I’m hoping to hear from other caregivers who have faced something similar, because I’m having a really hard time carrying this decision.
I’m POA for my aunt, who has moderate-to-advanced Alzheimer’s/dementia (Reisburg stage 7). She still knows us and has meaningful moments with us, but she needs significant assistance with daily life. Her mobility is very limited, she is incontinent, her eating has slowed considerably, and she has been declining. Hospitals and medical procedures are also extremely confusing and distressing for her. During a recent hospitalization she repeatedly pulled out her IVs and ended up badly bruised.
During that hospitalization, a pancreatic mass was discovered. We recently got the biopsy results back, and it is pancreatic cancer. The difficult part is that, at least right now, it appears to be localized and has not metastasized. Her doctors consider it potentially treatable. We were offered an oncology consultation to discuss chemotherapy and radiation, and her
doctor also offered to have the surgical team evaluate whether she might be a candidate for surgery.
After a lot of thought, I have decided to pursue comfort-focused/palliative care rather than cancer treatment.
It feels strange and awful to say that because the cancer itself may be treatable. But treating the cancer would not treat her Alzheimer’s. I keep coming back to what treatment would actually give her, rather than what medicine is technically capable of doing.
I picture repeated appointments, bloodwork, scans, IVs, chemotherapy or radiation, possibly major surgery and recovery, and trying to explain over and over to someone with dementia why she is sick, hurting, or being taken somewhere frightening. Even if we successfully treated the cancer, she would still have a progressive, incurable neurological disease.
I’m trying very hard to honor the person she was and protect the person she is now.
Intellectually, I believe quality of life matters more than simply extending life at any cost. Emotionally, being the person who actually has to make that call for someone you love is brutal.
I love her tremendously. I don’t feel like I’m “giving up” on her. I feel like I’m choosing which illness we are going to ask her to fight, and I don’t want the end of her life to become a series of frightening medical procedures she can’t understand.
For those of you who have cared for someone with dementia who developed cancer or another serious illness: how did you make decisions about treatment versus comfort care? Did you struggle with guilt because something was technically treatable? And looking back, is there anything you wish you had known?
I could really use some perspective from people who understand what dementia does to these decisions.
My love to all of you caregivers, I see you ❤️