Choices leading to the same end

My mother started showing signs of Alzheimer’s in 2003 at the age of 74. She was still a very competent housewife, though puzzled by such things as why she couldn’t remember what she had served for lunch.

By the time Dad died in 2015 my sister, who lived with Mom and Dad, had taken over the household chores. Mom made a mess of loading the dishwasher, or hung up clothes that were twisted all about. Or Mom put a few dishes in the dishwasher and wandered away.

After Dad died brother Tim took Mom into his own home, but that lasted about a half-year. She required professional care. For a year now, Mom has been living in an Alzheimer’s residence near brother Tom. He continues to visit nearly every day. He occasionally took her for outings and when he brought her back she would say why are you bringing me here? None of this looks familiar.

And we settled in for the long slow decline. A doctor officially declared her to be incompetent to handle her affairs (which we had known for a long time – I’ve been handling things since Dad went into the hospital two years ago). She still talks though many times she uses stock phrases. Mom is beginning to have trouble with stairs and Tom guesses she would be in a wheelchair within a year and likely death two years after that.

In mid April Tom noticed that Mom was nibbling her food, taking perhaps 20 minutes to eat a cookie. After a cursory checking of her dentures Tom took her to his dentist. Who made referrals. The reason why the dentures didn’t seem to fit and caused pain was because there was a tumor attached to the side of her tongue.

Towards the end of April surgery removed the tumor. The lab said it was cancerous and a type that is slow growing. It could have been there a long time and Mom wasn’t capable of noticing. She seemed to recover quickly and was back at the Alzheimer’s home in a week.

A short five weeks later and Mom was nibbling again. The tumor is back. The lab report was half right – the cancer was, in Mom’s case, actually growing rapidly.

Tom will take Mom to a surgeon tomorrow morning. The big question is whether another surgery is worthwhile. Did the first surgery and insufficient nutrition from pureed food weaken her too much for a second round? Will the tumor regrow in a few weeks, forcing us back to the same situation a third time? We already understand that chemo and radiation are not an option in Mom’s frail state and at her age. From the first surgery we know that Mom won’t handle a feeding tube well. All it would do is extend the known end.

If surgery is approved it happens Wednesday. If not approved, then the tumor grows until she can no longer swallow. Death is likely a couple days later.

I leave tomorrow to visit Mom either helping her get through the surgery or visiting with her while she can still talk. There won’t be any blog posts during this time.