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Surgery and dementia

Tabby-cat

Registered User
May 27, 2019
12
Does anyone have experience of the after effects of surgery for someone with dementia? Mum has been advised that she could have a replacement knee. She can’t make her own decision so I am trying to work out the best way forward. She is in a care home so they could help her with physio, but I have read that surgery can exacerbate dementia. It feels like a difficult decision to make, but mum is quite immobile and if surgery increased her mobility that could be a good thing.
 

Morganlefay

Registered User
May 20, 2014
76
Buckinghamshire
Does anyone have experience of the after effects of surgery for someone with dementia? Mum has been advised that she could have a replacement knee. She can’t make her own decision so I am trying to work out the best way forward. She is in a care home so they could help her with physio, but I have read that surgery can exacerbate dementia. It feels like a difficult decision to make, but mum is quite immobile and if surgery increased her mobility that could be a good thing.
I'm sorry to say that it is apparently well known in medical circles that anaesthetics do worsen dementia ( check with a doctor) My OH had a knee replacement a few years ago, about 4 years into his Alzheimer's diagnosis. He tried to pull out all the tubes and cannula things and had a VERY disturbed night in the hospital before they discharged him. No one bothered to query his suitability for a general anaesthetic. He needs another knee replacement but the nice surgeon doesn't want to do it because if the effect on his cognitive function and has suggested steroid injections instead, which we will do. I would not willingly let him have another anaesthetic unless it was life and death, tho if your .Mum could have help with physio that would be good, and the steroid injections don't seem stressful at all. Sorry, I know that's not what you want to hear :(
 

marionq

Registered User
Apr 24, 2013
6,034
Scotland
Early on in my husbands Alzheimer journey the surgeons refused to do a knee replacement as they said he would be unable to do the necessary exercises and the anaesthetic would be a problem. They had bad experiences with dementia patients.

In September after a fall while in respite he had to have an emergency hip replacement and he went steadily downhill. He didn’t waken after the op for three days and his eating and drinking never recovered. He died five weeks later.
 

Banjomansmate

Registered User
Jan 13, 2019
1,614
Dorset
The Banjoman fell and broke his femur and after the operation to pin it he was unable to cooperate with any medical staff, fought them tooth and nail and was eventually discharged back to his Care home unable to stand or walk because he didn’t have the cognition to interact with the OT. His capacity wasn’t brilliant before the op but seemed a lot worse after it!
 

Lawson58

Registered User
Aug 1, 2014
2,076
Victoria, Australia
My husband has not had any fractures, knee replacements etc but he has had five anaesthesias in the last five years for hernias, prostate and a colononoscopy. The first was prior to his diagnosis of Alzheimer's and after his surgery he was very confused and needed constant supervision. For the subsequent surgeries, I spoke to the anaesthetist about the problem and he never experienced the same problems again.

However, he required hospitalisation and a painful procedure for a blood nose, and nursing staff had a conversation with me about his refusal to communicate with them. He was fine once he came home. So not every person with dementia responds the same way so perhaps an in depth conversation with her doctor might be helpful.
 

Louise7

Registered User
Mar 25, 2016
1,786
So not every person with dementia responds the same way so perhaps an in depth conversation with her doctor might be helpful.
Mum needed a general anaesthetic for a gynae op around 2 years ago and we were concerned about this, having read various things about how bad this can be for those with dementia, so discussed it with the doctor. We went ahead with the op and Mum was fine afterwards with no adverse side effects. The staff put this down to the anaesthetist being vey skilled and calculating exactly how much anaesthetic was required - he visited Mum prior to the op to ensure that he got the calculations right. Mum has also had local anaesthetic on several occasions too and again there have been no problems afterwards. Speak to the doctor about your concerns so that you can weigh up the pros & cons of the surgery and make an informed decision about whether it is in your Mum's best interests or not.

I'm sorry to say that it is apparently well known in medical circles that anaesthetics do worsen dementia ( check with a doctor) My OH had a knee replacement a few years ago, about 4 years into his Alzheimer's diagnosis. He tried to pull out all the tubes and cannula things and had a VERY disturbed night in the hospital before they discharged him. No one bothered to query his suitability for a general anaesthetic.
I think it's fair to say that anaesthetic can have negative effects on those with dementia but it doesn't apply to every person with dementia. The anaesthetist needs to know that the patient has dementia but I think sometimes the message doesn't get conveyed to them.
 

jugglingmum

Registered User
Jan 5, 2014
5,616
Chester
My MIL had a knee replacement op using an epidural rather than general anaesthetic so maybe this is an option.

She was 88 at the time with no dementia and had a heart issue that precluded a general I think

she was pain free after the op and very pleased with it (she'd now 92)