I can only tell you my mother's story. She fell down the stairs and broke her hip when she was in roughly stage 4 to 5 of AD. She had an operation to put the bones back together, and was sent from the hospital to a Rehab center where Medicare would pay for 3 months of intensive rehabilitation. The problem was, in her confusion, Mom could not remember to do the exercises, could not cooperate with the therapist, continually told the nurses who tried to get her to do those exercises that "The doctor told me not to move the broken leg" etc. Afer only 2 months the Therapists reported that Mom was 'not meeting her goals" and Medicare refused to pay for any more time in Rehab or any more therapy. They did not take into consideration that she was a very old lady, 96, confused by the operation and pain pills, and unable to walk .. so she could not go home. She was transferred to the long term care unit of the same facility, and had to pay whatever remained of her own savings (luckily she had no house!) before Medicaid took over. Her hip never healed right, and although eventually she took a few steps, she seemed to have one leg longer than the other and it hurt. Mom died there at age 99.
She never really recovered to where she was before the operation.
So I am pretty much against any surgery unless absolutely neessary in AD patients.
A friend of mine's husband just had major surgery for something internal. He is 74. She just told me that he's never been the same since the surgery. His personality changed.
My mother was suffering from gall bladder and diverticulitis problems. She was 79. three doctor's all said NOT to do surgery as any anesthesia will cause more of a decline in her mind. So we controlled outbreaks via dietary that was helped by the fact that she was eating smaller meals.
It think the consensus is that if surgery is needed and they can do it with just an epidoral, then fine; but if it requires general, totally out, and a large length of time, then I lean on the side of caution and say, will it really add to her quality of life.
General anesthesia as well as the confusion created by the change of environment combine to make the possibility of confusion greater after surgery. Some recover from the effects and some do now. As for my Dad, a simple night in observation created enough stress and angst that it set him back. Each patient is different so there is no way of knowing but you should be prepared for a lessening of cognitive abilities at least right of surgery if not permanently.
As for the hip itself, the patient's short term memory is not sufficient to follow the directions given for rehab. Both of my parents have attempted PT and/or OT. The OT therapist gave Mom instructions. Fifteen minutes later Mom not only didn't remember the instructions, she didn't even remember the therapist had been there. So Martha's experience is more common than out of the ordinary.
BUt I also understand that something needs to be done so it's a true catch 22. I do wish you good luck and hope your Mom does well....
alzheimers is it's own disease and having a hip replacement surgery will not cause alzheimers to get worse. The problem of "worsening" symptoms comes from the general health of the person during the unfortuneate experience and during their recovery. Pain medications which usually are narcotics can cause increased confusion, decreased appetite, nausea etc... the immobility problems caused from the whole experience I find are the biggest reasons why people tend to deteriorate after surgery for hip replacements. The more one spends in bed the more at risk for other complications (pneumonia for one). Dehydration is also a risk factor due to a persons decreased mobility. so secondary infections, dehydration, changes in nutrition and pain, poor sleep, can all increase confusion in the elderly. It is really important to get excellent post op and rehabilitative care otherwise you will see the person deteriorate....some end up dying and some end up not the same as before. I have not heard of any research to support the idea that alzheimers would worsen from this experience. I am a gerontological nurse and have lots of experience working with alzheimers (dementia) and those who have fractured thier hips.