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Posted: Monday, May 25, 2020 10:45 AM
Joined: 5/25/2020
Posts: 1

My LO had a TIA about 5 years ago and since then he has gotten an ultrasound of his carotid arteries yearly. Last year the blockage was 50%, but our doctor said no surgery. My LO is 91 and he does not remember having the TIA, having the ultrasounds, and he doesn't understand why he has the ultrasound. I am questioning whether he should continue. It takes an hour and a half or so and although he has been cooperative in the past, I'm not sure how he will do this year. Then there is the question of surgery. I doubt he would understand why he is having it even if he is a candidate for it. If he were to be hospitalized, I don't think he would handle it too well. Any advice?



Posted: Monday, May 25, 2020 11:05 AM
Joined: 5/16/2017
Posts: 596

In your place, I would simply say ‘no more tests’.  Realistically, what it the point?  He is at an age + condition that hospitalization for any reason does not make sense.
Grandma H
Posted: Monday, May 25, 2020 12:32 PM
Joined: 7/31/2018
Posts: 52

I agree with terei. My DH is 80 and has had several TIAs. Three since January. He had carotid artery surgery 5 years ago when there was 70% occlusion and it set him back tremendously. We have all agreed that give his condition and age, surgery is not an option unless it were because of immediate life threatening occurance. As his neurologist has also said, "what is the point".
Jane Smith
Posted: Monday, May 25, 2020 6:16 PM
Joined: 3/23/2015
Posts: 109

When I was in a similar situation, needing to make a decision about medical tests for my person with dementia, a really helpful nurse suggested I think about it like this:

Will the test itself cause pain, distress, or upset?

What information will the test give you?  Is it information that can be used to help their situation (like, reduce pain, make them feel better, increase quality of life)?

If the only possible reason to do the test is for a surgery or procedure or something that you would not do no matter the test results, then think carefully about doing the test at all. What will happen if you don’t have the test or do the surgery and what are the likely outcomes of that?

It helped me. Something else that helped were two books. One is very short and probably available electronically, something like Hard Choices for Loving People by Hank Dunn maybe? Someone else here may know. It helped me think about specific situations  

The other is Being Mortal by Atul Gawande.  It helped me think about general questions, especially quality of life and how to figure that out. 

Nothing about this is easy and I’m sorry. 

Posted: Monday, May 25, 2020 6:58 PM
Joined: 10/24/2018
Posts: 1090

Jane Smith's position describes me. When Mom was 91, we had to make a split-second decision among hip replacement, probably unsuccessful hip pinning, and doing nothing, guaranteeing a painful, bedbound life at a time when we were still wondering if she wouldn't somehow make it to 95. The xrays to allow us to make that decision were very painful, of course, but we had to know what (if anything) was broken, and how. We went with replacement, as if she survived the surgery she'd likely be walking again in a few weeks, and would have very little pain from the hip for the rest of her life. 

The real decision is, as has been mentioned, what would you do if the ultrasound came back badly blocked? We also had this with Mom. At about 88 or 89 she had a suspicious spot on a lung xray, which could have been cancer metastasized from decades-ago breast cancer. Her PCP said privately to bro and me, "whatever it is is in very early stages and likely not to go anywhere for a long time. We're not really going to worry about that, are we?"  We agreed. 

All the best with your decision!

Lady Golfer
Posted: Sunday, May 31, 2020 1:41 PM
Joined: 11/9/2018
Posts: 21

I am a radiographer and also married to someone with ALZ, if you move forward with the ultrasound (US) or any future testing be prepared for the decisions you may have to make depending on the results of those tests.  Refer to your POA for healthcare that may help you in taking the next step.  And don't let any physician attempt to push you in to a decision you are not comfortable with.  I have seen this happen many times over my 30 years in the field.