Elderly Parent W/ Alzheimer's Get Checked for Polyps in Colon?

Updated on June 23, 2014
K.S. asks from Ann Arbor, MI
19 answers

I have to decide whether or not to have my elderly aunt with Alzheimer's get checked for polyps in her colon. What do you think? Her short term memory is nearly gone, and the procedure and the preparation for the procedure will be difficult for her to understand. If she had her colon removed (we don't even know whether she has cancerous polyps, but if she did), she wouldn't be able to take care of herself. My mom had some removed last year. Please give your compassionate advice.

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So What Happened?

Thank you for all of your responses. After some thinking and more research, we as a family have decided not to follow through with the test. I still wonder whether it is the right answer, but that's where I'm at now. Best wishes for all of you who have dealt with these big decisions.

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S.T.

answers from Washington DC on

oh, no, i wouldn't. it's hard enough to prep for that when you're fully present, aware and competent.
i'm so sorry. what a tough situation.
and i wish i could send a bazillion flowers and a huge hug to peg.
khairete
S.

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M.S.

answers from Washington DC on

I would not have done it to my dad who was in a similar state in his older years.

If you do end up doing it, I would insist that her prep work be done in the hospital.

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S.W.

answers from Minneapolis on

I'd suggest talking this through with her doctor, or even two doctors. As with all tests, there are recommendations based on age and health status, yet not all doctors will give the same advice.

Many of us will have cancer in our bodies at the time of our deaths, though the cancer will not be the cause of death.

I would ask very pointed questions of the doctor. Why is this test being recommended given her age and status? What is the prognosis of your aunt? How many years of life do they believe she realistically has? What is the cost (not just in dollars but in pain/confusion caused by procedures and possible follow-up procedures) versus benefit of this test?

I am not a doctor and I don't know any more about your aunt's condition than what you state here. But, you've said "elderly" and "Alzheimer's". My personal feeling would be to say "no" to this invasive test.

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P.M.

answers from Portland on

What an interesting, and complicated, question.

Doctors choose less rather than more for themselves when they are in their final, downward spiral. They know better than anyone what anguish end-of-life "rescues" bring to both patient and loved ones. And I read a report last week that determined that when it comes to end-of-life care, younger people tend to be more willing to pull out the stops for their elders than the elders tend to want for themselves. And as sad as it is, Alzheimers is an end-of-life disease.

Plenty of room for individual variation, of course, but here's where I am in my own life:

I'm 66. I have set up end-of-life documents requesting NO heroic medical measures should I become unlikely to recover, from whatever. My life was once wonderful, and it no longer is so much. I live with constant burning, aching, sometimes grinding pain in hands, hips, thighs, knees and feet. Many other pains come and go. A bad rectocele that I could never afford to correct requires me to use a finger to move my bowels at least once a day, and a hernia, painful varicose veins, type 2 diabetes, a rheumatic condition that may blind me… I could go on. My sleep is truly terrible. I am still functioning, but most tasks come at the cost of considerable discomfort.

So I'm looking forward to my final chapter, so much so that I have been choosing for the past couple of years to forego pap tests, mammograms, colonoscopies…. I do take care of myself, exercise and eat very carefully, so I'm holding my options open. But too much has been medically out of my reach for too long, and catching up is not really an option any more. Life hurts, and every year has been harder.

Family members know they are not to urge medical care upon me, and if I were forced to undergo arduous procedures, or brought back from the brink, with at best only uncertain and uncomfortable life extension, I would see that from my present position as cruel and unnecessary. I helped advocate for my own granny to be allowed to die (her wish, when she was lucid) when she was tortured by hospitalization for 9 horrible days.

And that's not even getting into the cost of tests and treatments that are not likely to improve the quality of an elder's life. There are practical reasons not to waste medical dollars. And when it's not helpful and not even wanted, it's harmful — and a waste that will continue to drive health care costs out of reach for the next generation.

And all this is just MY position; what I want for myself. It could certainly be different for others, but statistics appear to put me in good company. This is a difficult place for you. I send up a prayer for your decision to be the right one for your aunt.

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M.S.

answers from Kansas City on

Alzheimer's is such a sad condition. If this is for a routine screening, I would say "absolutely not". If she is having major symptoms of distress, bleeding or blockage, perhaps that would even be questionable.
.
Depending on her age and ability to function and current performance status, ask yourself, "if they find cancer, would you put her through the treatment"? And "what would the outcome be?" and, "would it improve her quality of life?"
My guess it would not.

I would opt for comfort measures and not do anything invasive. Many elderly people very often decline more rapidly when aggressive treatments are performed or if they experience an injury or anesthesia.

My heart goes out to you.

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P.K.

answers from New York on

How old is she? I probably would not put her thru it. Actually I am sure I would not. Is she having any symptoms at all or is doc suggesting it as preventive. You have to think about quality of life.

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J.S.

answers from Richland on

I know that for years I took my dad to have a colonoscopy but he never took mom. I never questioned the why. I just figured with everything that he was doing for her he had his reasons.

She died of her body shutting down, odd really, not many people actually die of the Alzheimers. I remember when she went into the coma, my poor dad, shouldn't we do everything to keep her alive, in case she comes out of the coma. I had to be the one to ask, what if she does, is there a difference? That is the ugliness of Alzheimers they are gone before they die, make it as easy on them and the family as possible.

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J.C.

answers from Philadelphia on

I would not put her through it. I am a huge believer in quality of life and I have seen first hand what dementia/Alzheimer's does to a person. This has led me to write my personal wishes in my living will. My wishes state that if I am ever in a position where I am unable to care for myself or make my own decisions with no reasonable hope of getting better, then I refuse all medical treatment except those treatments that provide comfort (hospice care) That means I refuse treatment for a UTI, pneumonia etc. I most certainly would refuse to have a colonoscopy.

I really feel for you because these decisions are never easy to make. I do believe that loving someone enough to let them go is one of the most selfless things you can do however. Blessings.

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A.M.

answers from Dallas on

If it is just a recommended preventative test no way. If she is having symptoms of a colon issue, I would still think long and hard before doing it. For me, it would depend on how old she is, how bad the alzheimers is affecting her and if she has any other issues. Kudos to you for caring for her and being so considerate about whether to do it or not!

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D..

answers from Miami on

I would not do it. Having two people in my life who have Alzheimers, I give you the advice that is heartfelt.

ETA: Bless your heart, Peg.

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J.C.

answers from New York on

Forget the procedure - that would be the easy part. How would they do the prep? Even if they use the pills, the bathroom part would be so tough.

Is there a reason they feel she needs this done? If she is elderly and is in relatively good health, I'd say to forget it.

I agree about the anesthesia - it will only hurt her memory further. Any kind, twilight or general.

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D.D.

answers from New York on

The alzheimers would make it hard to treat any condition with your aunt. Personally I wouldn't do a colonscopy with her. If she passes from untreated colon cancer instead of alzheimers then it's no different than her having a heart attack or falling and suffering a fatal head injury and passing. Your family's job at this point to to make sure she's safe and cared for with as much of a quality of life as possible. Too much medical intervention would be confusing and frightening for your aunt.

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E.B.

answers from Beaumont on

I wouldn't do it. It would interfere with the quality of her remaining life.

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M.B.

answers from Austin on

Having to undergo a procedure like that, with having a general anesthesia would probably only confuse her more. (The general anesthesia tends to add to cognitive difficulties...... we saw a major decline when my mother had her hip replaced 3 years ago. Before the surgery and rehabilitation in a care facility, she was much more capable of taking care of herself and being left alone. After the surgery, she was much more confused, forgot daily care routines, and things like that. Granted, she was 87 or so at the time?)

If this is a "routine" screening (I think they like to do one every 10 years, right?), I would pass.

If it were a test the doctor has ordered because of previous medical history, or current symptoms, I might consider it.... it just depends on how far her dementia has progressed.

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S.B.

answers from Houston on

My mother has advanced alzheimers and FTD. So I completely understand. This disease SUCKS!!!! I can't think of a more cruel disease than this.

My question is what happens if they find something? Surgery? Chemo? What is the purpose? I'm asking because we have decided as a family that we will not do any type of treatment for my Mom. We will make her comfortable but no life saving measures at all and that includes a feeding tube.

A couple of years ago, she had to be put out to pull a tooth. It was
terrible. Putting a person with this disease under is not a good idea. It affects their memory more. It accelerates the disease.

So again, you and your family need to have a very serious conversation and decide what you will and won't do. Personally, I would refuse the test. To me, it serves no purpose. BUT that is me.

I'm so sorry for your Aunt and family.

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D.B.

answers from Boston on

Unless there is some clear and immediate indication of a problem (such as a lot of rectal bleeding), I'm not sure what value the procedure would have. I agree you would never be able to get her to do the prep work. It seems to me she would have to be admitted to the hospital to even monitor this, and of course the hospitalization is confusing and disorienting for many elderly people and particularly for those with significant Alzheimer's. Even if she is in a facility now and has some in-home care, it would be tough for the caregiver to force her to drink the prep liquid. If this is just the usual recommendation for a colonoscopy every ten years that we all get, I don't see the point. You don't want to neglect someone with Alzheimer's, of course, but there are some things that a family chooses not to pursue.

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G.B.

answers from Oklahoma City on

I truly don't know. She has a terminal illness and it's effecting her. On one hand cancer is painful, polyps in the line of poop is often painful too. It might be that not having it done would cause her physical pain.

I can't imagine what you're going through. I'm so sorry.

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M.O.

answers from New York on

I'd be inclined to say no. This sounds like a classic case of a medical protocol overwhelming the individual patient's needs. But I'd consult with a gerontologist before making the decision.

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X.O.

answers from Chicago on

How old is she? Does her PCP think she should have it done?

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