Michelle Cottle

He was 78, had been taking care of himself, but also helping my mom, who has had, like, every medical issue under the sun, it feels like.

And so when he was diagnosed in August of 2024 with some fairly significant bladder cancer, we were thinking in terms of aggressive treatment.

But...

As things went on, there started to be issues with cognition.

Also, whenever you're in these kinds of treatments, you wind up with infections, you get unbalanced, you're prone to falls.

So he was having all these usual issues that can be a problem, especially for older patients.

And he wound up in the hospital and wound up with what we thought was a pretty serious case of hospital delirium.

But it eventually got so bad

that his oncologist sent him for a neurological assessment, at which point they realized he also had Alzheimer's, at which point everything just spiraled.

You immediately shift gears from thinking in terms of beating back the cancer to thinking

what they call comfort care.

You back off aggressive treatment and you're trying to help a patient be as comfortable as possible, basically while they're dying.

So this was the trajectory.

But what happens in a lot of cases is like the physical and cognitive issues play off each other and make each other worse.

And we definitely had that with my dad.

So, yeah.

So originally we weren't that concerned about that.

the cognitive slippage, because the kind of chemo he was on, we had been warned, could produce these kinds of glitches, and we had actually been told to be on the lookout for them.

So we would have these weird moments, like he would get lost driving himself to an appointment and then deny anything had happened, or...

He was at the ER waiting to be treated one night and became 100% convinced that he was waiting in line to reenlist in the Navy.