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Old 10-30-2012, 03:39 PM   #1
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Question Cataract surgery???

Mom is 81 and in the last stage of dementia and is in a nursing home.

She just had her eyes tested and she has cataracts in both eyes. They are asking me, her POA, if it is okay to have corrective surgery. For permission.

Mom no longer is looking for a book, is in a wheelchair full time and requires full support. She had a stroke in may of this year which declined her considerably to where she is today. She does not make conversation and she is unable to put together understandable sentences. She can eat but, she occasionally needs to have Queing to eat.

So, I'm not sure. I am afraid of the surgery enhancing her dementia. Is the risk worth it? I want what is best for mom.....but what is that?

Any and all advice is most welcome. Looking forward to listening. Thanks in advance, as always,

Sherry

 
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Old 10-30-2012, 04:04 PM   #2
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Re: Cataract surgery???

Hi sherry, my mom was very much in the same stage as yours when she also could have had the same op. this is a big dessions that you have to make, I guess you would need to ask yourself if this op. will make a difference to your mom, will she be able to leave her eyes alone while the heal, it takes a good week for them to stop inching, we made the choice of not going through with it as it really would not have made any difference to my mom, this is about keeping your mom as comfortable as possible, every time they go through something like this they seem to slide down that slippery slope a little faster and never regain those lost steps. From you post I can hear the I desission but down deep you know what is best for mom. This is the reason poa,s are not always making easy choices and your mom made you her poa for a reason. These are difficult choices but I think you will know what to do in you heart.

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Old 10-30-2012, 07:35 PM   #3
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Re: Cataract surgery???

My Mom is also in the same stage as your Mom.... and I agree with Jags. You have to ask yourself if this surgery is going to improve Mom's quality of life and if the benefits are going to out weigh the possible side effects and discomfort. Is seeing a little better worth it in Mom's world. Will Mom understand what is going on. Will she be able to follow directions as she recuperates. What anesthesia will they use and it's effect on the cognition... or will they do the procedure with numbing eye drops leaving her awake and fearful because she doesn't understand what they are doing. What are the possible complications that she might experience. These is information you need to make an informed decision.

I will say that the doctor will recommend elective and corrective surgery based on a healthy adult rather than a loved one that has dementia. It is what they do. Their perspective is much different from ours. We have to add in the dementia factor into the equation because the doctors do not add that into their recommendation.

Having the POA is not an easy job. You do have to make important decisions because Mom can't. You seem to take them seriously and take the time to investigate the consequences of the decisions you have to make. Good for you We each have to make these decisions for our loved ones from time to time. Make them with mom's best interest in mind.... including her dementia diagnosis and current health. You know what you need to do

Love, deb

 
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Old 10-31-2012, 04:45 AM   #4
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Re: Cataract surgery???

Dear Gabriel and Judy,

Thanks so much for your replies. Y
YOu are right, the POA is difficult, but a job it is and mine to decide. That is why I value this board so much. If I need to, I ask here, and then, I don't really feel that I made the decision alone. So many people in my or our lives are and can be supportive, but truly I don't feel that I value or can value their suggestions as much as here, so I don't even ask anymore. And that is okay.

So, I know what I have decided and I will inform the nursing home today. She seems to be content now, which is a new feeling, the stroke took a lot out of her and she hasn't recovered, nor will she. In further investigation through the nurses, mom wasn't able to follow the instructions throughout the test, so recovery, surgery and days ahead of this will be understandably confusing to her, and therefore in my opinion unnecessary.

Thanks, saying no just became soooo much easier! Hugs to you both!!!

Love, Sherry

 
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Old 10-31-2012, 07:40 AM   #5
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Re: Cataract surgery???

Keaner, I do understand and why I love this place. I think we all know in our hearts what is the right answer but our minds need to catch up. Talking to those that have been through the same journey many times help shed light on what we already know. I have had to make this decision related to mom's broken hand which the doctor wanted to pin. I opted as you did, not to have surgery and to let it heal naturally. She did amazingly well and maintained all hand mobility without the complications of surgery.

One of the recent decisions I have been involved in was with a friend and her Mom who fractured her hip. It was not a complete break but what we would call a "crack" in the femur head. The doctor pushed for a complete hip replacement but she decided for no surgery. Surgery would have involved anesthesia, a hospital stay, surgery pain, and rehab all lasting 6 to 8 weeks. Instead she came back "home" to her room, is on fall watch, but was up and walking in a week with very little signs of pain.

I do know there are times you don't have the option but it is always worth digging into the consequences of each choice and not just taking the first recommendation.

You did good Contentment is our main goal in everything we do!

Love, deb

 
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Old 10-31-2012, 08:31 AM   #6
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Re: Cataract surgery???

Yes Deb I do agree, being the POA was/is the hardest part and you know what, that was okay because each dessicion I had to make I had to really think about alternatives, it could have been so muchless stressful to have some else make those choices. Sherry you followed your heart after carefully investigation, you go girl, your mom at this stage does not need any extra stress of anything needless. Lets face it, this is about mom, and only mom...Saying NO is one of the hardest things to do,
But one of the greatest gifts to your mom.
Hugs Judy..
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Old 10-31-2012, 08:51 AM   #7
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Re: Cataract surgery???

It is not easy to decide for your Mom. Given her age of 81, if she is not in late stage, I may say she should go ahead do it for quality of life (it helps to see with healthy eyes.)
If she is in early or moderate stage, this may work out. Now she is in late stage as you mentioned and has trouble talking, it may not be a good idea for her to go through this. Usually it is local anesthesia and she may get upset during the operation and it would be dangerous. It is up to you and the doctor. If the op. will work out, she can go through it, but if she will be upset and confused, it is better not. To be honest, for minor surgery, it won't hurt her dementia - just confuse her.
My late FIL had had a few minor same day operations when he was 87 (early moderate stage) and 90 (late moderate stage.) Well, the last one upset him a great deal but saved his life for another 2 years or with better quality for 2 more years. (He was able to talk very well for these minor ops.)
It depends on the other issues. If she is blind, will that be harder to help her? Will she be very upset?
It is a hard call. I would worry that she may get upset and the op. will not work out because she is in late stage and cannot express her feelings properly.

Hugs,
Nina

Last edited by ninamarc; 10-31-2012 at 09:09 AM.

 
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Old 10-31-2012, 04:35 PM   #8
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Re: Cataract surgery???

Sitting with Mom today I was thinking about this thread and another consideration revealed itself to me. As dementia progresses the ability to process visually also declines. Some of the visual difficulties caused by the dementia include.... reduction in small eye movements causing inability to track what they see, color perception changes especially losing the green, blue, and purple spectrum, depth and motion perception, visual acuity causing blurring, and object or facial recognition. Decrease in the peripheral vision is prominent. We can see our shoulders move looking straight ahead. Their vision is as if they are looking through a tube. No matter how "good" their vision is these problems still develop.

Mom had cataract surgery and vision correction a few years before her Alzheimer's diagnosis. Her vision is "perfect" according to the doctor. Yet I see all of the above now that she is in the later stages of Alzheimer's. She sees me if I am directly in front of her. If I move quickly she loses me. Lighting make a huge difference in what she can see and can't see. She responds better to yellow, orange, and red. She no longer can see words as she once did. She is fearful of shadows, glares bother her more, and she responds more to light changes than what is there. Vision is more than just what the eyes receive. It is also what the brain does with what the eyes see.

Just something else to think about

Love, deb

 
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