My client Allen was 80 years old with advanced heart disease when he was diagnosed with stage 2 prostate cancer. The urologist met with Allen, his two daughters, and I and explained the options. Allen could have surgery as a first step but it often needed to be followed up with either chemotherapy or radiation. These treatments had side effects that could severely impact his quality of life. The other option, watchful waiting, involved monitoring the cancer’s progression but taking no immediate action. The doctor discussed that Allen’s heart disease was more advanced than the prostate cancer. There was a concern that treatment for the cancer might even hasten his death.
Allen was leaning toward watchful waiting, but his daughters urged him to consider surgery.
“Dad, they have that robotic surgery now, and you probably won’t have to be in the hospital very long. This could slow the cancer from spreading,” said one daughter. “Shouldn’t you give it a try?”
“Well, the more I think about it, the more I’m convinced doing nothing is best,” Allen said. “I know you girls want me to get this treated, but I really don’t want to go through all that. Let’s just see what happens and take it day by day.”
It’s seldom easy for family members to watch an aging loved one decline treatment for cancer or another disease. With medical advances and technology, our culture leans toward invasive and aggressive medical interventions; however, doing ‘everything possible’ is not always the best choice. Sometimes treatments and procedures can do more harm than good. In Allen’s case, there was a real risk of infection or other complications from the surgery, and/or a decreased quality of life.
Although Allen’s daughters were unhappy at first with his decision, they understood his reasoning after we talked about the pros and cons. They compromised as a family and planned with the physician to have the cancer checked again in six months. As a care manager, I help families make informed decisions about healthcare, taking into consideration the senior’s needs, values, and wishes. These choices are ultimately up to the person facing the treatment needs in most cases. The decisions can be more complicated if the person has cognitive decline. In this situation, care management services, help families understand how to work within the medical system to provide the best care options for their loved one.
If you or someone in your family are facing aging challenges, please give us a call at 610-667-2838 or email us at CareManagement@waverlyheights.org. We’ll be happy to assist!
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