My MIL is 86 years old and has had dementia for at least 5 years, and it's progressively getting worse. She has moved from her home to a retirement home where she is fairly self-sufficient (no cooking, someone comes in to clean, etc.).
My husband is deceased, but another son checks on her daily, sets her meds up for her, and things like that.
She has needed knee replacement surgery for 5 or 6 years, at least. In fact, about 5 years ago she was scheduled for the surgery, but because she couldn't ever learn to do the pre-surgery excercises, we decided against it. I was going to her house every day, lying on a loveseat across the room from her on the sofa, doing the exercises, calling them by name, giving all kinds of hints, and she had so much difficulty - - wasn't ever able to do one on her own.
Now, 5 years later, she is in even more pain and is asking for surgery. Both her geriatric doctor and the surgeon are saying there is no problem because of either her age or her mental condition. My BIL, his wife, and I are uneasy about this, thinking she may have better knees, but that the surgery and all that's involved will push her into further mental deline sooner.
Also, she has said that people that exercise are crazy. It's not good for you. She tells her son that he shouldn't play raquetball because he's wearing out his body. Another problem is that she has always considered surgery or medication a quick fix, and doesn't do anything to help herself.
Her surgery is scheduled for July 28, and we don't see any way around it since both she and her doctors are saying there's "no problems". Other than her knees and her mind, she's in good health.
Can anyone who's been through this or who has more knowledge than I tell me what we might expect?
on my personal feelings, I think the whole thing is nuts
the friggin doctors are only saying 'yes' because its easy money for them. If something goes wrong no one will be the wiser. Because she can't do the exercises, she'll never make use of the knees anyway, so why have the damn surgery and put her through all the after-surgery, healing, pain she's going to be in.
I would say the surgery would be positive if she was able to go out shopping, enjoying life by being out with friends, etc. Since she has dementia, this isn't happening, so again -- why have the surgery???? Why, again -- because its 'easy money' for the doctors!
The mother should not be the one able to 'grant permission' -- anyone with dementia definitely should've been declared incompetent to make decisions.
She wouldn't know what she's agreeing to.
As for her comments -- again, coming from the mouth of a dementia patient.
Are they kidding me???
So, again from me to you -- having surgery at her age, in her mental condition, etc. is NUTS and just plain wrong, wrong, wrong. She's not going to be able to be self-sufficient. The anesthesia alone with rob her of whatever memory she had or decrease it in many ways. And she's not going to be ambulatory so whose going to get her in and out of the bathroom, etc.??
Doctors are just in it for their own financial means. At her age, she should be given pain-relieving medicine and leave her alone.
I'm with Caring, Carken. Elective surgery for a dementia patient is NUTS.
Anesthesia is very very hard on a dementia patient. My dad could never survive it. What little mental ability he has would be wiped away after surgery.
I have had 3 knee surgeries myself, and there was every so much after care needed! I was in therapy for 6 months. The anesthesia 'bout took me out permanently, I was in the hospital for 5 days, on crutches for 3 months (think mom could handle crutches? Bet not), and after my 2nd surgery, mis-stepped with my crutches and re-tore my ACL that had just been repaired and had to have another surgery to fix it.
I am telling you from experience - knee surgery is very very difficult to recover from. Lots of exercises, therapy and pain.
Whoever has POA - tell the docs "NO FAST $$ HERE", and cancel it.
My Mom had hip surgery. She was unable to understand or accept that there would be painful exercises during rehabilitation. She never cooperated with the doctors or the PT, and never was able to walk again.
By the time she fell and broke the hip and needed surgery, she was in stage 5 or so of dementia.
I think the operation and the attempt at rehab did not do her one bit of good at all.
I will echo what has been said here. Knee surgery is a big deal and take a lot of exercise and therapy for it to be successful. It your mom is unwilling or unable to do the pre surgery exercises she is not going to do the post operative exercises. If she doesn't do those she will be worse off than she is now.
The other problem is the anesthesia. If she does have dementia there is a great chance that it will make the dementia worse. It happens often.
If it were my Mom, no way would I let her have the surgery. Actually it was suggested that Dad have surgery on his knee but his geriatric doctor shook her head NO and we all agreed. He would never be able to handle the post opt. I they can not remember what to do and be willing to do it.... it's not a good idea.
If the POA and medical POA are not in place you need to do that in the morning. We have both and I am not sure what we would have or could have done without them. They are of utmost importance!!
At mid-point in the illness of dementia. My mother who was still able to communicate at that time was suffering stomach discomforts. It was found that she had gall stones.
Well, when we discussed it with her doctor, the doctor said 'no' to surgery because the anesthesia would take more of her cognitive ability. So with my experience and others, we all say that this is a very bad idea.
But don;t be the bearer of the news. Simply show these posts to others and let us tell them.
Carken...follow your instincts! I surely agree with what everyone has said.
It is unfortunate there are doctors that only see $$$...I also endured 3 knee surgeries before having that 4th one that actually corrected the problem.
Any form of dementia can easily be accelorated by ANY challenge.....even a cold. Your MIL needs to hear from a Dr. that agrees with you and brother-in-law that this surgery would create more challenges...
What many of us here have done is write a note with challenges, worries, and health info about our loved one when we take them to a Dr. appt. I used to hand this to the receptionist when I signed them in...and the Dr. always appreciated and addressed whatever we needed him to do.
You say she is in a retirement apt...have you thought of getting her into an environment that would be more attentive to what she needs...and will be needing in the future?
I'm so glad you posted...you were already doubting this surgery....many here who have already faced this situation know too well what lie ahead!
My own Mom (we and the Dr. think) was hit by a car early one morning (that did not even stop!) and lay there for several hours in 40 degree temps before someone noticed her. Her hip was shattered....and she never returned home. Even tho Alzheimer's had not previously been diagnosed, we all had been seeing strange behaviors for a couple years...but did not want to believe our Mother would be a victim.
After the hip surgery, the disease was very obvious to us all...she did not understand any of the exercize instructions or even the Dr. instructions on staying in bed, using walker, or anything else......hope you're able to have serious discussions with those Drs. pushing for this surgery. The decision is not theirs.....................Pam
Last edited by petal*pusher; 07-16-2009 at 06:43 AM.