Debbie, I know you've thought of this, but does it matter if she has
cancer or not? She already has one terminal illness (AD), so its not
like she has a potential for healthy years ahead to preserved by
treating a secondary illness. If she does have cancer, are you going to
put her through treatments? If not, then what do you need the
information for? What does the data bring to the table in terms of how
you deal with her? Its the same equation, cancer or no cancer.
Palliative care and supports, keeping her comfortable, out of pain, as
happy and content as possible.

Mm MIL died from end stage AD, and by the time she finally went, there
was nothing left of her mentally, and almost nothing physically. It was
brutal, and I know my husband (an only child) prayed something else
would mercifully carry her off rather than have her die by slow inches
over months and months.

Mary G.

I would ask her physician just what you put here. If this person says just
get her to drink it, I would get a second opinion. I am an R.N. These
people sometimes have very delicate fluid balance, at least my Mom
does. Anything that interferes with this, and trust me this is going to
interfere in a major way, will cause her dementia to get really worse, for
at least the immediate future. They need to do this in hospital in my
opinion. I have cared for patients when I worked the medical floor, who
were in exactly this situation. Do Not For A Minute think this is not
going to be a Major procedure.

These are all good points. It's not my decision alone, but if she did
have cancer, I would vote aginst surgery, chemo, etc. However, I did
think we could find out if she had cancer by doing the colonoscopy. Now
I wonder if it is worth it to find out. I will be showing all your
e-mails to the other family members involved, and will also have a
discussion with the family doctor. In some ways, I think we're doing it
for him, and really, that's crazy.

Debbie

Hi Debbie,

Others have replied to you very well and given you excellent advice, so I am
just endorsing what they have already said.   It is a tough call and I
sympathize, but can offer a sort of a parallel.

A few months ago my mother in law (who is in a nursing home) suddenly turned
jaundiced.   Since there is a DNR in place, they asked us what to do.   Not
knowing if it was a gall stone blocking a duct, and knowing that is a very
painful way to die, we asked that she be taken to the hospital and diagnosed
properly.  It turned out that she has pancreatic cancer, which even if
treated aggressively, has a poor survival rate.   The doctor put a stent in
place which gave her a few more months of comfort, but we all agreed it
wasn't wise to put her through any aggressive treatment.   Now she is
finally come to the place where palliative care is all that can be done.

Although I am so sad for her and for the situation, knowing her as I do, I
can honestly say that knowing she will soon be out of her pain and the
awful-ness that alzheimers has wrought of her mind, there is some small
sense that it is probably better to go of something else, sooner,  than to
die of alzheimers later.

It is always a tough call.   It isn't my choice, it is yours, and so only
you and your family can make it.   Once you have decided, go straight ahead
knowing that you made the best choice available with what you knew at the
time.   No guilt is allowed around here, we are all caregivers who love our
relative/spouse/loved one, and we know that there are tough choices in this
life, and even tougher ones when it involves another persons life.

I have a pop-wisdom list of true-isms and one of my favorites was;

"all the important decisions of life are made on the basis of insufficient
data"

Just do the best you can and pray you have chosen wisely.   That is what we
did.

Debbie, when my husband was not too far into AD he had an appointment with
the cardiologist.  He had some minor heart problems previously, but I
decided to cancel the appointment.  If they had found something serious,
there would have been nothing I would have done about it except pray that it
took him before he went all through the stages of AD.  If anesthesia is used
on an AD patient, it really sets them back.  You have to make the decision,
but if it were me, I would not have the colonoscopy done on her.  JMHO>
Gwen

i think you need to consider this very carefully.  if cancer was
diagnosed, would the pain and agony of major surgery be worse
than palliative care that would let the cancer release her from a
certain slow deterioration to a vegetative state?

i have that exam every 2 years, because of family history, and
it's extremely unpleasant, even if you're mentally prepped for
it.  if the patient is not completely calm and relaxed, it can
also be quite painful.  

if polyps are found during the exam, it is the usual practice to
remove them (and biopsy them), which can be painful.  if a tumor
is found, the surgery is not minor, and general anesthesia almost
always causes a catastrophic cognitive and memory loss.  the
usual treatment is surgery:  a colostomy, which requres the
patient to deal with living with a bag hanging on the abdomen for
the rest of his or her life.

you might ask the medical folks if it would be possible to
diagnose with a less invasive procedure, and if they did find a
tumor if it would be possible to use chemo without surgery
requiring general anesthesia.  if this was an option, you would
want to consider whether chemo would cause further memory loss.

i say this knowing that my living will instructs my caregivers to
give me only palliative care for a pain free death in such a
situation.  what were her wishes when she was lucid enough to
make decisions about advance directives?  does she have a living
will?

Hi - I just wanted to thank all of you for the good advice. The family
read it over and came to the conclusion that we couldn't put her
through the colonoscopy. We told the family doctor this morning, and he
was in full agreement. He said that doctors have an obligation to put
forward a full treatment plan, but that off the record, he felt we were
making the right choice.

So it is a bit sad, because it is a turning point in her health care,
but when we got back in the car and my MIL said, "Well, that was easy
and there's nothing wrong with me!", I
knew in my heart that it was the best thingfor her.

Thanks again for your support,

Debbie

Hello there! I too am new to the group and have been in a similar
situation with my dad that I have been caregiving for. I tried cleaning
him out at home and it did not go well. I told the doctor that if this
is necessary than it will be done in the hospital! It was done at the
hospital. Doctors claim it's tuff to explain to Medicare why
hospitialization would be needed for a patient with AD for a
colonoscopy.....if doctors feel the proceedure is necessary
then 24hr care is necessary with a portapoddie. It worked for me and
many others in my area. You're in my prayers!

If I knew then:

I would not put anyone thru this unless you  intend to follow thru
should something be found.
My husband, early stages, still understood clean out procedures, had
this done, in hospital...he had had colonoscopy many times prior. always
found benign polyps
Result:  BP dropped while lightly sedated.
Procedure stopped, he came out not knowing where he was, who he was
---so confused.  lost lots of memory much of which was never recovered.

Florence