This will be kind of a doozy to read..my apologies.
A bit of background:
My grandmother is 80 years old today. Though she is only 80 it seems she is aging much faster than her other elderly peers. My grandfather died nearly six years ago of a heart attack and my grandmother has lived with me ever since. Ever since his death she has been severely depressed and seems she is only living to die at this point. She is still mourning his death but is also becoming increasingly scared of her own demise. For the past six years I have watched a major cognitive decline in her.
Terrible Year:
This past year she has been unable to catch a single break. In June she received a cortisone shot right before finding out she needed her second hip replacement. She had to wait three months in severe pain for the cortisone to leave her system. She got the replacement in Sept. and is still struggling. She was told she need spinal stenosis surgery but that was delayed when they found a large growth on her breast that she refused to tell anyone about (she has had breast cancer before). They took out three lymph nodes while removing her breast and found aggressive cancer cells in one of them. Now they would like to do chemotherapy to make sure microscopic cells haven't spread through her lymphatic system.
Possible Dementia:
It seems as though no family members will listen to me when I say I believe she has dementia. Her cognitive decline is not "normal aging". I've seen it for a couple years but it has become increasingly severe over the last year. She is incapable of remembering a conversation we had 10 minutes prior. She has become increasingly confused over the last year and it seems like she never has any idea what she is talking about. She tried to tell me I was in my 30s and would not budge when I told her I am only 20. Sometimes it is like she goes back in time and thinks we are in a different year. She has had friends of different ethnicities all her life but is all of a sudden becoming more and more racist, almost as though she is back in her childhood when racism was "normal". It is becoming harder and harder to take her out in public. She is angry all the time and although I know it is mostly frustration with herself she takes it out on those trying to help her. She said to me yesterday for the first time "I always feel confused." This holiday season was also the first time that my cousins started to notice a large shift in her. She asked about my cousin who "ran the Boston marathon last year" which my cousin DID do, but about 14 years ago.
THE QUESTION:
Finally, sorry for making you read all that. Is chemotherapy a good idea? She is terrified of it (and does NOT want to lose her hair) but if it is only for microscopic cells is it worth it? They said the cells could take aprox. 5 years to grow into another aggressive cancer but I am unsure she will still be functioning in five years. I am afraid chemo will do more damage than good for her.
She sounds confused, not incompetent. Thus, she's allowed to make a decision about chemo herself. If she's depressed and anxious, there are meds that can help with that, which help clarify her thinking a bit.
Have you read Atul Gawande's On Being Mortal?
Like said, if its just confusion she can't make an informed decision. Since drs. feel it could be a while for cancer to grow, there is no emergency. Think about the side effects. Will they diminish her quality of life?
If she has to spend the last years of her life hooked up to chemicals that will make her sick, weak and vulnerable to other infections....
As far as surgery for the spinal stenosis...With the dementia, anesthesia is not a great thing for people with dementia. She will probably not be able to participate well in rehab.
The chemo and I would imagine surgery for the breast cancer will be difficult to manage then adding the surgery for the spinal stenosis...
What I would do if this were my Mom, my Grandma, my Sister and Myself...
I would opt not to have surgery for any of it.
I would opt not to have chemo.
I would contact Hospice and prepare. If at all possible I would contact friends and schedule visits with people that I have not seen in a while. I would eat stuff that I know I shouldn't, I would read books that I should have read before.
(sort of like the Tim McGraw song)..
I would love deeper
I would speak sweeter
I would give forgiveness I'd been denying..
Live like you were dying
And one more thought..If she does not want surgery, she does not want chemo and she is "forced" or pushed into she probably would not do as well as if she wanted to "fight" this. Again Quality VS Quantity.
Have her primary care doctor prescribe Hospice and go from there. I believe that you will be doing right by her by letting her live the rest of her life without treating the cancer.
Having breast cancer is down right scary. Sorry that your Gma's cancer had returned. How did she deal with the cancer the first time around? Was it that that caused the depression? One is always reminded of the surgery every time one dresses or takes a shower, even many years after the fact.
I wonder if immune therapy is available for breast cancer? It would be something to look into. And find out what are the common side effects. Could Gma deal with those side effects? How would the quality of her life be?
My mom was diagnosed with uterine cancer at the age of 80, had the hysterectomy and chemo. Following that there was a rapid decline in her brain function. Initially we all attributed it to "chemo brain", Google it. But, that is not what it was. The decline continued.
Ask doc about effects of anesthesia and chemo on the brain. Any surgery or chemo should be very carefully considered. If grandma doesn't want the treatment don't try to talk her into it.
First of all, how great of you to have the generosity and maturity to take on the caring of your grandmother! Caregiving is a very tall task for anyone, but very specially for someone so young. Most people your age (and many people of all ages) are all about their lives, not wanting the “burden” of caring for an elderly loved one. May God bless you for your kind heart!
Now, about chemotherapy, my answer will be brief and to the point. What would I do? No chemotherapy. Period.
My mom received chemo and radiotherapy plus many other things about eight years ago, she had very aggressive breast cancer, and yes, I have the blessing of still having her with me, but AT WHAT COST? A cost or a price that is not for many to pay.
Your grandma is tired, VERY tired. She is depressed, ill, in pain, frustrated, confused and feels lonely. Add the severity of chemotherapy (which she is pretty familiar with) to that mix and I think what you get is like a cruel punishment. I think she is ok with dying Concernedpatron, and it is ok to go when our time comes, no matter how hard it is for our loved ones that wish we never left, we will all go at some point, and maybe she will have many more years with you, one never knows! but with my most honest heart I would tell you don’t make her go through all that again now that her strength is not even half of what it was before!
God bless both of you and hope you obtain the blessing of wisdom, so you get to clearly see the answer! A hug!
My dad had prostate cancer that wasn't diagnosed until he was in his late 80's. And yes, the cancer had likely spread to one of his kidneys, his hip, and eventually other places. His family doctor told me that it would "be a speedy demise." Dad lived under hospice care for nearly 4 years and lived to be a full 91½ years old. We did not choose to put him through chemo, radiation, or surgery, and I'm glad we didn't. He was an artist and some of his most beautiful paintings (in my opinion) came out of those final years of his life. He lived in a nursing care facility where he was loved and well-cared for. The employees encouraged him to continue painting and even set up a weekly art class for the residents and had Dad share his skill with them.
Letting our loved one enjoy their final days is so much better than having them experience the discomfort that comes with many of the treatments. This doesn't mean that I think everyone should forego cancer treatments, but I personally think that it should not be done to the elderly, especially when they don't desire it. My dad did not want these treatments, and I honored his wishes.
You are an incredible young person for advocating for your grandmother!! Your hard work and testimony to help her will be honored by the Lord. In my opinion and based on past experience, if you know how she is already, and that treatment would only aggravate the already showing symptoms of aging, cognitive decline, etc., then I would weigh the costs versus the benefits to her and make a decision based on that.
We discovered a malignant tumor on my 91 year old mom. We did not know it to be malignant originally. Her Dr. insisted that we biopsy it “so we at least know what we are dealing with.” We declined. My mom and I were caregivers for my dad, and had discussed what we thought was best for him and devoted as mom was to him, when we had a fork in the road, we opted to keep him comfortable and let him live that way without the invasive, hard core treatments that stronger and younger people may opt for. I knew that would be what she would want as well. I thought that I might struggle with “well I didn’t do everything I could” later, but I did not struggle with that. Harsh treatments cause a lot of difficulties that can make people struggle in long hospital stays or rehab centers. Chemo therapy would be to say the least, hard on her system and most likely aggravating her existing issues. I would do whatever I could to bring comfort and moments of joy, if only a few, for her and keep going. Many Blessings to you and your family!! 💗
You should talk with her regular Dr., by appt. or by sending a letter, and explain her confusion and depression. He/she should put her on anti anxiety medication. If she’s already on it, he/she will know the dosage needs to be increased. I went through this, and when my mother was finally on the correct dosage she was a new person. It calmed her anxiety and negative thinking.
Personally, I would honor your grandmothers wishes to Not have Chemo. At her age, putting her through Chemo could cure her or slowly kill her.
May the Lord bless you and give you the guidance you need each day ahead.
If you can find a true Palliative Care group, they will help you and your grandmother make treatment decisions going forward with the goal being her comfort. They will deal with any chronic illness, not just terminal diagnoses.
If you cannot find this sort of care in your area, a geriatrician would also be very helpful going forward in deciding what care to offer. I'm sorry your grandmother and you are going through this.
I wish you the very best
I wish you the very best
That said, talk to her doctor about meds for her moods. There's no real way to take away the confusion, but she could be helped to feel better.
My husband's parent, who had no dementia, rejected chemo treatment at the age of 78.
Just like pets, when 1 is deceased the other is 99.9% shown to die 6 six months from the death of their companion. Pets have also been studied to die when their favorite human passes.
Now the question is, are you letting the Doctors perform these procedures for her or yourself? Are they helping Grandma or placing her in a life that is more painful? Have ANY of the doctors told you that at 80 yrs young, just being placed under anesthesia she may not wake up?
Anesthesia general/local has a greater possibility of Mom dying on the table, she turned 86 in August. I asked my siblings if they are comfortable with Mom being DNR, yes. Were they ok with Mom eating chocolate until she gets the tots, has insulin dependent diabetes which can cause her to go into diabetic coma, yes.
I am guardian/conservator for Mom, but I still want siblings to realize and understand what Mom wants. We have agreed to keep her comfortable and if she wants chocolate, let it happen.
She has Alzheimer's, in a GREAT assisted living facility. We want her to just be happy and whatever happens, it comes on her terms.
Me, I would not want Grandma to live the remainder of her life in more pain due to the procedures. The cure is worse than the illness. You love Grandma dearly, but what is truly better for her? Talk with an end of life specialist individually and then with Grandma present for her to open up and tell you what she wants.
Listen to your heart. That is God's way of speaking with you. You may or may not be religious, but He still listens and answers in His time.
All the best to you during this time of need.
Remember, everything you read on this thread are JUST suggestions just as mine.