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I feel that we are at the end of the road and should now just keep her comfortable. Here's a little background - my Mom was formally diagnosed with Dementia a little over 4 years ago. 3.5 years ago she was diagnosed with Bladder Cancer. After a hospitilization due to the bladder cancer I made the decision to move my Mom in with us to better care for her. Due to her dementia she was unable to follow doctor's instructions, was messing up her medications and was also forgetting to turn off the stove. Moving forward to now - she no longer socializes with us or calls my 4 girls by their names (not sure she knows who is who anymore). Her walking gait has become different. She would sleep until noon if I let her. She no longer knows what day of the week it is or what season it is. When she does talk with us it is only things from when she grew up - she will be 80 this November. She has had too many bladder biopsies for me to count and she has had chemo treatments directly in the bladder and 2 rounds of BCG bladder treatments. The cancer came back - in June we completed 18 rounds of radiation treatments. She just underwent another bladder biopsy and again the cancer is back. She has high blood pressure, a leaky valve that has gotten worse since last year and diabetes. Her cardiologist has told me that he won't open her up again (she had open heart surgery in 2008). She is not a candidate for bladder removal or chemotherapy due to her health issues and she cannot have anymore radation.

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I find it useful sometimes to ask doctors what they would do if this was THEIR parent. Or ask, "is it time for Hospice or palliative care". Some docs hesitate to bring up the subject and we do everyone a favor by bringing it up ourselves.
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You don't need anyone to answer this question for you. You already know the answer to your question. I'm thinking where this site CAN help you is in your not feeling guilty for MAKING that right decision. You are, by the way.

Ask her doctor if he thinks she might be a candidate for hospice and how you can go about having her evaluated. It's time.
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It rather sounds as if your mother is out of options in any case. And my goodness she has certainly been through the mill, poor lady.

Who's been in overall charge of her treatment so far? - urologist, oncologist? Anyway; I'd ask that person to look me in the eye and and explain what will happen if from here she receives palliative care only. It really doesn't sound as if there is much alternative, but you might find it helpful to understand what to expect so that you can plan her care. I'm sorry that all the treatment she has already undergone hasn't been more successful and hope that there will be effective ways of keeping her comfortable from now on.
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