Mum is due to have cataracts removed from both eyes under general anesthetic on Monday. The consultant feels it will benefit her eyesight but I am worried about the after effects of the anaesthetic and operation. She lives in a residential home and has been quite settled until this last weekend. She has become agitated and is not sleeping well. (Not due to worry about operation as she has forgotten about hospital visit). Doctor has prescribed a mild sedative. She has to have a pre op assessment on Thursday and will discuss my concerns then but wondered if any on forum had any experience on pros and cons of such an operation.
Cataract operation.
- Thread starter Smrtber
- Start date
No experience I'm afraid, as my husband's consultant and the doctors at the Eye Clinic discussed it, and came to the conclusion that it was a huge risk in terms of the potential affect on his dementia from the disruption to routine, the strange environment of the hospital, strange people around him, not to mention the affect of the anaesthetic and surgery itself, for relatively little potential benefit. He could no longer read anyway, and could still see well enough for watching TV (although he didn't, much), and recognising people.
No personal experience but a fellow resident at the NH dad was in who had late moderate dementia had both cataracts done recently. She used to call out a lot but since the op, anaesthetic and op went well, she is more settled and the staff and her OH think now she can see better she is making a little sense of her dementia world and doesn't feel so isolated.
I was advised against my husband having his cataract op. The anaesthetic drugs are likely to make him much worse and confused and agitated. basically if your Mum can get around without bumping into things then its best left alone
Not cataract op but emergency hernia op for dad when he was in late moderate stage and we were warned by the surgeon that in some dementia cases it worsens after an anaesthetic but in dads case it made no noticeable difference so I guess everyone is different in how they manage the effect of drugs even when in the grip of dementia. However the risk was worth taking as it gave him another 18 mths of hernia pain free quality of life.
It has always been stated a general anaesthetic can have a detrimental effect on dementia but your posts @love.dad.but..[URL='https://forum.alzheimers.org.uk/threads/cataract-operation.105116/#post-1461671']#3 [/URL]and #5 show its not always true.
I wonder if changes have been made to the type of general anaesthesia given to patients with dementia , rendering it less dangerous. We should try to find out.
I think a part of the problem is with post operative pain relief which won’t apply with cataract surgery. The amount of anaesthetic needed to carry out this operation will not be a great amount as the procedure is quite a short one. I’ d had both mine doe without a general anaesthetic.
The multiple folllow-on drops needing to be placed in the eye for some weeks is often cited as the decision not to carry out the operation if a person is living at home. However the nursing home should be able to manage this for your mother.
I think it’s a case of balancing out the pros and cons as it so often is , especially where dementia is concerned. Also some people react more adversely to anaethetics and opiates than others do. My husband did badly.
The multiple folllow-on drops needing to be placed in the eye for some weeks is often cited as the decision not to carry out the operation if a person is living at home. However the nursing home should be able to manage this for your mother.
I think it’s a case of balancing out the pros and cons as it so often is , especially where dementia is concerned. Also some people react more adversely to anaethetics and opiates than others do. My husband did badly.
Just about to go to hospital tomorrow, but only one eye is being treated. Father can still read. Staff at local cataract centre were good, but those at the dedicated eye hospital were useless as I haved experienced in the past. They organised a pre-op appt at local hospital , the local centre consultant undertook a best interests discussion. I was unprepared for this since I thought that clearly there would be a benefit in someone not going blind. I did give reasons that I thought an op would be beneficial e.g. ability to occupy himself during the day. I said we used a memory board with reminders but forgot to say that because of being unable to remember the ability to read even signs or symbols - e.g. for toilet was more important than for someone with a poor memory. It was felt that father would struggle with having a local anaesthetic but consultant would do op with a general. I understand that the cataract anaesthesia is relatively light and only administered for a short time. ...
And this is how today went. The six o'clock in the morning get up was horrible. counted down the night before. Prepared an easy to cook favourite meal - curry. Told him to shower. Kidnapped dirty clothes and replaced with clean ones. Locked kitchen door to avoid nightime eating and hid the cereal in a new place. Locked shower room to stop him having another shower. 6.00 a.m. got up and turned his light on to wake him up. He got dressed in the clean clothes. Luckily husband could drive us there. Was concerned about non compliance. Admin at the eye hospital as hopeless as it usually is. They noticed they had his name wrong and corrected it. Unfortunately lost number one slot on the list to someone who needed it more. Hanging around wasn't wonderful. General anaesthetic administered and I was asked to come to recovery as soon a he was out. He was groggy but very much still there. No adverse affects noticed.
I had hoped that the transparent patch over his eye would act as a trigger to remind him he had had an operation. It didn't and we had constants round of repetitive questions. I put very large font notice on bottom of bed saying you 'You have had eye operation, do not remove eye patch' but because it was transparent he didn't know he had one on and I had to keep explaining but at least I didn't have to cook and iron at the same time. He kept fiddling with the eye patch. I went to the nurses station for 2 minutes to receive medication and ask how long I really had to keep him off fiddling with his eye. In that space of time he removed the eye patch. When I got back to him I grabbed his hands and called for a nurse who taped him up again. After tea now he is sitting in front of a mirror and a the 'you have had an eye operation' poster and it seems to be providing him with all the stimulation and explanation he needs. The posters will go up everywhere, but I am really worried about tonight. I wish I had a pressure mat and then I would know that he was a) out of bed and b) likely to fiddle with eye shield. I am thinking I will send him to bed at usual time but wait and wake him just before I go to bed around 11.30 and get him to have a wee and hope he will go back to bed until about 5.30 for second wee of night. if I am lucky he might go till 7.00. I am going to put a bell on his bedroom door in the hope that this will wake me up. I think I have a house door alarm which will chime if someone goes past it. I needed to be at the hospital, the concept that they could have managed to care for him was somewhere off in cloud cuckoo land. I'm disappointed there wasn't a check list of suggestions on how to manage an Alzheimers patient.
And this is how today went. The six o'clock in the morning get up was horrible. counted down the night before. Prepared an easy to cook favourite meal - curry. Told him to shower. Kidnapped dirty clothes and replaced with clean ones. Locked kitchen door to avoid nightime eating and hid the cereal in a new place. Locked shower room to stop him having another shower. 6.00 a.m. got up and turned his light on to wake him up. He got dressed in the clean clothes. Luckily husband could drive us there. Was concerned about non compliance. Admin at the eye hospital as hopeless as it usually is. They noticed they had his name wrong and corrected it. Unfortunately lost number one slot on the list to someone who needed it more. Hanging around wasn't wonderful. General anaesthetic administered and I was asked to come to recovery as soon a he was out. He was groggy but very much still there. No adverse affects noticed.
I had hoped that the transparent patch over his eye would act as a trigger to remind him he had had an operation. It didn't and we had constants round of repetitive questions. I put very large font notice on bottom of bed saying you 'You have had eye operation, do not remove eye patch' but because it was transparent he didn't know he had one on and I had to keep explaining but at least I didn't have to cook and iron at the same time. He kept fiddling with the eye patch. I went to the nurses station for 2 minutes to receive medication and ask how long I really had to keep him off fiddling with his eye. In that space of time he removed the eye patch. When I got back to him I grabbed his hands and called for a nurse who taped him up again. After tea now he is sitting in front of a mirror and a the 'you have had an eye operation' poster and it seems to be providing him with all the stimulation and explanation he needs. The posters will go up everywhere, but I am really worried about tonight. I wish I had a pressure mat and then I would know that he was a) out of bed and b) likely to fiddle with eye shield. I am thinking I will send him to bed at usual time but wait and wake him just before I go to bed around 11.30 and get him to have a wee and hope he will go back to bed until about 5.30 for second wee of night. if I am lucky he might go till 7.00. I am going to put a bell on his bedroom door in the hope that this will wake me up. I think I have a house door alarm which will chime if someone goes past it. I needed to be at the hospital, the concept that they could have managed to care for him was somewhere off in cloud cuckoo land. I'm disappointed there wasn't a check list of suggestions on how to manage an Alzheimers patient.
Thanks for posts. Will attend pre op tomorrow but am really thinking of cancelling operation as Mum will find it hard to cope with post op regime.
I think residential home is better set up to deal with things than me. Father is not reporting any pain. He has now stopped looking in mirror and is reading newspaper. Husband has had three eye surgeries and pain was not an issue. How will/did she respond to drops? They probably put some in at the pre-op. They are not difficult to do. Am very concious that being able to read a sign to indicate where a toilet is will make life in future much more manageable, since it is impossible for him to remember where one is. Consultant would not do two eyes in one op. Quite unusual to do that ..plus person's vision would be blurred ..suppose could depend on whether they are mobile. Does your mother still read notices etc.
Mum doesn't read notices. No longer reads newspapers etc and unable to follow TV programmes but is still able to recognise people and point things out in photographs.
So the honest opinion of last night. He seemed to be a bit hyper and stayed up until past 10.00 despite the 6.00 a.m. get up in the morning. I settled on pinning some windchimes on his door and they did the job of waking me up but allowing husband to sleep. Father took his patch off twice don't know if it was as he went to bed or when he got up to use the toilet. If I had known better I would have had someone to do a waking night with him. I have now removed the eye patch and have taped the back of his glasses so hopefully he cannot get to his eye to rub it. I am about to contact the care agency and see if I can buy any hours for this week so I can go to sleep during the day. Am kicking myself for saying I would do eye drops instead of the nurse doing it because at least then the nurse could have kept an eye on the healing at least for the first week. Should have clipped father's nails before the op and will now do it this morning. Hope you don't mind these post smrtbr but the docs and anaesthetist were positive about the notes I had given them before op and said it was helpful so I am using this to make notes of what helped me and will give it to them. there wasn't anything to help people caring for dementia patients on what was an otherwise really useful pre op information.
Your observations have been very useful and will help with questions I will ask at pre op this afternoon. Mum is in a residential home so no nursing care. I know they will monitor Mum if she has op but if they have concerns will just send for ambulance and will end up back in hospital.
What an afternoon! After agonising all week about whether to let Mum have operation the desicion was thankfully made by clinician. Good desicion but the process has been disappointing. Started in eye clinic. Eye measurement tried to be taken but Mum was not cooperating and took two machines and lot of distress to get vague measurements. I voiced my concerns about having general anaesthetic at this point but was told it was a routine operation and would improve Mum's vision and confusion. Decided to continue with pre op. Had various tests and was then taken in to see clinician. He told us that as Mum had had a heart attack less than six months ago there was no way she would be given a general anaesthetic and if operation was to go ahead in future she would need to be treated at a specialist eye hospital. Well, releaved that I didn't have to make ultimate desicion but can't understand why eye clinic had not read medical history before putting Mum through ordeal of pre op! It seems the 'whole person' is not considered.
Sorry to hear about that for you but as you say making decisions is so difficult. There are times the best decision is one that someone else makes.
Even I wondered if it was the right thing, but I feel father has a good few years ahead of him and the eyesight is crucial. After posting about the night from hell (missed out wading through the wee wee on the floor of the bathroom) I have to say last night was completely different. I basically stuck eye shield on: covered hair with a strip of kitchen roll and bandaged right around his whole head like an Egyptian mummy. Eye shield did not 'fall off' last night and I was roused briefly so think he did use the toilet at night. He can now see differences in colour with the different eyes. We went out for a couple of walks yesterday and it may be imagination but I thought his walking was better. I have used some of the surgical tape to fasten his glasses on. I made a tight cord going between the two bits that hook over the ears and now he cannot just whip them off and rub his eye.
I know it would be difficult but I think I would probably go ahead with operating on the other eye. Part of my motivation was to get this done before any care home stay might become necessary because at least he has one (or even) two to one at my house.
Even I wondered if it was the right thing, but I feel father has a good few years ahead of him and the eyesight is crucial. After posting about the night from hell (missed out wading through the wee wee on the floor of the bathroom) I have to say last night was completely different. I basically stuck eye shield on: covered hair with a strip of kitchen roll and bandaged right around his whole head like an Egyptian mummy. Eye shield did not 'fall off' last night and I was roused briefly so think he did use the toilet at night. He can now see differences in colour with the different eyes. We went out for a couple of walks yesterday and it may be imagination but I thought his walking was better. I have used some of the surgical tape to fasten his glasses on. I made a tight cord going between the two bits that hook over the ears and now he cannot just whip them off and rub his eye.
I know it would be difficult but I think I would probably go ahead with operating on the other eye. Part of my motivation was to get this done before any care home stay might become necessary because at least he has one (or even) two to one at my house.
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