Expert: Paula Damgaard - 8/6/2010

Question
Recently we were told that our 84 yr old mother with Alzheimers is suggest to have colonoscopy, due to her red blood cell count low.  Stool sampled, negative.  Our family, highly concerned of this. We're trying to research other possibilities of why her red blood cell count could be low.  Also concered about watn she may have to go through in the preparation for this surgery at her age and level of AD. She is in a nursing home and she hates taking here meds. She's gets aggitated very easily (sadly she has sundown syndrome episodes. Can't commuicate, physically in tough shape.) We know before she had gotton so ill she would want quality of life.  Sad it is beyond due this disease.  Theres no going back:(  We grasp pur moments to catch a word that once in a while seems to make sense.  Graps it, treasure it.   My sister is proxy on her care and is torn of this decision. My husband and I try to place our selves in our mom's statements of quality of life before she got so sick.   The colonoscopy, the Anesthesia to us would only deteriorate and harm her more at this point in her life.  But not for us to decide though we feel strongly to support our sisters decision. Any suggestion for more links to research would be helpful.  Thank you.

Answer
Andy,

You say your mom requested quality of life?? Then no way on this earth would I ever consent to letting someone do a colonoscopy on her.  There is no reason to do it.  

First of all, if they do it, (doctors feel they have to do it because they think the families want them to be aggressive and treat everything), and they find something say cancer, then what?  Will you put her through chemotherapy and radiation??  Wouldn't it be much better to call Hospice now and tell them to take over??  

Second, the preparation alone will push your mom over the edge.  She will not understand why she 1, has to drink all the stuff she would have to drink to clean out her intestines and 2, the result of drinking all that stuff, would mean a huge mess for the nursing home!!  She will be going to the bathroom non stop!

This should not be a torn decision for your sister, you need to tell her she needs to respect your mom's wishes!  Call Hospice they will be able to support all of you and help you care for your mom correctly.

Remember, doctors took an oath to heal everyone and make them better, but sometimes they need the families to say enough!  We don't want any more we just want comfort care.  That is your option!

I know this is hard, but what you would put your mom through will be so much worse.  

Take care of each other and I hope you find peace in knowing that you did what your mom would have wanted.  Paula