title: Caregiver perspectives on cancer screening for persons with dementia: "why put them through it?".
abstract: OBJECTIVE
  To describe the perspectives of family caregivers toward stopping cancer screening tests for their relatives with dementia and identify opportunities to reduce harmful or unnecessary screening.
  
  
  METHODS
  Focus group study.
  
  
  METHODS
  Alzheimer's Association support groups for family members of individuals with dementia.
  
  
  METHODS
  Four focus groups including 32 caregivers (25 female; 24 white, 7 African American, one American/Indian; mean age 65.5, range 49-85).
  
  
  METHODS
  Focus group transcripts were transcribed and analyzed using methods of grounded theory.
  
  
  RESULTS
  Caregivers considered decisions to stop cancer screening in terms of quality of life and burden on the patient and caregiver. Many described having to intervene in the patient's care to stop unnecessary or harmful screening, and others met resistance when they advocated for stopping. Physicians varied widely in their knowledge of dementia care and willingness to consider cessation of screening.
  
  
  CONCLUSIONS
  Many family caregivers wish to stop cancer screening tests as dementia progresses and are relieved when physicians bring it up. Caregivers are open to discussions of screening cessation that focus on quality of life, burdens, and benefits. Interventions are needed to increase caregiver and clinician discussion of screening cessation and to increase clinician awareness of the need to reconsider cancer screening in individuals with dementia.
authors.affiliation: Indiana University Center for Aging Research, Indiana University, Indianapolis, Indiana 46202, USA. atorke@iupui.edu
authors.forename: Alexia M
authors.initials: AM
authors.lastname: Torke
authors.forename: Peter H
authors.initials: PH
authors.lastname: Schwartz
authors.forename: Laura R
authors.initials: LR
authors.lastname: Holtz
authors.forename: Kianna
authors.initials: K
authors.lastname: Montz
authors.forename: Greg A
authors.initials: GA
authors.lastname: Sachs
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000523:psychology*; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D017028:Caregivers / Q000523:psychology*; D017281:Cost of Illness; D003657:Decision Making; D055088:Early Detection of Cancer / Q000523:psychology*; D005260:Female; D017144:Focus Groups; D006801:Humans; D007196:Indiana; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology; D019564:Unnecessary Procedures / Q000523:psychology*
keywords: Alzheimer's disease; decision-making; dementia; early detection of cancer