I remember the internal debate I struggled with as my parent’s cognitive decline progressed. When they first moved into Assisted Living, they were scheduled for visits with the dentist. I knew it had been at least two years since their last exam and with a dentist visiting the facility, it was simple enough to have the staff take them down when it was time for their appointment. However, my parent’s both refused to see the dentist. We tried three different times and each time one or both of them dug in their heels and declared that they no longer needed to get their teeth cleaned. Six months later, my Dad was diagnosed with a tumor on his tongue. Would that dental visit have eased his pain or changed the outcome?
I consider this experience as one of my clients, an 85 year old who has been diagnosed with Alzheimer’s and is managing in her own home, was recommend to be screened for colon cancer using the new Cologuard kit. Cologuard is a do-it-yourself, mail-in DNA test that helps detect some colon cancers. Having just experienced this test myself, it’s not as simple as on would imagine, and does require that it be shipped back in a timely manner once you “collect” your sample. I have to say, I had a lot of fun joking around about the process and the “package” I needed to ship. Sorry to those of you who don’t like potty humor, I am a self-confessed big fan of it.
I brought up the topic to my husband because I found it tricky and wasn’t sure my client could manage the steps for the do-it-yourself part. You basically need to preset the kit in the commode for the collection, then take a sample and ship both the small sample and collection which requires a few extra steps before sealing the package. Once your package is sealed, it needs to be shipped back in 24 hours using UPS. Sounds easy, but since I just did it knew it took a little planning to complete.
As I’m wondering to my husband if my client can follow the steps, and ensure it gets shipped back in a timely manner — he is wondering what the family would do if they found out mom has colon cancer. He felt that he would probably be skipping his testing when he is 85 and battling other health issues.
Are there some things we need not test for once we reach a certain health status? Is the guide really to focus on those things that can prevent other health issues like a dental visit to maintain good oral hygiene versus testing for a cancer that may kill you when you are 85 years old? There is only the answer that is right for you.
I wondered if my Dad’s refusal to see the dentist was because he knew something was wrong and didn’t want anyone to find out or intervene. I do recall sitting with his primary care physician a few months before the tumor was diagnosed while she opened up his month and checked his teeth and tongue to see if she could figure out why he was drooling more. They chalked it up to swallowing issues related to his Alzheimer’s.
When it’s our job to monitor the health and well-being of our loved ones, when do we choose to stop the testing? I think for all of us that answer is very different. Hopefully, you got a sense of the choices for end-of-life care your loved ones would make and can use that as your guide. Caregiving ain’t for sissies. Convinced.