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My mother has hormone-receptor-positive, HER2-negative, advanced-stage breast cancer. She's been taking Faslodex for it since 2017. She began exhibiting signs of dementia in 2014 and in July 2018 we moved her to a memory care unit. We probably waited too long to do that. She is at the beginning of Stage 6. She has no memory of recent events. She has very few memories of earlier life (ex. she doesn't remember any of her past homes, that her brother and sister are both long dead, major events in our past lives) but she does still remember me. She says the same things over and over, but its about 5 minutes of talking and it all makes sense (its always about the garden where she live now - she's impressed with the variety of plants).


Mom always said two things to me my whole life: don't put me in a home and don't let me die of cancer. Now she's living her two worst fears.


Faslodex can hold off the advance of mom's cancer for many more years to come, her oncologist has told me. But mom has declined very quickly cognitively since entering memory care. And physically she's declining too (her teeth are beginning to fall out. She's getting wounds on her feet from her fragile skin splitting. She has no feeling of pain anywhere - the dentist worked on cavities without any reaction from her and the podiatrist said her foot wound should be painful but he treated it with no reaction from her).


I am mom's medical POA. I have no siblings and my dad died 25 years ago, so there's no one else to consider. At what point do I make the decision to stop the Faslodex and let her go into hospice?


I'd welcome any advice.

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Don’t let yourself be made more miserable by remembering ‘don't put me in a home and don't let me die of cancer’. The promises about never going into care can trip a lot of guilt, but don’t change reality when it is simply impossible (financially, emotionally and safely) to arrange care at home. Cancer is not the inevitable death sentence we all feared forty years ago, and both treatments and pain control have improved a great deal. Hospice and the whole concept of palliative care are less than forty years old, and have made many things more kindly and human.

Two close family members of mine have died of cancer in the last year. The previous relative to die lived to three months short of 100, in a living death she never would have wanted. A quicker death from cancer looks to me like a better option.

It’s hard time, and look after yourself as well as your mother.
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You my dear are stuck between a rock and hard place.. My dad died of cancer many moons ago. That was his greatest fear while I was growing up.

My mom got dementia/ALZ.

My firend's dad died of cancer, and she told me that she would rather deal with her dad's cancer, rather than seeing mom dwindle away with dementia/ALZ. ALZ is just an emotional rollercoaster.

You are dealing with the 1/2 punch. Keep her comfortable, put her on Hospice. Get your Hopsice team on board. Talk. Honestly, Mom was on hospice 3 times, 2 times she graduated out of hospice. The last time she made it to Heaven, finally.
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I was also going to suggest hospice.

Does she have a living will? Did she want every treatment available or willing to accept that at some point we're all going to die? Or somewhere in the middle? If you know the answer, I think that will help you to decide whether or not to continue cancer treatment.

If it were me, I would pursue discontinuing it and making her comfort level the priority.
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Mom will eventually die from the Dementia. Does her medical POA have what she did or did not want?

My opinion, call in Hospice, let them evaluate Mom. If she fits the criteria they will except her. Yes, they will probably stop the chemo but she will be kept comfortable. With what you describe, it may be her time.
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