Follow
Share

My mom was diagnosed with dementia more than 14 years ago. She is now 92, doesn't recognize me 90% of the time, doesn't eat regularly (she is in a facility where they care for all her needs) and has just been diagnosed as severly anemic. She is on hospice but they have given my 2 sisters and I a few options (blood transfusion, endoscopy/ colonscopy to find the spot of bleeding, or making her comfortable) I am of the opinion that we need to make her as comfortable as possible and let her pass with dignity. I do not know whether my sisters will agree to this, and I am not allowed to make the decision alone... I am wanting to find out what stages she will go thru. Will there be pain for her? What can I do for her to make her more comfortable? Hopefully some of you out there have gone thru this before and can help me out a little- thanks in advance

This question has been closed for answers. Ask a New Question.
As several others have mentioned, B-12 deficiency may be the challenge. Pernicious anemia can mimic dementia and contribute to it, and it's very common among the elderly. She could get B-12 shots if she is really low. Other than that, if it were my mother (who is now 94), I wouldn't put her through surgery or a colonoscopy in an attempt to determine what's causing the anemia.

My mother-in-law ended up having a large tumor mass, which went undetected until only 2 days prior to her passing when it metastasized. When it was first discovered her blood count was way out of line. Some cancers can cause anemia. :-(
Helpful Answer (0)
Report

My mother (86) has had this problem for a couple of years. She has had the colonoscopies and endoscopies and occult blood tests, and she's refusing any more of them. Also two series of 10 iv iron infusions. They found some stomach bleeds when she started vomiting blood a few years ago, and the doctors closed those off during the endoscopies. After all this, still anemic, and now they find high white counts and think she has some leukemia or lymphoma process going on, which is currently being investigated.

At the point she's saying no more tests and no more treatments, no matter what they find. I take those words with a grain of salt. She won't agree to a course of chemotherapy or any more long series of iron infusions, but I believe she will accept more blood transfusions if necessary. When she gets dizzy and short of breath because there's not enough oxygen in her blood, the transfusions do provide immediate relief and get her back on her feet at least for a while. I consider the blood transfusion more in the nature of palliative care. It's not a cure but it helps her feel a whole lot better, for a while.
Helpful Answer (3)
Report

The question to focus your sisters' minds on is: what is best for your mother?

The interventions available would be a) probably futile (the likelier causes of the anaemia are not going to be curable); b) potentially harmful (blood transfusions can overload the vital organs - it's really not as simple as saying whoopee let's give her a few units); and c) distressing for a lady who - yes? - is currently comfortable and content.

And for what? Best case scenario, what would we be trying to achieve?

Your mother remains entitled to the best care that medicine can offer her: which is to ensure she is protected from pain and fear. I'm sure your sisters will support you on that.
Helpful Answer (4)
Report

My dad was just diagnosed too with anemia but his iron level is okay. Doctor decided to recheck it in 3 months. Thyroid low also. Wondering about B12 too. Dad is 82 and all those tests just seem like $$$ adding up and unwanted trips for all these procedures plus follow ups. He says he feels fine.
I want to let it be and do nothing (kinda)...FOG coming on!
Helpful Answer (2)
Report

Has a stool test been done to determine that there is blood in it? Is that why the doctors are suggesting an internal bleed? Has her B12 been tested? A lack of B12 can lead to anemia as it inhibits the bodies ability to absorb iron.

The prep for a colonoscopy is very uncomfortable, I cannot imagine putting a 92 year old through the prep let alone the procedure.

My granny did not have dementia, she had chronic leukemia. She has 2 or 3 blood transfusions in the last year of her life. She refuse any other treatment.

If your mother was my mother, I would see if she could manage the blood transfusion, perhaps it could be done overnight. Otherwise make her comfortable for as long as she has left.
Helpful Answer (2)
Report

I think I would not argue it. I would lay out what the actual procedures would look like. I'd also get a doc on board to do the explanation. That always worked better for me.

I was all about " just me mom die in peace, not in pieces" which is what she told me she wanted.

But then she gave the three of us joint poa for health.


It always sounded to my bothers and sil's like I WANTED mom to die. So I found it better to let doctors explain the choices.
Helpful Answer (2)
Report

I am not is that position, but I would opt for comfort Care too.
Helpful Answer (2)
Report

Thanks Barb...My feeling is to do nothing and let it be... I do not know if my sisters will also feel this way (we disagree on MANY things) but the ideas you have put forth will be good arguments for me to put out to them, should I need to!
Helpful Answer (4)
Report

So, what would colonoscopy prep look like for your mom with dementia? Would the folks at the facility be able to get her to drink that nasty stuff? Can she still get to a bathroom or commode? What will the effects of the anesthesia be on her? And if they find an internal bleed, what is the treatment? Surgery under general anesthesia?

If you aren't going to do the treatment (surgery for a bleed) don't do the test.

Transfusion? Will she tolerate sitting there with an IV in her arm, or will she rip it out?

Discuss the options with a geriatric doctor and your sisters and come to a consensus.
Helpful Answer (4)
Report

This question has been closed for answers. Ask a New Question.