My mother is 95 and has dementia. She is in the hospital and her stools are black and her hemoglobin is low. They say she has upper GI bleeding. Has anyone's senior loved one who has dementia had an upper GI endoscopy? How did it go? At this time I am not going to consent to it as I am concerned her dementia will get worse from the anesthesia. They say it's "light" anesthesia but still I am concerned. Also I dont want her to have any physical issues from the procedure. She is getting Protonix at the moment.
Scroll down to read it.
The bleeding has stopped.
Moreover, the family is advised NOT to do this procedure in this case due to an increased chance of perforation and increased bleeding.
Most of the time, medications the person normally takes have caused irritation to the lining of the GI tract. To avoid this in the future, make sure the person drinks plenty of fluids or eats something when taking meds.
in medicine so take all of this with a grain of salt. I am 70 years old but do not have dementia (yet anyway). I had esophageal cancer (not a good cancer to have) and a bleeding ulcer in the past and as a result have had numerous endoscopies both to treat it and follow up care. I can not speak to her illness or the the treatment and it's side effects. Hare is what I know:
1.) I would tell you that the biggest risk would be the anesthesia, and they do put har to sleep for this procedure.
2.) There is never any pain associated with an endoscopy, at least not for me. That was not true of the treatment for the cancer.
3.) I can't speak to the dementia, but I would guess that it would have little or no impact on an endoscopy.
4.) If she is bleeding from her upper digestive tract she really does need this procedure asap.
I wish you and your mom the best of best of everything. My heart goes out to you and your mom. I only have one piece of advice to share: and that is SEEK OUT THE BEST DOCTORS AND HOSPITAL YOU CAN FIND, DO YOUR RESEARCH. I am twice a cancer survivor and I am only still here because I took control of my care and had the very best of care from the best people and hospitals I could find. Best wishes to both of you
Thank you for the update.
My mother has cancer along with late stage dementia. she is 95, will be 96 in February. She has vaginal bleeding that originally thought to be a bad UTI. When UTI was ruled out, NP did a manual vaginal check for bloodwork. That was extremely upsetting, mom didn't understand. Met with medical staff about options. Blood tests indicated 3 types of cancer: Colon, vaginal\ovarian and a 3rd indeterminate. To know for sure what type would require a trip to hospital for an invasive procedure that would have been torture for mom to endure. And to what end? She is almost 96, and I wanted her to just be comfortable and peaceful during the end of life process. She is now in hospice, on pain medication, anti-agitation meds, now in a wheelchair (she was using a walker until just before Thanksgiving) and is loving staying in the community room. She is watching all the comings and goings, like she used to do when she sat on her porch watching the neighborhood and visiting with family and friends.
When I visit, I hold her hand, scratch her back and tell her all the stories she used to tell me. We sing, laugh and I bring what we call a "hug puppy" for hugging her family that can't visit her. I bring cookies and sometimes we sing.
She is dying, but she is not in pain, is feisty and makes the staff laugh with her comments. I want to enjoy what is left of a long life, well lived.
There comes a time when you accept the journey that began when mom started many years ago. She gave birth to me, its now my job to help her navigate dying.
I agree, its time for Hospice. I would never put my Mom thru something like this.
Best of luck.
For instance her stools can be tested for H Pylori which is the common cause of ulcers which is the common cause of blood in the stool (dark blood means upper GI bleeding). OR they can give a course of cipro and hope for the best. It rids the system of any H Pylori caused ulcerations. It is less liked now as it can cause some tendon complications, but still a good antibiotic.
Now if you are looking at say a stomach cancer they would be able to ID that and you would be able to say "Hospice and Palliative care now please", but you would at least KNOW.
The medication is indeed light and almost always safe. However, as a nurse I saw a young woman die of the procedure when the vagus nerve was hit and she went into a dysrhytmia of the heart. She happened to be the daughter of a fellow RN. The procedure is quick and often very easily done.
So you have a few options here, but I would say one is NOT to allow the bleeding to continue if it can easily be stopped.
I think that I would ask for a course of Cipro if they would give.
Then if the black stools continued I would want to know what is happening in order to make further decisions.
But with a 95 year old with dementia I can well see a reason to say no interventions at all, and if the stools continue dark and the HH continues downward, get in hospice and allow mom to go of whatever illness is currently on board. With this decision being yours I can easily make a case for going EITHER way you are most comfortable with.
Ultimately I can see a very good case for saying "Let's go with a course of cipro. If that's not the answer we don't even need to know the question. We would need hospice, the good drugs, and a peaceful exit."
Sorry. It's all on you as so often happens. I as an RN would have a hard time MYSELF with deciding this one even for myself. Were I well and happy I would go with this USUALLY very easy and uncomplicated procedure. Were I in the throes of dementia, I would want to go of whatever I could get to take me. My brother had early Lewy's and he felt the same and was GLAD to have sepsis on the scene to take help him out.