86yo Mom was in hospital for fall in Feb. On her CT scan they found a suspicious area in her bladder and blood in the urine. Called in a urologist consult, who recommended a cystoscopy in the office. She has significant mobility issues and advanced dementia. I took her to the first appt for the procedure and they couldn't do it because could not visualize inside of bladder well and said infection. There wasn't any infection. She had to wait 6 weeks to get back on schedule and be brought back to try again. Try number 2 after a huge hassle in the office getting a urine specimen, test was done. He could see clearly that there are a couple areas inside the bladder that are abnormal and weeping blood. So now he is saying she needs to go to hospital and have another cysto under anesthesia for biopsy. I had been lead to believe they would do that with this test. I ask him exactly what this would accomplish and the plan if it is cancer. He of course recommended surgery, chemo and radiation. Mom meantime is saying yes we need to do as the Dr says. I told him we would not be treating it so is the additional test really necessary? He said then we can just wait and watch her and wants her back for followup visits. He never has sat down and really discussed anything with me or us, just quickly and hurriedly rushes in while I'm dressing her and states these things. I just don't know if I'm doing the right thing for her. I thought possibly if we had a specific diagnosis she would be eligible for palliative care or something for comfort. She is completely incontinent of bladder and bowel. Without the additional procedure we won't know for sure what we are dealing with. On the other hand it is so very difficult to get her to these appointments. She is a large woman in a wheelchair and I have a very bad back and am not to lift over 10 lbs. I feel after moving her like I want to crawl in a hole and die the pain is so much. She lives in AL memory care and they would take her to appointments but I think I have to. This past time when I went to get her she was to be all ready and she was sitting in the dining room wearing a pair of shorts,diaper and a jacket. No shoes, socks or underwear or blouse. I took her to the room and appropriately dressed her and changed her soiled diaper. The aids told me she had refused to put on anything else when they tried to get her ready. I don't know if she fought with them, but all I said was that what she had on wasn't appropriate for a Dr visit and she changed without incident. I surely would hate for her to show up for an appointment in the condition she was in. Sorry this is so long but I just need to vent and a little guidance please. I've ask my husband and siblings and all say do what you think is best. I just feel like I'm failing her somehow.