Colonoscopy for an 85 year old?(4 Posts)
My 85 year old mum has been anaemic for at least a couple of months. A stool specimen has just revealed that there was blood in her stool. The GP has said that the next step would be a referral to a bowel specialist and that she should be seen within 2 weeks. My mum has a probable diagnosis of Alzheimer's and moved into a care home a few months ago. She is very early stages and the main way she has been affected wrt to the dementia is through loss of language -though she knows what she wants to say and can usually eventually convey her meaning - but it is of course very frustrating for her. She is naturally pessimistic and I don't think would want treatment if it is cancer which she has had 3 times before. We are due to see the GP together on Tuesday. I spoke to the GP today and she said we need to decide if we want any investigations at all as there may not be a point in putting her through any trauma involved if we're not going to do much anyway. She has become more frail but can still walk unaided and dress herself etc so I think would be okay for a colonoscopy. Does anyone have experience of an elderly relative having a colonoscopy? Thanks.
This is a really difficult decision, and one which many of us will face.
My concern would be anesthetic, as both my mother and DH's grandfather showed marked and lasting declines in their mental capacity following operations.
I found this on the Alzheimers Org website as the reason for a research project:
"Major surgery that involves general anaesthetic, such as for knee and hip replacements or for heart conditions, is common for many older adults. After general anaesthesia there is an increased risk of developing prolonged problems with thinking that go beyond the short period of temporary disorientation that is typical after surgery.
This long-lasting disorder is known as post-operative cognitive decline and is thought to be associated with inflammation in the brain, similar to that seen in Alzheimer's disease. There is a need to understand how this cognitive decline develops and ways to prevent it, since it poses a particularly high risk to the ageing population."
I think my decision making would be based on:
1. How invasive will the colonoscopy be? Some anaesthetics seem to be worse than others, and I assume a colonoscopy would not produce the sort of inflammation that is associated Alzheimers. (But I am not a doctor!)
2. What alternatives are there to cancer. By ruling cancer out, is there a chance that the cause might be something that is easily treatable.
3. And would knowing it is cancer help identify a palliative treatment which would improve the quality of her remaining life.
4. Also how unsettling is she likely to find the whole hospital experience.
My mum also has loss of language as her primary symptom, and has been very anaemic in the last few years.
She did have a colonoscopy, but just with sedation, and though she didn't really understand what was going on she coped OK (this has not been the case at all for GAs). The preparation was a bit difficult as she couldn't process what was going on, but it was only the one day.
She didn't have cancer, but has continued to be v anaemic. Iron infusions made a massive difference to her wellbeing. If it had been cancer, then dad and I would have had some tough decisions to make as I don't think surgery would have been an option for mums welfare.
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