Grandmother declining further tests or treatment

[9peoplecalling]

My grandmother recently moved from my house into a care home. She is 87. She had some blood tests which came back showing she was anemic and so she was sent to see a consultant who took a stool sample.

i had a phone call from the care home this evening saying that the consultant had called and had a phone consultation with my grandmother and the nurse at the home. The results of this “FIT” test were quite high and he thinks its likely a growth/cancer but apparently he and my grandmother both agreed it was better to let whatever it was run its course and she declined further tests or treatments.

i understand that she doesnt want to go to hospital and have a colonoscopy but its left me feeling very confused about what to expect she may or may not have cancer (the consultant said there is certainly something going on but obviously he couldnt say for sure what)

if she does have cancer we have no idea how far along it is or how aggressive it is.

has any one else had anything like this because i am feeling very unsure of what is going on!

my grandmother doesnt have much memory and so the likelyhood is she will have forgotten this ever happened by tomorrow and i have no idea how to handle it.

I am the only person who visits her and so she relies on me to keep things sorted out for her!

I would think ensuring whoever looks after her will prioritise her comfort is important

There’s no need to know, just keep her comfortable and carry on.

If she doesn't want any further investigations... then she doesn't want any further investigations.
At the age of 87 and requiring 24 hour care already shows how vulnerable your grandmother is. Having to go for further investigations of endoscopy and colonoscopy is very invasive and could distress her. If they find anything.... what would they do? Would they subject her to an operation?? Or chemo? With awful side effects etc.

Being treat with palliative care, treating the symptoms and ensuring comfort is sometimes the best way

I'm sorry you're in this situation, we are in the same boat with my Granny so I know where you're coming from.

In our case, the consultant has also decided (with family input) that further tests are rather pointless. They would be invasive and uncomfortable and, due to her age, any cancer would only be treated palliatively so the tests don't really assist her. Instead they will continue to treat symptoms as they arise and we will focus on ensuring her comfort rather than having her in and out of hospital for appointments.

Would you be able to chat with your Grandmothers GP? They may be able to help and advise as to how you can navigate the situation and the next few weeks and months.

Good for her! At 87 (& much younger ages, to be honest) this is exactly the right thing to do. As long as she is kept comfortable and pain-free, that's all that matters. Not everyone wants lots of fussing, hospital trips and treatment.

This.

I was a carer for elderly people for 22 years, and the kindest thing in this situation is to ensure that the lady is kept comfortable, pain-free and without any medical intervention.

I also agree that this sounds sensible. Even if she chose to have invasive tests & cancer was found, what then? The Consultant is unlikely to find surgery appropriate for an 87 year old who is already frail enough to require a care home. Ditto chemo. Chemo in itself is hellish

Good quality palliative care seems to be the kindest option.

I also think the best course at her age is no treatment.
No good will come for any of you from knowing the extent of it or even if it’s there. Let nature take its course. What will be, will be.

I chose for palliative care for my OH and the home involved the hospice outreach team for advice.
Your gran is making the right decision ... and her memory lapses may be a blessing in this situation.

The only question I would have is whether CHC funding depends on having a diagnosis. I would hope that it doesn’t, that it’s based on the care needed, not on the reason for that care.

I wouldn’t let that change my decision though. I can’t see any point in invasive testing if it won’t affect treatment

At 87, needing a care home and not having a great memory her quality of life is declining. One of two things is now going to happen:

1 she has bowel cancer and will continue to age and show more symptoms of ill health / old age and be made comfortable while this progresses and she eventually succumbs.

2 she doesn't have bowel cancer and will continue to age and show more symptoms of ill health / old age and be made comfortable while this progresses and she eventually succumbs.

I say this next part as the daughter of someone with dementia who is in a care home: the kindest thing for your grandmother is that she doesn't have to live for years with dementia and ill health taking away all of her quality of life and dignity. Sometimes that may be sooner than family members would like but that is better for her than reaching the point where she is really struggling on a daily basis.

Just because we can treat someone doesn't necessarily mean we should.

Being kept comfortable, and pain free in a familiar environment is a very reasonable decision in these circumstances.

That was my first thought as well.

As long as she has any pain controlled, I see no point in invasive tests for such an elderly person who has health issues anyway. My Dad died at 84 because the cancer treatment he started was really awful so he didn’t want to go through with it. He had no dementia and I remember a nurse saying I wish more people were like your Dad.

As hard as it is the kindest thing is to let people go as peacefully as possible.

I don’t blame her tbh. My mum decided not to have chemo or radiotherapy for cancer, as she didn’t want long drawn out side effects. As a result, she’s signed off from oncology with no further scans etc and under the care of the palliative team. We don’t know how long she has as she refused a prognosis (she’s currently defying what we thought she’d have left)

Palliative care are doing a great job in helping address and manage
Pain and side effects. I’d try and accept your grandmothers’ decision (hard as that prob is) and work with the palliative team to set up options for care, pain relief etc

My Mum had cancer in her 80s and was pleased it was too far spread on discovery to be worth treating as she had no intention of having chemo etc. and didn't want to face arguments with any of us.
And that was someone fit and well up to that point and still living independently.