Okay, so. After this post, I'm going to start f-locking things talking about Gramps because I realize that not EVERYONE is going to want to read about it.
I have an uncle who's been in care for many years now. Dilemmas of this kind are starting to come up for him. They're not easy.
What would be best for your grandfather's quality of life? Is the bladder cancer such that it would make his remaining time miserable or could he deal with it? If you ask me, brain trumps bladder.
Yeah, I agree with you totally -- brain trumps bladder, and in my gut I agree that his quality of life would not be improved by allowing the dementia a chance to progress unchecked.
That is *such* a tought choice. I would hope that if my mind started to go that my body would naturally be there as well.
Assuming that they do a cystoscopy and there is something to remove/fix, I wonder if there's a way to avoid using general anesthesia (I assume that's being completely out is what progesses the dementia). If they can do a local the way they sometimes do for C-sections and such, maybe it wouldn't cause so many problems? Speaking as someone who just had surgery while awake, it's just an option that springs to mind - and I wonder why it didn't occur to the doctor who is supposed to know the way anesthesia can affect dementia...
Well, as I said before, the doctor was a dipwad. And it was the same doctor that didn't use enough local anesthetic for the cytoscopy, did the surgery in an outpatient clinic, and completely botched the after-care, so I'm not sure Mom would even trust this guy to do another surgery (provided it was even necessary).
Dr. Pearson (aka "Dipwad, MD") probably didn't make any effort to educate himself on my grandfather's OTHER problems, unlike his neurologist, who, so far, is AWESOME.
(Funny -- so much of my grandfather's tangling with Medicare is what fuels my resistance to and distrust of govt run healthcare.)
There is sadly, no right answer. And no one can tell you what to do. I think it comes down to quality of life. Even if this surgery extends his life, would it be a life worth living?
And, remember, that it isn't just about him, but you and your mother as well. Can you handle taking care of him in the condition he's likely to be in after the surgery?
I don't know if it will help, but Newsweek did a great article on this topic.
Yeah, I know-- that's what makes this such a bitch of a situation. There IS no right answer. Me, I'd want my mind intact, even if my body started to go, and would probably opt just for pain management, if fixing my body meant screwing with my brain. And but I can't assume that what I'd want for myself is what someone else would want.
That said, during his clearer days, Gramps has shown moments where he's aware of the fact that his brain isn't working quite right, and I think it really troubles him.
And... I'm sure that's a great article, but I'm a bit too emotionally bruised to read it objectively right now. I know what's coming, and I know it's inevitable. My mother has extended his life significantly primarily through changing his diet depending on what seem like ever-changing nutritional requirements. But I cannot read about or discuss "end of life care" right now. I'm sorry. :(
I'm sorry to hear this. Decisions like this are never easy (in fact, a decision like this actually divided my family and they've never patched it up again) but I think the only thing you can do is try to consider what your grandfather wants, right?
Mom's going to talk with her sibs, but right now she is of the opinion that a cytoscopy would be a needlessly painful experience for him, since, if he DOES have more growths, she isn't sure she's willing to sacrifice his mental state to another surgery. And there's also the part where Dr. Dipwad didn't arrange for a nurse to come visit and clean the catheter insertion point, so Mom had to do it, and with Gramps being in a completely fucked-up place mentally, she also had to contend with him getting out of bed at odd hours (sometimes NAKED), wandering around the house looking for "a dance hall." And it took him three months to recover mentally from that. And here's the rub -- even if he HAD been kept in a hospital, he would've been put in 5-point restraints to keep him from getting out of bed, and he would've been discharged ANYWAY once he was physically better, regardless of his mental state.
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What would be best for your grandfather's quality of life? Is the bladder cancer such that it would make his remaining time miserable or could he deal with it? If you ask me, brain trumps bladder.
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Assuming that they do a cystoscopy and there is something to remove/fix, I wonder if there's a way to avoid using general anesthesia (I assume that's being completely out is what progesses the dementia). If they can do a local the way they sometimes do for C-sections and such, maybe it wouldn't cause so many problems? Speaking as someone who just had surgery while awake, it's just an option that springs to mind - and I wonder why it didn't occur to the doctor who is supposed to know the way anesthesia can affect dementia...
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Dr. Pearson (aka "Dipwad, MD") probably didn't make any effort to educate himself on my grandfather's OTHER problems, unlike his neurologist, who, so far, is AWESOME.
(Funny -- so much of my grandfather's tangling with Medicare is what fuels my resistance to and distrust of govt run healthcare.)
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And, remember, that it isn't just about him, but you and your mother as well. Can you handle taking care of him in the condition he's likely to be in after the surgery?
I don't know if it will help, but Newsweek did a great article on this topic.
http://www.newsweek.com/id/215291
I hope everything works out for the best.
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That said, during his clearer days, Gramps has shown moments where he's aware of the fact that his brain isn't working quite right, and I think it really troubles him.
And... I'm sure that's a great article, but I'm a bit too emotionally bruised to read it objectively right now. I know what's coming, and I know it's inevitable. My mother has extended his life significantly primarily through changing his diet depending on what seem like ever-changing nutritional requirements. But I cannot read about or discuss "end of life care" right now. I'm sorry. :(
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In any case, good luck with it :(
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Augh. :(
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