Help my Dad had a knee replacement yesterday but won't/can respond to instructions...

Discussion in 'I care for a person with dementia' started by FrustratedTaz, Jan 14, 2015.

  1. FrustratedTaz

    FrustratedTaz Registered User

    Jan 14, 2015
    1
    My Dad had a knee replacement yesterday, before he went in everything was explained to hospital as to his condition & everyone was happy. We prepared him as much as we could but he does not fully understand what is going on. The op went well but in the evening he became restless trying to get out of bed even though there were sides on it by trying to slide to the bottom. He is not responding to instructions or understanding what is going on. He had a restless night & this morning managed to fall out the bottom of the bed opening everything up resulting in him needing to go back in to theatre this morning. We have discussed sedation with the hospital but they don't want to go that way. Has anyone any suggestions in how we can help him. We are now thinking about having a member of the family with him 24 hours a day to try & keep him calm. My poor Mum is at her whit's end to the point of a break down with it, we just don't know how to handle him.......
     
  2. marionq

    marionq Registered User

    Apr 24, 2013
    5,533
    Female
    Scotland
    Some months ago I posted under Surgery and Dementia. My husband also needed a knee replacement and the surgeons were against it for just the reasons you describe. Posters on TP warned me against going ahead with any kind of surgery for him other than life and death stuff as it often has this kind of outcome. He will have a lengthy stay I fear and you may indeed need a family member to help him as well as anti anxiety medication.
     
  3. Witzend

    Witzend Registered User

    Aug 29, 2007
    4,282
    SW London
    Is there a particular reason why they won't use sedation? I think it's often the case that medics in general just don't understand dementia - they can't grasp that someone CANNOT remember instructions, no matter how often they're told, and often will not cooperate with e.g. physio, because they are unable to understand why it's necessary.

    I do hope you find a solution for your poor dad and mum. Such a worry for you.
     
  4. TinaT

    TinaT Registered User

    Sep 27, 2006
    7,095
    Bolton
    #4 TinaT, Jan 14, 2015
    Last edited: Jan 14, 2015
    In the present NH crisis I would imagine that nursing staff are under great strain and will not be able to give the 24 hour attention your dad needs. I would also be worried about deeper sedation in view of the dementia as this can cause more and permanent deterioration in mental capacity.

    Under the circumstances it would seem there is no other option but to arrange family to be with dad constantly until he recovers sufficiently not to cause himself further injury.

    My husband had a hernia operation and I not only stayed with him in hospital but also after his return to the care home as I was so worried that he might burst his stitches or cause other injury to the wound. I slept on a mattress on the floor of his bedroom for a week. Care Home staff were very kind and helpful but I felt that he needed more constant attention than they could give at this time.

    A hard fact to accept that he might not get the attention he needs from nurses but hopefully it will be a very temporary measure.

    xxTinaT
     
  5. Sammyjo1

    Sammyjo1 Registered User

    Jul 8, 2014
    194
    My OH had a hernia operation before he was diagnosed. He became incredibly confused afterwards and it seems that there were 2 things causing it.

    Firstly it is apparently a well known fact that dementia patients do not respond well to a general anaesthetic and will be confused afterwards. Hopefully this should wear off soon.

    Secondly he had been prescribed Tramadol for pain relief and it seems that a common side effect of this is confusion. Once he stopped taking the Tramadol he improved rapidly.

    It may be worth checking whether your dad has been put on Tramadol.

    I do hope it gets easier for you - it must be a very worrying time
     
  6. alypaly

    alypaly Registered User

    Nov 7, 2014
    9
    My OH had a hip replacement earlier this year. We were warned that his dementia might take a turn for the worse but the prospect of him not being able to walk because of the pain seemed worse so he decided to take a chance.
    Like your Dad he was very confused for a couple a days after the op. He got out of bed and wandered the corridors the first night. The nursing staff were great but really didn't have the time to do 1:1 so I stayed with him 24/7 sleeping in the same room to stop him getting up and generally feeding him and stopping him doing all the things he shouldn't like crossing his legs or walking without a stick. Even when I left half an hour to go for meals he got really agitated and tried to leave the ward. After 4/5 days he was still confused and in a really bad temper with me whenever I left him alone. Thankfully after a week he was discharged and six months later he is completely well again, able to walk etc with no pain. His dementia was getting worse anyway so its hard to tell if any deterioration was due to the anesthetic or just the progression of the disease.
    I think you need to have someone stay with him all the time if possible. It worked for us and stopped him undoing the work of the op. My experience is that the confusion and agitation slowly fades but it did take a few months before he was back to nearly normal and all that time I had to watch him like a hawk as he couldn't remember any of the hip precautions or exercises.
     

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