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My mother is 97, has dementia, and is extremely hard of hearing. When a visiting nurse discovered that she has a prolapsed uterus, he urged us to take her to the ER, which we did. Being there for several hours was very traumatizing for her. Two days later, she was examined by a gynecologist who recommended the above procedures. I'm not sure what to put her through. After the gynecologist's exam, she said she had gone through major surgery and was grateful for being fixed. I can see the necessity of the pessary to keep her uterus in place, but why put her through the ultrasound and biopsy? If she had cancer, we would not put her through any aggressive treatments.

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I'll tell you this; at 90, my father was SO traumatized by an MRI of his brain, I refused to get him further MRIs as was suggested he have every few MONTHS by his doctors due to a brain tumor. The tumor was going to kill him one way or another, so what was the point of furthering his pain & anguish?

My Uncle George was diagnosed with pancreatic cancer at 98; the 'slow growing kind', which I never heard of. He just turned 100. He's done nothing about the cancer, and it hasn't killed him yet.

My motto is this: allow the very elderly to live what's left of their lives in peace and with as little pain & trauma as possible. If this issue is causing your mother pain, and the procedure will not cause her more pain than it cures, go ahead. If not, don't do it.

Good luck!
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At her age of 97 I'm not sure why you would even consider any of it. Is she in any pain or discomfort? If not and if it were me, I would leave well enough alone, and let her live that rest of her life as comfortable and non traumatizing as possible. She deserves that much. Best wishes.
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OldAlto Mar 2021
I thought the same thing when the original poster said the nurse "discovered" the prolapse. To me, that means her mother was not complaining of any discomfort or pain that led the nurse to even look for that. I honestly don't know much about a uterine prolapse, but it being "discovered" made me wonder why she needed treatment if she wasn't uncomfortable.
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My mother was told a few years ago (with absolutely no evidence) that she had ovarian cancer. She hadn't had a gynecological exam in decades, so the ultrasound was excruciatingly painful for her and the only good thing that came from it was the proof that her doctor was a bonehead. I wouldn't recommend it unless it was absolutely necessary to save her life, and even then, at 97, her care should be focused toward her comfort and little else. (In my opinion, of course.)

It's always OK to say no to doctors. It doesn't occur to them to let you know that's an option. Ask if there are other options, but unnecessary procedures should be pretty low on the list.
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I would tell them a solid NO to the biopsy. Tell them that you will not be treating any cancers that would show up either surgically or with chemo and that you would request palliative and hospice care in case of any cancer, so that there is no need to do this test, and you as POA are refusing same. I would accept the pessary for comfort sake and to prevent infection, and etc. Tell Mom she is right up there with the likes of Queen Victoria, who after all her children suffered throughout her elder years with a seriously prolapsed uterus. I wish you the best.
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I've heard far too many stories of women in the nursing home with an untreated prolapse, I would definitely opt for the pessary but not any of the rest of it. And just so you know, there are pessaries that can be left in place for an extended period of time (several months), there shouldn't be any need to remove and clean it daily.
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Don't Do It!
It would probably kill her to go thru it.
Juse keep her comfortable.

My Dad will be 97 next month and when he ended up in the Hospital because he couldn't urinate, they wanted to do all kinds of tests on him and the only thing I let them do is put a Cathiter in him and give him fluids for being dehydrated and antibiotics.

I told them No to all procedures and Test they cane up with because I told them no reason to do tests because he was too old fir any procedure.

I guess it's just their job (Hospital) Policy, to ask you to do these things like going thru a Drive Thru and have them ask if you want fries or a pie with your order.

When you go to a Hospital, you most definitely need an Advicate.
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jmccloud Mar 2021
Good call! Also remember, it's the elderly that are used for 'practice'!
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Mom was 92 when she developed tongue cancer. I didn't want her to choke todeath. So she did have an operation to remove large growth in her tongue. Had about 3 months of rehab. Learning to talk, eat, etc. 4th month the cancer moved into her neck. We were not going to put her thru chemo or radiation. 5th month after convincing doctor to write prescription for hospice. She signed the papers and died a week later. I prolonged her life 6 extra months, but she did suffer. Hindsight.
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Prolapse is very uncomfortable, and could get her into all sorts of hygiene/infection issues too. Never mind the biopsy, I'd be asking for recommendations on preventing recurrence.

PS The gynaecologist would be very wrong not to *offer* the full range of options. Explain them to your mother as clearly as possible and as much as she's able to understand, and give her a choice in what happens next.
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Is your mother ambulatory?

My mom, 91, with dementia, had a prolapse and got a pessary a few years ago. It had to be taken out and cleaned by a nurse practitioner on a regular basis -which Mom hated. Being in stirrups, she was very uncomfortable (emotionally)with the whole situation.

We had the pessary removed for the last time and kept out after Mom broke her back. She was no longer ambulatory the way she was, and the prolapse works with gravity. Now she spends most of her days seated or laying down and it hasn't been an issue.

Also, she's had 4 skin cancers and we've stopped taking her for check up on those things. Because, why? Same as you, we're not going to put her through any kind of surgery or aggressive treatments, she doesn't want that either. So why put her through the visit. The going out somewhere she's unfamiliar with for something she doesn't entirely understand to be seen by someone she will probably not remember. It just ruins the whole day.

Unless she is bothered by the prolapse, at 97, I'd skip the pessary (which would also mean multiple follow up visits) and the biopsy. I only opt for Mom's comfort as a priority these days.
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babsjvd Mar 2021
I too do not encourage the dermatologist for my mother...I am a full believer that mans medicine gets in the way of God’s plan sometimes...
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IMO too many of you see 97 and immediately segue to the belief that means end of life. I've learned from experience that people can live a long time in an extremely compromised state, my own mother spent 18 months in the nursing home as physically dependent as a newborn infant and she was not the only one there in that condition, some had been there before her and were still there when she died at age 99. There are different levels of prolapse of course but having your uterus hanging out between your legs is not something to shrug off at any age.
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