanced care.

I hope you feel comfortable with your decision; I think it's the best under the circumstances.
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Reply to GardenArtist
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Thank you all for taking the time to consider my question and respond - I truly appreciate it.

I considered that the scan is for making a decision about the medication, but I had this conversation 1 1/2 years ago with her previous doctor. She was unhappy that Mother wasn't making any gains in bone density(?!) and wanted to prescribe the annual Reclast infusion, which was not covered and costs thousands of dollars. But, cost aside, this made no sense to me for someone of Mother's advanced age and state of decline.

So here we are. Mother is in memory care now and going into the last phase of dementia. She sort of recognizes me but doesn't really know who I am (she referred to me as her sister for a while, which was sort of funny since she is an only child). Her mobility has also declined sharply in the last 6 months, so getting her loaded up and then in and out of offices and exam rooms is stressful and exhausting for both of us (I insist on taking her myself - I want to hear and speak about what the doctor says), and I consider all trips out very seriously.

I got a reply from the doctor a few minutes ago and she does want the scan in order to make a decision about the alendronate. I will take her for the sake of due diligence, but I intend for it to be the last time.

Again, thank you all for your input; it has helped.
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Reply to glsdaisy
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Im guessing that docs are graded by Medicare on the percentage of eligible patients who have there age eligible testing. Bet they get $0.25 extra per appointment per patient. That's not worth me hauling mthr in for another test with possible consequences!
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Reply to surprise
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It’ll send his kid to college..or help dr buy new car....that’s all it’ll do ..no good for your mother as there’s no point to it.
That’s my opinion. Hugs 🤗
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Reply to CaregiverL
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We all know that as we age our bone density decreases, there is nothing to be learned here. I would not put your mother through this, it doesn't make any difference one way or another.
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Reply to DollyMe
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No, I wouldn't put her thru it. Just a thought though, maybe Dr. wants a scan to see if the meds are having any effect. I was surprised, after a fall, that my Mom laid still for the Xrays she needed. A scan for osteoporosis is very simple.
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Reply to JoAnn29
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Since she's already on fosamax, what else would they do if her bone density is not good? On the other hand, if her bone density is good, she may be able to get off fosamax. That would be good.

It's a hassle versus benefit situation. If it's not to much hassle, getting the bone density scan would offer more knowledge. If that knowledge leads to her taking less meds, then that would be a benefit.
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Reply to needtowashhair
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I wouldn't disagree that a bone density scan isn't appropriate at her age.   I decided not to have them several years ago.  My condition is known; I know what I have to do, and having a scan is only going to highlight deterioration.    I refuse to take any of the toxic meds, especially Fosamax, and what I need to really is get busy with some good exercise programs (more gardening will help!)

But there's another issue from the medical standpoint, and that's whether doctors do almost everything they can to identify and treat symptoms.    There's an ideological clash in that position though.   Some doctors are realistic and confident enough to know when conditions can't be changed, but others might be concerned for blame if they don't at least suggest possibilities.  

Think of how often people blame doctors in posts here, even without addressing the entire situations, especially when the posters haven't educated themselves as to conditions and don't know what to expect.   It's not my intent to criticize anyone, but we each approach our care and our loved ones' care with different levels of research and knowledge.

Some of the "doctor killed my parent" posts reflect a paucity of knowledge about aging and the death process.    If I were a doctor, I'd be thinking of CYA approaches "just in case."
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Reply to GardenArtist
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I agree with Cali. Guess what, her bones at this age aren't very dense. So what to do. She is being, in my opinion, treated as somewhat a vending machine for money for tests. Next she will be used for big pharma's cash machine for the latest best in drugs for osteoporosis. The last "miracle" for that ended in causing MORE hip fractures (go figure) and causing other side effects as well. There is a lot to be said for palliative care at a certain point. My brother is well enough in his mind at 85 to make clear that is what he now wants.
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Reply to AlvaDeer
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Is your mother currently taking anything for the osteoporosis? Because if not, then this one of those things where you have to confused whether or not the risks outweigh the benefit. Why put her through the hassle? I’m sure getting her dressed and out of the house isn’t an easy task and then the scan itself (which doesn’t take long but can still be traumatic)......I’m in agreement about palliative care. Eliminate unnecessary appointments for ailments that can’t be cured & that aren’t bothering her or affecting her QOL. My mother has had osteoporosis for years and takes something for it and she had a bone scan recently and I thought why? At this point why? She’s not really leaving the house anymore (COPF, emphysema, fibromyalgia) and she’s not moving around much in the house. I saw no point in putting herself through the hassle because it’s a struggle going out when you are on oxygen and in pain 24/7 but she said it needed to be done so what do I know?
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Reply to worriedinCali
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needtowashhair Jan 13, 2020
OP said she is already on meds for osteoporosis.
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Palliative care is warranted at this point in her life, in my opinion. I do the same for my 93 y/o mother who also suffers from dementia and about 10 other health issues. When she was last hospitalized for pneumonia, the neurologist came in to see her and scheduled a 'follow up' appointment for after she was released from rehab. A follow up for neuropathy, for which there is no cure OR decent treatment (besides what's already being done). So, WHY would I schedule a follow up appointment with this woman when mother is in a wheelchair, it would require me and DH to take a day off from work, involve a big co-pay, etc etc? The doctor looked at me like I had 2 heads when I told her NO, I hadn't scheduled a follow up appointment and was not going to! It serves NO purpose to take herculean efforts to extend the life of a dementia patient. But on behalf of the doctors, there's no $$$$$$$$$$$$ for them in NOT scheduling these appointments, whether they're warranted or not, let's face it.

Wishing you the best of luck!
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Reply to lealonnie1
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The question to ask her doctor is what will you do based on the results of the scan? If there is not going to be any change in treatment, then no to the scan. If there would be a change to treatment, what would it be and what would be the desired outcome?

If it is just to tick on a box on a form, that she has had a 5 year scan then no way.
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Reply to Tothill
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I'd cancel the appointment. The only appointments I'd do at this point is anything that would provide comfort for your mom. Sometimes I think some of these doctors, or the corporate business end of the for profit, greedy health care industry, will do anything to rake in more money without any thoughts as to the victim they are making money off of. There are wonderful doctors and health care workers out there but sometimes they are at the mercy of who is signing their paychecks.
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Reply to Tiredandweary
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At 86 with dementia, any kind of testing is fraught with potential meltdowns--and why the heck a bone density test at 86??

I know docs are trying to just do their jobs, but sometimes I wish they'd LOOK UP at their patients and think : "Is this really the best way to deal with this patient? She is not 'all here' she very elderly and not in great shape. Why put her through testing that is just going to prove to me what I already know: Her bone density is garbage".

My mother is bent completely over--in a C-curve and she cannot stand up straight or even close to it. A bone density test for her would just show us in depth what we can SEE with bare eyes. Her bones are all so porous it's a shock she hasn't snapped a hip in one of her falls. She ASKED about a BD test, as she loves all things medical, but he PCP said he could see what he needed to know, just looking at her.

You have the right to say no.
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Reply to Midkid58
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needtowashhair Jan 13, 2020
I don't think of 86 being that old. In my family, it definitely is not. Grandma had a bone density scan when she was 100.
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