Friend with short term dementia and BC

VJSL8 · January 2015

Next week I am going to stay with a long time friend who has BC, who lives a couple hours away. She is 74 but very physically healthy and I'm sure she will be fine. The problem is that she has short term dementia. when the doctor told her about it, she cried but by the time she got home, she asked--what did I go to the doctor for? She didn't even realize she had a biopsy by the time they got home.

She has no ability to remember what just happened. She has no family and most of her friends have stopped coming around, I suppose because they can't deal with her situation. This mutual friend and I are her designated representatives for all her issues--trust, power of attorney, advanced directive.

We are struggling to make medical decisions for her. She is having a lumpectomy and of course they want her to have radiation but given her mental condition we're not sure that is a good option. She has no one to take her there every day. so someone would need to be hired (I live too far away and our mutual friend works). And it would be traumatic for her to relive each day learning she has BC. Plus I know that while radiation is the standard of care, not everyone opts for that choice.

It is an ethical dilemma that we are struggling with, wanting to do what is best for our friend both physically and mentally. Any advice would be appreciated. (we have talked to her attorney who set up the power of attoreny etc and he basically said it is up to us to decide.)

Moderators · January 2015

This is a very difficult situation. We are so sorry to hear what you, and your friend, are going through.

Have you discussed treatment options with her physician. Perhaps you would find our section on lumpectomy (plus radiation) versus mastectomy helpful. Mastectomy vs Lumpectomy.

It sounds like the treatment team will need to really help you with the decisions that work best for her long-term, given her condition.

Please let us know how we can help.

Warmly,

The Mods

VJSL8 · January 2015

I haven't talked to her doctors, our mutual friend has and has found it difficult to talk to them since she is not the patient. A a lumpecty has already been diecide upon. The patient is quite alert and I don't know if these new doctors completely understand her mental condition. Not sure our mutual friend is a strong advocate or even knows what questions to ask.

I will go back when she has her oncology appt in a couple weeks after we have all the final test results back. If she has node involvement then we will definitely figure out a way for her to do radiation.

I'm calling her everyday to remind her that I am coming to visit and everyday she is surprised to hear from me.

One conversation she started by saying--Oh I was just thinking about our trip together, how is your friend K, how is your brother, Oh I was just thinking about our trip together, How is your friend K, how is your brother, Oh I was just thinking about.......This was a 5 minute conversation where she couldn't remember what we had just spoke about. It is so very sad.

Kittybelle · January 2015

I'm so sorry about your friend! It's very possible her doctors really don't understand the extent of her dementia. My mother is the same way: she's seems perfectly fine, until she just .. isn't. And the short-term memory loss varies day by day.

A study last year found that radiation may not be appropriate for women over 70 with early stage bc. Radiation Treatments After Breast-Conserving Therapy for Elderly Patients. It does seem like the difficulty of radiation would outweigh any benefit. Best wishes for your friend. She's very lucky to have you looking out for her.

VJSL8 · January 2015

I had seen a write-up about this study but not the actual study--thanks. I will copy it and bring it with me when we see the oncologist.

Friend with short term dementia and BC

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