Memory Care and Cancer Diagnosis?

Laurie1282 · June 21

Friends, I am about 3 months out from placing my husband with Alz in a memory care facility. We recently found out that he probably has a blood cancer and will have a bone marrow biopsy to determine type and prognosis. The oncologist said it could be 9 months to 8 years for the type he has (MDS). I am wondering if he will still be accepted into a memory care facility with a cancer diagnosis. Does anyone have experience with this? Thank you!

SDianeL · June 21

Oh I'm so sorry about your husband's diagnosis. The question you must answer is if the bone marrow biopsy shows cancer will he/you choose treatment or palliative/hospice care? My husband is in memory care and they saw a spot on his lung and wanted to do a biopsy and I said no after thinking about it. If it was positive would we do treatment? The answer was no. Why put him through that? Would it prolong his life? No. Dementia may take his life before the cancer did. He may quality for Hospice if he chooses not to undergo treatment. This link might help: Sending hugs. https://www.payingforseniorcare.com/cancer-care-decisions-for-older-adults

terei · June 21

First of all, I would find out what types of treatment would be done if he tests positive. would it make him ill or nauseated? would he be able to tolerate an IV without pulling it out? could he follow instructions for radiation? If any of these things are true I would not be putting him through any testing that is painful or he doesnt understand. IMO as caretakers, we are obligated to the LO to have their lives be as comfortable + calm as possible. Treating pain is one thing, other than that I would not treat anything that would lengthen the time of a progressively more miserable existence.

What would be the purpose of extending his life if his dementia is causing a compromised quality of life? Doctors seem to want to treat and extend life without considering the consequences. \

I would also suggest reading ‘Being Mortal’ before I made any more testing/treatment decisions.

psg712 · June 21

Heme/onc nurse here. There is a big range of severity and treatment options under the umbrella of MDS. I would probably allow the biopsy and associated testing, then have a frank talk with an oncologist about recommendations, based on the specifics of the pathology results. Some folks just need periodic blood tests for monitoring. Others can have stable disease for a long time (years) on oral medication. I don't see a problem with someone in MC doing this. There are many MC residents who are on medication for diabetes, heart problems or other chronic illnesses.

The big decisions will come in if he is at a point of requiring blood transfusions and/or is recommended IV chemotherapy. You and the oncologist can talk about where you want to draw the line for your LO. Ask the doctor what the consequences and timeline might be if you chose to forgo these treatments. Ask the MC health director how they would support your LO through whatever treatment you would like to consider, or through the consequences of choosing not to treat.

JDancer · June 21

I would give serious thought to the bone marrow biopsy. I've not had one myself, but several people have told my how painful they can be.

Your previous posts indicate he's probably 81, and I assume his dementia is advance if he's moving to MC. In a similar situation I would limit medical intervention.

Denise1847 · June 22

What does his Advance Directives state? I would definitely be guided by that and any discussions he had re extending life when there is suffering.

Sunnyside42 · June 22

My husband has night sweats that his doctor suspects might indicate cancer in his body. His doctor asked me the question, do you really want to pursue further testing etc. because if you learn it is cancer, do you want to put him through cancer treatment and all it entails? I agree. Alzheimers is fatal, long drawn out in many cases, and if it were me, I would not want to prolong it. If something else intervened taking my life, I would choose that, and I believe my husband would agree.

Laurie1282 · June 23

As psg712 mentioned, there is a "big range of severity and treatment options under the umbrella of MDS" We do want to find out what level of severity he has so will have him do the bone marrow biopsy. If he has years to live, we will continue with our current plan. If he has a more severe case, we will likely get hospice involved and try to keep him home. In any case, we will NOT subject him to any strenuous treatments like chemo or transfusions.

Thanks all for your comments!

midge333 · June 23

@Laurie1282: That sounds like a well-thought out and reasonable plan!

Rocky2 · June 24

My DW had EOAD and cervical cancer. She was in MC for about 8 months before she passed. The MC had no issues with a resident with cancer. We chose to have DW undergo a course of radiation therapy but no additional diagnostics or therapies. I transported DW to and from her radiation treatments and the MC staff were very helpful in getting DW ready for her appointments and monitoring for any symptoms. I agree with the others who advise not to have A PWD undergo any treatments, including many cancer treatments, that would cause stress, anxiety or reduce the quality of life for the patient. The plain truth is that dementia is a terminal disease. Aggressive treatment of co-diseases will not change that fact. I learned that the best thing I could do for DW was to try to provide the most comfortable and stress-free days possible.

Tom

Laurie1282 · July 7

https://alzconnected.org/discussion/comment/213480#Comment_213480

I really appreciate your comments. We did have the bone marrow biopsy which was quite simple and easy for my husband. Will get results with oncologist on July 18. Hard to wait so long. We just want him not to suffer.

Memory Care and Cancer Diagnosis?

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