My MIL has dementia (lewy body/mixed). She lives in an AL. She has reached the point that when anything goes off routine she loses it for about a week. They forgot to help her shower last Saturday, she went completely hysterical until Thursday. Calling random people to try to “break out”, leaving my husband and I hysterical messages, etc.. Yesterday, she called me but didn’t know she called (she does this a lot) but then started talking like a little girl on the phone. It was very disturbing. She also has a history of breast cancer. She went through chemotherapy about 3 years ago and it was almost too much for her physically. She is back to annual screening. It’s time for her mammogram and I just don’t can’t imagine putting her through it. I can’t imagine what a false positive or a real positive would do to her mentally. I really can’t imagine her going through chemo again. Two weeks ago I took her to meet with a Neurologist, she thought she was at a Therapist the entire time. She has an EEG and CT coming up with them. I am fine with the CT scan, but I am also wondering about the EEG. I notice when her disease progresses it a big step down, then she is steady for awhile. We have definitely taken a step down recently. Thoughts on when to stop routine screening and how much to put a dementia patient through?
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I had breast cancer over 35 years ago. I had found all my own lumps both benign and malignant even when mammograms were negative (A-OK). At age 70, having become sick of calcifications and biopsy threats, I stopped all mammograms after a talk with my doctor. I continue to do self exam on the remaining breast. Now, at age 80 that is where I am. A personal choice. My reasoning is:
1. We will all die of something. At 80 while I might accept a mastectomy I would not treat any other way and would not treat advanced cancer, but would enter hospice. There are MANY deaths much worse than going of cancer, and as an RN I know which ones they are.
2. I found my own lumps. I actually trust myself more than the machines.
3. The false negatives are frightening and disturbing.
4. I have decided I am happily ready to live with the results of my own decision for myself.
Now, if MIL cannot discuss her choices with you, this decision fall to the POA. I, were I POA for my mother, would make the same decision I did for myself.
Just know whatever decision you make you do live with the consequences of it, both the good and the bad.
Best luck. More difficult to make this decision for others than for ourselves.
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I also would not do any testing where she would have to be sedated. Sedation can cause a decline.
I honestly would discontinue most "routine" testing.
When my Husband became non compliant at the dentist I stopped routine dental exams/cleanings.
Honestly at this point I would transition her from AL to Memory Care and contact a Hospice and let Hospice be her Medical Team.
We are conditioned to want to fight and do everything we can to stop death but in cases like your MILs she is never going to get better. If she lives long enough she will eventually lose the ability to swallow.
Shame on the doctor who is advising you to take her in for a mammogram knowing her condition.
After a two-week hospital/rehab stint that made my poor mother crazy with delirium, I made the decision that we were done with hospitals. (We'd already been done with specialists for a while.) What could be treated in place at her MC was treated, and what couldn't be wouldn't have. I put Mom on hospice, and she plugged along for another eight months, including bouts with Covid and gout that were treated in place.
Medical technology is just Man getting the way of Nature. At some point, it's OK to just let Nature take the lead without interference. Nature always wins anyway.
If she flips out for a week because the shower schedule was disrupted, imagine what she's do if you forced her to do a mammogram?
If it turns out she has cancer, my guess is you're not going to force her into treatment for it.
She has dementia and it will get worse. Clearly it's pretty advanced now if she's trying to get people to 'break her out' of the AL and has regressed to talking in the little girl voice. Clearly she's out of it and will likely need a higher level of memory care than an AL provides.
What matters is her quality of life. If she can have some level of contentment and is doing okay, leave her to it. No invasive screenings or testing.
So, NO I would not take her for a mammogram. It would likely be too stressful and getting her to follow the directions, etc.
And, even if it was malignant, would we really want to put her through an aggressive treatment?
Our loved-ones have Dementia, which is a fatal disease. Why would we want to try to prolong their life?
I agree with the others that I would pass on any future testing. It's more important that her depression/hysteria/anxiety be improved since her cognitive disease prevents her from being able to do this on her own.
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