Alzheimer's and Cancer diagnosis

[funkyspunk]

My step father (86, 87 in June) has later stage Alzheimer's. He's not terrible terrible but his care is challenging (incontinent both ways, wandering, getting up every night wanting to 'go home' and getting quite irate about it, can't dress himself although he did manage to go through my mums drawers rip a pair of tights into pieces and proceed to put on 4 pairs of her socks on each foot) but not bad enough to go into a home. His short term memory is non existent.

I digress.

He was diagnosed with cancer today. He's got to go for a scan and removal of the tumor.

My questions are:-

Would you tell him even?

Would you risk a general anesthetic rather than a spinal block? I've known countless elderly people who've had a GA and has actually triggered dementia when they were perfectly normal prior.

Would you consent to chemo/radiotherapy?

Thanks

[Huckleberries73]

No I wouldn’t tell him
and I wouldn’t have the cancer treated. Palliative care only.

i say this as a full time carer of my husband with Alzheimer’s

[Peekaboobo]

As a PP said, I wouldn't tell him and I wouldn't have the cancer treated either. Just pain relief.

I wouldn't treat cancer in myself aged 87 if it helps.

[Alphabet1spaghetti2]

I agree with both @Huckleberries73 and @Peekaboobo

With hindsight I should have stood my ground and refused a pacemaker for my mil when she had advanced Alzheimer’s. It wasn’t in her best interests to have and that was an easier treatment to undergo.

[funkyspunk]

That's what we've decided as a family. My mother has POA so she has to make that decision, but I couldn't believe the specialist yesterday, we immediately told her he had advanced Alzheimer's and she proceeded to ask him if he knew why he was there and he didn't, then... THEN....she handed HIM the consent form for him to sign to have this investigative procedure to be done! I did chime in, and said he hasn't a clue what he's signing and that mother would have to consent......

He currently seems okay, he has really off days when he feels terrible but he doesn't know where...just that he feels rotten, not sure if its age, Alzheimer's or cancer related....

I appreciate all your advice x

[Silverumbrella]

I’m so sorry your father is going through this. If Alzheimer’s isn’t bad enough the extra stress of a cancer diagnosis must be dreadful for you all.

My 81 year old mum has Alzheimer’s. I am taking her to the breast clinic tomorrow for an urgent appointment as we’ve found a large lump.

We have already said (as a family) if it’s serious then we will go down the palliative care route, there is no way we are putting her through surgery and/or chemo. She had an ultrasound scan last week for a completely separate matter and that was stressful enough.

I can’t believe the consultant would even suggest putting your poor father through an operation at his age and with Alzheimer’s.

[Candleabra]

Why don’t you think he’s bad enough to go into a home?
As a carer myself I understand the gradual nature of dependency and you probably don’t realise how bad things are and how much you’re doing.
As awful as it sounds I wouldn’t consent to any treatment, I would want him to be made comfortable. Surgery and chemo will be brutal, and borderline even in an otherwise healthy 86 year old. The side effects coupled with incontinence alone will be difficult to manage and distressing for the patient. Aggressive cancer treatment is not the answer here.

[funkyspunk]

@Candleabra

Simply put, my mother doesn't want him to go into a home unless absolutely 100% necessary. We have a carer come twice a day to get him up/dressed etc and an evening visit for toilet/pad change which mother does do from 10.30am until he comes in the evening and then again all through the night. We were having 4 carers a day but he would have always just been to the loo before they turned up therefore it was a waste of time, so the option for more care assistance is there if she wants.

I will mention about the operation to her, we've not thought about not going through with that because the specialist said "this needs to be removed" with the emphasis on needs. It already looks quite sizeable and the tumour is located somewhere that if he doesn't get it removed more complications will inevitably happen.

[MissyB1]

Depends on exactly where this tumour is, and what it will do. For example if it was going to completely block his bowel that’s a painful death. Sometimes surgery is palliative, it just allows a more pain free decline.

Also no family member can consent for him as such. It would be a discussion with the medical processionals, and there is a very specific consent form for patients without capacity, which has to be signed by various people.

But I agree it sounds like palliative care is the right way to go.

[funkyspunk]

@MissyB1

He has no capacity... mum with POA will have to sign.
The tumour is situated right at the top of the urethra... so potentially a really dodgy place.