Advice on cataract surgery anxiety

[Whisperer]

Dear All

Not sure if this post will help me or not but any advice would be most welcome.

Attended the hospital eye clinic 11th April and my mum needs a cataract removed from each eye. The first will be done 8th May. My mum’s dad was in WW1 and had a lot of damage done to his eyes in a Chlorine gas attack. My mum grew up in a household where a parent had very poor sight and the constant refrain was “be careful of your eyes”.

My mum’s short term memory is now very poor and I get her to all doctor, dentist, foot lady, hospital, etc, appointments. I live with my mum and basically I am her sole carer. She is in total denial as regards there being any memory problem and will not return to the Memory Clinic. The GP and Memory Clinic believe my mum’s memory problem is linked to her past vascular problems, resulting in past heart surgery. All that has been developed in an earlier thread and it is specifically the cataract matter I am seeking guidance on.

My mother remembers the pending cataract treatment. As happened previously my mum remembers some recent events, if they are linked to strong emotions, in this case worry. Each day starts with me giving my mum her medications. Without any prompting my mum starts questioning about the cataract treatment, when it is exactly, etc. I can answer all the questions, reassure, etc, but within thirty minutes it starts again, with my mum remembering none of the answers. I can get in this loop repeatedly with mum and distraction does not work. I accept the logic of the loop but just need to try and reduce it.

Any suggestions or is it the case of just getting through the next three weeks? Any advice would be welcome. This issue is trivial when compared to other people’s problems on this site and I am committed to caring and helping my mum as her condition gets worse. It just seemed worth asking in case someone has experienced something similar.

 

[100 miles]

Gosh I remember this stage. I used to give a long answer to start, then a shorter answer, with progressively shorter answers. And then start again. Maybe I should have skipped the longer replies. Who knows? But if she was interested I was (normally) happy to give the information. It was probably easier for me as I wasn't living with her all the time.

You will both manage. And hopefully you won't find her standing by the bedroom window at 3am clutching her eye patch. My tip is to buy some surgical tape because you might need to tape the eye patch a few times.

100 miles

 

[Canadian Joanne]

Is it absolutely necessary for her to have this surgery? When we went to the consultant with Mum, he told us it would only minimally improve her quality of life but it would have to be done under general anaesthesia, plus the possiblity of my mother picking and poking at her eye and getting it infected was very high. We thought it over and decided we didn't want to risk the general anaesthesia or the infected eye.

It would have had to be a general, as Mum could barely sit still long enough for him to look at her eyes. It may well be different in your case.

 

[Hazara8]

Dear All

Not sure if this post will help me or not but any advice would be most welcome.

Attended the hospital eye clinic 11th April and my mum needs a cataract removed from each eye. The first will be done 8th May. My mum’s dad was in WW1 and had a lot of damage done to his eyes in a Chlorine gas attack. My mum grew up in a household where a parent had very poor sight and the constant refrain was “be careful of your eyes”.

My mum’s short term memory is now very poor and I get her to all doctor, dentist, foot lady, hospital, etc, appointments. I live with my mum and basically I am her sole carer. She is in total denial as regards there being any memory problem and will not return to the Memory Clinic. The GP and Memory Clinic believe my mum’s memory problem is linked to her past vascular problems, resulting in past heart surgery. All that has been developed in an earlier thread and it is specifically the cataract matter I am seeking guidance on.

My mother remembers the pending cataract treatment. As happened previously my mum remembers some recent events, if they are linked to strong emotions, in this case worry. Each day starts with me giving my mum her medications. Without any prompting my mum starts questioning about the cataract treatment, when it is exactly, etc. I can answer all the questions, reassure, etc, but within thirty minutes it starts again, with my mum remembering none of the answers. I can get in this loop repeatedly with mum and distraction does not work. I accept the logic of the loop but just need to try and reduce it.

Any suggestions or is it the case of just getting through the next three weeks? Any advice would be welcome. This issue is trivial when compared to other people’s problems on this site and I am committed to caring and helping my mum as her condition gets worse. It just seemed worth asking in case someone has experienced something similar.

You have hit upon perhaps the most 'irritating' feature of dementia, the constant repetition of the same topic or question. The professional term often used is perseverative behaviour. You have clearly understood the reasons behind this and also why this 'loop' persists. You have tried 'distraction' and found this does not address the problem. You also appear to have a healthy expectation in terms of the reality of this feature. i.e. "is it the case of just getting through the next three weeks?" As each case, alas, is so very different, one can but look to personal tactics and offer them as a possible tool. You will, I am sure,be aware of 'tone' and' body language' in all of this and how it can really communicate to the one living with dementia and it sounds like you will be answering in a calm and collected manner. So, what did I do? Well, I sometimes changed routine, or changed the subject (linked to the question asked, but side-tracking). I would sometimes jot the response down on a paper and show it to my mother, saying nothing. I would sometimes simply make a drink and say nothing. It is also important to try and home in on any 'trigger' which sets off the repetition, i.e. medications.

This is a tricky area. As far as the one you care for is concerned, the repeated question is the first question and nothing more. And when people at times 'correct' this repetition, it challenges not only the person's sense of well being (what did I do wrong?) but also engenders a feeling that their memory is at fault. This in turn can manifest itself in agitation and you are back to square one - but worse. I am pretty sure from your post, that you have a learned handle on all of this, but simply wished to sound out other people's experience. Consider the above as simply that.

( And touching on cataracts, my late mother managed to cope with her one bad eye without any incident. Anesthesia (injection in side of eye) and about 20 minutes, then 30 minutes rest and that was that. She was in her mid 90's and pretty fit.)

With good wishes.

 

[Whisperer]

Gosh I remember this stage. I used to give a long answer to start, then a shorter answer, with progressively shorter answers. And then start again. Maybe I should have skipped the longer replies. Who knows? But if she was interested I was (normally) happy to give the information. It was probably easier for me as I wasn't living with her all the time.

You will both manage. And hopefully you won't find her standing by the bedroom window at 3am clutching her eye patch. My tip is to buy some surgical tape because you might need to tape the eye patch a few times.

100 miles

Thank you for your reply. I will keep my fingers crossed about 3am. I posted to see if anyone had an idea that Ihad not thought of. Truth is there is no magic bullet. Thanks again and I hope where ever you are on the caring role road you are managing. Matters are stable for a while then move on and only ever in one direction. It is uncertainty I am slowly learning is my regular future companion.

 

[Whisperer]

Is it absolutely necessary for her to have this surgery? When we went to the consultant with Mum, he told us it would only minimally improve her quality of life but it would have to be done under general anaesthesia, plus the possiblity of my mother picking and poking at her eye and getting it infected was very high. We thought it over and decided we didn't want to risk the general anaesthesia or the infected eye.

It would have had to be a general, as Mum could barely sit still long enough for him to look at her eyes. It may well be different in your case.

Thank you for your reply. My mother needs cataracts removed from both eyes. Without this being done her sight will just get worse. It is limiting her reading and knitting, which I hope will pick up after the surgery. Mum is okay keeping still, at present it is just her short term memory which has been badly damaged. Being at home with her I can try and ensure the eyes are not picked at. Please again accept my thanks for your comments. I hope your mum is doing okay at present.

 

[Whisperer]

You have hit upon perhaps the most 'irritating' feature of dementia, the constant repetition of the same topic or question. The professional term often used is perseverative behaviour. You have clearly understood the reasons behind this and also why this 'loop' persists. You have tried 'distraction' and found this does not address the problem. You also appear to have a healthy expectation in terms of the reality of this feature. i.e. "is it the case of just getting through the next three weeks?" As each case, alas, is so very different, one can but look to personal tactics and offer them as a possible tool. You will, I am sure,be aware of 'tone' and' body language' in all of this and how it can really communicate to the one living with dementia and it sounds like you will be answering in a calm and collected manner. So, what did I do? Well, I sometimes changed routine, or changed the subject (linked to the question asked, but side-tracking). I would sometimes jot the response down on a paper and show it to my mother, saying nothing. I would sometimes simply make a drink and say nothing. It is also important to try and home in on any 'trigger' which sets off the repetition, i.e. medications.

This is a tricky area. As far as the one you care for is concerned, the repeated question is the first question and nothing more. And when people at times 'correct' this repetition, it challenges not only the person's sense of well being (what did I do wrong?) but also engenders a feeling that their memory is at fault. This in turn can manifest itself in agitation and you are back to square one - but worse. I am pretty sure from your post, that you have a learned handle on all of this, but simply wished to sound out other people's experience. Consider the above as simply that.

( And touching on cataracts, my late mother managed to cope with her one bad eye without any incident. Anesthesia (injection in side of eye) and about 20 minutes, then 30 minutes rest and that was that. She was in her mid 90's and pretty fit.)

With good wishes.

Thank you for your thoughtful reply. In all honesty the points you have touched on are familiar. I attend a Carers group where I am welcome despite my mother not attending. It seems this is common and later the PWD comes along. I raised the thread more in hope and ensure I am not missing something. Your comment about a written note made me smile.

My mum constantly checks the money in her purse when it is grocery day , always a Wednesday as over the past years.She tells me then a few minutes later does it again whilst we are off to the supermarket. I tell her the amount but she still counts it. I put a written note in the purse. Read then ignored. Even got mum to write the note once hoping she would recognise the handwriting. That caused a slightly longer time delay, before being ignored and said notes counted again. Before the surgery the constant questions were what day is it, what month is it, what year is it? The giant calendar behind my shoulder when mum looks at me having no meaning.

Unfortunately my mum has a cataract in both eyes so treatment is required.

Thanks again. I love my mum dearly and I am committed to doing all I can to help her as this dreadful illness crashes into both of our lives. The biggest problem I have is her denial there is a problem. The GP and Memory Clinic both believe the cause is Vascular Dementia for which there is no drug treatment. The advice is denial is my mum’s coping mechanism so leave it in place. On that basis I avoid raising the Memory Clinic being recontacted. To do so causes upset. Took me a long time to accept that one, in my darker moments alone it still eats at me. I guess we all want what we cannot at present have.

You refer to your late mum and I am sorry for your loss. Please againaccept my thanks for your thoughtful reply. I hope your future goes well.