I would not authorize a colonoscopy for my Loved one with dementia. First doing the prep would be a nightmare for both of you. (Is he continent now? If not even more of a nightmare!) Getting him to drink all the prep solution in the time necessary would be difficult. And if it tastes bad even more of a problem. Then we get to the twilight anesthesia. Anesthesia is a problem in general for people with dementia. Not to mention once home you will have to deal with someone that may have balance problems for a while.
Now I will ask the hard question. What would you do if the results came back indicating that there is cancer? Would you opt for surgery? and possibly chemo? radiation? If the answer is no to these possibilities why would you have the colonoscopy done? There are tests that can be done in home stool samples. Easier, less invasive. But that may give you a false positive or negative result (don't cha just love the ads for that test) but if the doctor is looking for blood in the stool that is a way to start. But again getting back to the questions above.
So...I would not have the colonoscopy done on my loved one.. (And I didn't my Husbands doctor asked, she said it was due and I declined and said with his dementia a colonoscopy was unnecessary and she agreed)
You REALLY have to have a good reason to do this invasive procedure on someone who is over 75. My SIL is a GI doc and he is always very wary to do colonoscopies on the elderly, the bowel lining is so thin, a perforation is a real risk.
Also, with dementia, he probably can't make the decision to say yes or no to such a procedure and the prep would be horrible.
I am a firm believer in not putting a person under any anesthesia, who is experiencing any signs of dementia.
In Nov. or 2018, my bride of 28 years (at the time) went under general anesthesia for surgery. At the time we did not know she was experiencing dementia but we were seeing signs of confusion. About 10 months late the confusion, delusions and hallucination should up, literally in one night. The switch flipped and she is now in full blown Alzheimer's Disease.
It wasn't until I was in a caregivers support group that I learned that anesthesia is a definite progessor of dementia.
I agree with the other comments. Why put your husband through this?
Prayers and blessings to you and your confidence in your decision!
Has the test been done to look for occult blood in stool, and was it positive? Can you tell me your husband's age? If your husband were positive for colon cancer would you treat him with surgery, possible colostomy, and chemotherapy?
These are all things to ask yourself. My own father had similar results in his 90s and he did no testing after discussing with MD what he would do if postive. He had some weakness, who knows whether of age or iron poor blood. He died in his easy chair at 94. There are other blood tests to be done to rule out other possible reasons for this drop. You could also wait and retest in 6 months. I myself an 80. If I had this result I would not treat any condition unless obstructed. In that case I would have an MRI. Colonoscopies are not complication free in and of themselves and I have witnessed, as a nurse, death after perforation of the bowel. This complication will be discussed before the test, in fact as a pre op warning about possible complications. I am only saying I would not take this, but there are many things I would not including CPR, vent, dialysis, feedings by PEG or NG. I guess I am saying I am ready to go. Your husband cannot make his own decisions, and you I assume are his POA and will have to. Make the decision for him you think he might make, the one you think best for him. That's the best you can do. I wish you both good luck and hope you'll update us. Meanwhile do some internet research on reasons for iron-poor blood, etc.
I would increase the iron in his diet, spinach, beets, liver, etc. and retest in a few months.
Low iron can make you just feel crummy and exhausted, so getting some in him naturally should help avoid the side effects from supplements like headaches and constipation.
I am a firm believer that we should not chase symptoms if we aren't going to pursue treatment for whatever is found. At 74, they always find something, it's part of the sickcare system.
This really puzzles me, but perhaps I just don’t have the medical knowledge. I’ve had low iron levels, and boosted them with iron tablets (doctor prescription). The suggested dietary supplements (spinach etc) are good, but don’t pack as much punch as tablets if there is a real deficiency. (I knew a guy with large blood loss through haemophilia, and the doctor tried to be kind in explaining to me firmly that spinach wasn’t the answer) I’ve also had about 6 colonoscopies (polyps, family history etc), and the prep is not much fun, much worse than the colonoscopy itself. At 74, I’m not having another. I’ll just stick to stool tests.
What puzzles me is how a lot of blood can be lost in the bowel without ANY of it being detectable in a stool test. If a lot of blood is passing from the bowel internally into the stomach cavity, would a colonoscopy be the only/ appropriate way to check – and where would the blood be going if not into the bowel, or into a detectable swelling in the abdomen? Plus are there other potential causes for low iron besides blood loss?
Unless you can find medical support to explain this coherently, I’d be asking for a second opinion before even considering a colonoscopy. Good luck!
When you're elderly, it's unnecessary to go through such tests/risks:
1) If they find something, I guess you won't operate? So don't do the test! Whatever they find, you're not going to go through with the operation (even more risky; can die; can cause accidental tissue damage during the test or operation).
2) The test your doctor wants to do, normally means your husband will need anesthesia. PLEASE don't do the test. Anesthesia has many risks. Can create EVEN MORE dementia.
3) At some point, one has to die of something. I decided for my sister (who was very grateful later), not to go through with the test. Her "bleeding ulcer" (it's not sure there was an ulcer) turned out to be totally temporary (caused by the hospital, strong medications). As soon as she went home, the bleeding/symptoms stopped. The test would have been totally unnecessary anyway (of course we could not know that). We had already decided, not to do the test no matter what. If you must die, then die at home (it's what my sister wants), without having gone through dangerous testing (for which anyway, we would never have operated after, if there was indeed an ulcer).
4) Of course every case is different. But we can still learn from each other. (My sister was/is very lucky. She's at home, very healthy.)
5) Iron levels low? There are iron supplements (they also have side-effects). My sister is home. Our private doctor is reducing the iron supplements (from the hospital), slowly, slowly to zero, while increasing iron-rich food.
They're likely looking for internal bleeding, not cancer.
My mother had severe anemia (and dementia) misdiagnosed by her doctor as "she needs more exercise" (My #1 reason for getting off Kaiser, but that a whole other story). She ended up in the hospital, not the gym, and they wanted to do a colonoscopy AND an endoscopy. She refused to drink the prep after a while, and they couldn't force her, so she wasn't cleaned out all the way. The doctor did it anyway, and the results were inconclusive. (They suspected a bleeding ulcer.)
They gave her five blood transfusions, and the problem went away.
Your answer was very helpful and answered some of my questions. My husband is 74 and will not be able to do the prep for a colonoscopy and the doctors do not seem to understand this. It would be like trying to get a 3-year-old child to comply. If they want to try by putting him in the hospital and trying to do the prep, I will agree. I can't believe that a colonoscopy is the only way to diagnose what is going on. I also suspect a bleeding ulcer. Why can't they just treat him for that. I will follow up with a gastro doctor like they want and then will see what happens. Just got a prescription for Iron pills. Did your mother have any problem with constipation with them?? Thank you for your helpful answer.
Seeker12: Heredity factors, e.g. family history (blood relatives) with colon issues/diseases should be addressed also before proceeding with a colonoscopy or other less invasive colon screenings.
No relatives have had any issues with colon or colon cancer. Also, no history of dementia, parents lived to 96 and 98 with no dementia but my husband was diagnosed at 68 and now is in moderate to advance stage at 74. Not sure why he has it, very smart, educated, and active person his whole life. Hope science can give us some answers someday about this crazy disease. Thanks for your answer.
First doing the prep would be a nightmare for both of you.
(Is he continent now? If not even more of a nightmare!)
Getting him to drink all the prep solution in the time necessary would be difficult. And if it tastes bad even more of a problem.
Then we get to the twilight anesthesia. Anesthesia is a problem in general for people with dementia. Not to mention once home you will have to deal with someone that may have balance problems for a while.
Now I will ask the hard question.
What would you do if the results came back indicating that there is cancer? Would you opt for surgery? and possibly chemo? radiation?
If the answer is no to these possibilities why would you have the colonoscopy done?
There are tests that can be done in home stool samples. Easier, less invasive. But that may give you a false positive or negative result (don't cha just love the ads for that test) but if the doctor is looking for blood in the stool that is a way to start. But again getting back to the questions above.
So...I would not have the colonoscopy done on my loved one.. (And I didn't my Husbands doctor asked, she said it was due and I declined and said with his dementia a colonoscopy was unnecessary and she agreed)
Also, with dementia, he probably can't make the decision to say yes or no to such a procedure and the prep would be horrible.
yes!
please OP, don’t do it.
In Nov. or 2018, my bride of 28 years (at the time) went under general anesthesia for surgery. At the time we did not know she was experiencing dementia but we were seeing signs of confusion. About 10 months late the confusion, delusions and hallucination should up, literally in one night. The switch flipped and she is now in full blown Alzheimer's Disease.
It wasn't until I was in a caregivers support group that I learned that anesthesia is a definite progessor of dementia.
I agree with the other comments. Why put your husband through this?
Prayers and blessings to you and your confidence in your decision!
Don't do it, please.
These are all things to ask yourself. My own father had similar results in his 90s and he did no testing after discussing with MD what he would do if postive. He had some weakness, who knows whether of age or iron poor blood. He died in his easy chair at 94.
There are other blood tests to be done to rule out other possible reasons for this drop. You could also wait and retest in 6 months.
I myself an 80. If I had this result I would not treat any condition unless obstructed. In that case I would have an MRI.
Colonoscopies are not complication free in and of themselves and I have witnessed, as a nurse, death after perforation of the bowel. This complication will be discussed before the test, in fact as a pre op warning about possible complications.
I am only saying I would not take this, but there are many things I would not including CPR, vent, dialysis, feedings by PEG or NG. I guess I am saying I am ready to go.
Your husband cannot make his own decisions, and you I assume are his POA and will have to. Make the decision for him you think he might make, the one you think best for him. That's the best you can do. I wish you both good luck and hope you'll update us.
Meanwhile do some internet research on reasons for iron-poor blood, etc.
Low iron can make you just feel crummy and exhausted, so getting some in him naturally should help avoid the side effects from supplements like headaches and constipation.
I am a firm believer that we should not chase symptoms if we aren't going to pursue treatment for whatever is found. At 74, they always find something, it's part of the sickcare system.
What puzzles me is how a lot of blood can be lost in the bowel without ANY of it being detectable in a stool test. If a lot of blood is passing from the bowel internally into the stomach cavity, would a colonoscopy be the only/ appropriate way to check – and where would the blood be going if not into the bowel, or into a detectable swelling in the abdomen? Plus are there other potential causes for low iron besides blood loss?
Unless you can find medical support to explain this coherently, I’d be asking for a second opinion before even considering a colonoscopy. Good luck!
I ADVISE AGAINST IT.
Of course, I don't know your husband's situation.
BUT seriously:
those tests have RISKS.
When you're elderly, it's unnecessary to go through such tests/risks:
1) If they find something, I guess you won't operate? So don't do the test! Whatever they find, you're not going to go through with the operation (even more risky; can die; can cause accidental tissue damage during the test or operation).
2) The test your doctor wants to do, normally means your husband will need anesthesia. PLEASE don't do the test. Anesthesia has many risks. Can create EVEN MORE dementia.
3) At some point, one has to die of something. I decided for my sister (who was very grateful later), not to go through with the test. Her "bleeding ulcer" (it's not sure there was an ulcer) turned out to be totally temporary (caused by the hospital, strong medications). As soon as she went home, the bleeding/symptoms stopped. The test would have been totally unnecessary anyway (of course we could not know that). We had already decided, not to do the test no matter what. If you must die, then die at home (it's what my sister wants), without having gone through dangerous testing (for which anyway, we would never have operated after, if there was indeed an ulcer).
4) Of course every case is different. But we can still learn from each other. (My sister was/is very lucky. She's at home, very healthy.)
5) Iron levels low? There are iron supplements (they also have side-effects). My sister is home. Our private doctor is reducing the iron supplements (from the hospital), slowly, slowly to zero, while increasing iron-rich food.
6) Find a good, competent doctor.
7) My thread might help you, or not.
https://www.agingcare.com/discussions/im-only-venting-no-question-stress-worry-sister-in-hospital-473532.htm
My mother had severe anemia (and dementia) misdiagnosed by her doctor as "she needs more exercise" (My #1 reason for getting off Kaiser, but that a whole other story). She ended up in the hospital, not the gym, and they wanted to do a colonoscopy AND an endoscopy. She refused to drink the prep after a while, and they couldn't force her, so she wasn't cleaned out all the way. The doctor did it anyway, and the results were inconclusive. (They suspected a bleeding ulcer.)
They gave her five blood transfusions, and the problem went away.
I wouldn't recommend doing it.
Your answer was very helpful and answered some of my questions. My husband is 74 and will not be able to do the prep for a colonoscopy and the doctors do not seem to understand this. It would be like trying to get a 3-year-old child to comply. If they want to try by putting him in the hospital and trying to do the prep, I will agree. I can't believe that a colonoscopy is the only way to diagnose what is going on. I also suspect a bleeding ulcer. Why can't they just treat him for that. I will follow up with a gastro doctor like they want and then will see what happens. Just got a prescription for Iron pills. Did your mother have any problem with constipation with them?? Thank you for your helpful answer.