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My mother has had diagnosed osteoporisis for a number of years, as did her mother. She has been on alendronate probably longer than she should. She is going into end-stage dementia and her mobility has really declined in the last few months; she's using a walker now but will probably be in a wheelchair soon. Her doctor has scheduled her for a bone density scan. My question is, what good might be achieved at this point? Has anyone else dealt with this one? I've already had to say no last year to a cardiologist who wanted her to do a stress test for a minor heart arrhythmia.


Thank you.

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At 86 with dementia, any kind of testing is fraught with potential meltdowns--and why the heck a bone density test at 86??

I know docs are trying to just do their jobs, but sometimes I wish they'd LOOK UP at their patients and think : "Is this really the best way to deal with this patient? She is not 'all here' she very elderly and not in great shape. Why put her through testing that is just going to prove to me what I already know: Her bone density is garbage".

My mother is bent completely over--in a C-curve and she cannot stand up straight or even close to it. A bone density test for her would just show us in depth what we can SEE with bare eyes. Her bones are all so porous it's a shock she hasn't snapped a hip in one of her falls. She ASKED about a BD test, as she loves all things medical, but he PCP said he could see what he needed to know, just looking at her.

You have the right to say no.
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needtowashhair Jan 2020
I don't think of 86 being that old. In my family, it definitely is not. Grandma had a bone density scan when she was 100.
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I'd cancel the appointment. The only appointments I'd do at this point is anything that would provide comfort for your mom. Sometimes I think some of these doctors, or the corporate business end of the for profit, greedy health care industry, will do anything to rake in more money without any thoughts as to the victim they are making money off of. There are wonderful doctors and health care workers out there but sometimes they are at the mercy of who is signing their paychecks.
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I wouldn't disagree that a bone density scan isn't appropriate at her age.   I decided not to have them several years ago.  My condition is known; I know what I have to do, and having a scan is only going to highlight deterioration.    I refuse to take any of the toxic meds, especially Fosamax, and what I need to really is get busy with some good exercise programs (more gardening will help!)

But there's another issue from the medical standpoint, and that's whether doctors do almost everything they can to identify and treat symptoms.    There's an ideological clash in that position though.   Some doctors are realistic and confident enough to know when conditions can't be changed, but others might be concerned for blame if they don't at least suggest possibilities.  

Think of how often people blame doctors in posts here, even without addressing the entire situations, especially when the posters haven't educated themselves as to conditions and don't know what to expect.   It's not my intent to criticize anyone, but we each approach our care and our loved ones' care with different levels of research and knowledge.

Some of the "doctor killed my parent" posts reflect a paucity of knowledge about aging and the death process.    If I were a doctor, I'd be thinking of CYA approaches "just in case."
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No, I wouldn't put her thru it. Just a thought though, maybe Dr. wants a scan to see if the meds are having any effect. I was surprised, after a fall, that my Mom laid still for the Xrays she needed. A scan for osteoporosis is very simple.
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Thank you all for taking the time to consider my question and respond - I truly appreciate it.

I considered that the scan is for making a decision about the medication, but I had this conversation 1 1/2 years ago with her previous doctor. She was unhappy that Mother wasn't making any gains in bone density(?!) and wanted to prescribe the annual Reclast infusion, which was not covered and costs thousands of dollars. But, cost aside, this made no sense to me for someone of Mother's advanced age and state of decline.

So here we are. Mother is in memory care now and going into the last phase of dementia. She sort of recognizes me but doesn't really know who I am (she referred to me as her sister for a while, which was sort of funny since she is an only child). Her mobility has also declined sharply in the last 6 months, so getting her loaded up and then in and out of offices and exam rooms is stressful and exhausting for both of us (I insist on taking her myself - I want to hear and speak about what the doctor says), and I consider all trips out very seriously.

I got a reply from the doctor a few minutes ago and she does want the scan in order to make a decision about the alendronate. I will take her for the sake of due diligence, but I intend for it to be the last time.

Again, thank you all for your input; it has helped.
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I agree with Cali. Guess what, her bones at this age aren't very dense. So what to do. She is being, in my opinion, treated as somewhat a vending machine for money for tests. Next she will be used for big pharma's cash machine for the latest best in drugs for osteoporosis. The last "miracle" for that ended in causing MORE hip fractures (go figure) and causing other side effects as well. There is a lot to be said for palliative care at a certain point. My brother is well enough in his mind at 85 to make clear that is what he now wants.
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Since she's already on fosamax, what else would they do if her bone density is not good? On the other hand, if her bone density is good, she may be able to get off fosamax. That would be good.

It's a hassle versus benefit situation. If it's not to much hassle, getting the bone density scan would offer more knowledge. If that knowledge leads to her taking less meds, then that would be a benefit.
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It’ll send his kid to college..or help dr buy new car....that’s all it’ll do ..no good for your mother as there’s no point to it.
That’s my opinion. Hugs 🤗
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Im guessing that docs are graded by Medicare on the percentage of eligible patients who have there age eligible testing. Bet they get $0.25 extra per appointment per patient. That's not worth me hauling mthr in for another test with possible consequences!
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I did read a while back that after a certain age medication does not help anymore.
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