Do Anesthetics do More Harm Than Good in Elders?

I have to deal with this issue every day when my mother, age 89 and with just a half set of dentures on top, bemoans about her lack of teeth. When we checked out getting new set, or getting these relined or fixed, the dentist said she'd have to have oral surgery to tighten the skin. Bone loss had made skin loose, and in that case dentures would always slide around.

This is something I wish I had known, that she had taken action on herself while she could still handle it. She hasn't had her dentures worked on in the 8 years I've been caring for her...probably years before that. So good idea to keep on top of these things. Now her mental condition is so fragile that she would probably have major panic attack at the work being done.

Of course, something like a broken bone or a hip...am thinking to ask dentist that if Mom does need some major surgery, could an oral surgeon be slipped in the same session?

Also, why can't anesthetic be injected, a spinal at the right place, a shot to calm the person, a short hit of laughing gas. Hope someone is working on this problem, cause the elderly ain't going away.

To Carol Bradley Bursack: You are very wise and seem genuinely concerned about giving advice to caregivers and patients alike.
You also gave the answer to many who ask "What would you do, if you were in the same situation yourself?" I agree that surgery in one's eighties is risky no matter if dementia is an issue or not. It may be risky to a patient in their seventies. One aspect not mentioned, is intubation. When one is put to sleep under anesthesia, a breathing tube is immeditely inserted down the throat of the patient. This may cause a multitude of issues. First of all, not everyone CAN be intubated. There may be blockage, distortions of the esophagus, throat, mucus pockets etc. Then there is the ever looming problem of "Will the patient wake up soon enough?" One might try accupuncture for short surgeries. I had a tooth extraction under hypnosis, and it worked beautifully....no pain, no bleeding, but that is vey unusual.
The types of surgery that can NOT be excluded are : Appendectomy, Bladder or Vaginal Prolapse, Removal of Foreign Objects..
Good Luck with your advice to all those who seek it.
Norene
p.s. No matter what they tell you, a Colonoscopy is not necessary in every case.

My mother had an outpatient procedure for which she had to be mildly anesthetised a couple of years ago when she was 70 years old. The anesthesia that was used was the kind that knocks you out enough that you have no memory of the procedure, but supposedly you can come out of it quickly. She did not fully come out of the anesthesia for approximately 4 days. When I got her home following the procedure, I could not rouse her up enough to even get her out of the car. I had to call my husband to come home from work and we finally got her in the house using a wheel chair. We had to take her to the ER later that night because I didn't know what else to do - she was very woozy and incoherent. They didn't find anything wrong with her in the ER and sent her home. She has since sworn she will never again have any surgery of any kind. The bottom line is, even the mildest forms of anesthesia can have adverse effects on the elderly.

Anesthesiologists work on these questions all the time. A great deal of research has gone into various types of anesthesia since 1982. Some drugs will put you to sleep for a short time, some longer, some with no effects and some with short-term effects.
The drug known as Versed, for example, is supposed to be a short-term, IV, affecting the memory, however several stories that I've heard about this drug tell about a different outcome. Sometimes the memory does not return to what it was prior to surgery. Do you want this?
In addition, not all surgery is absolutely necessary. There are risks. Do you want to take those risks? John Murtha just died of complications following Gall Bladder surgery. Apparently, there was perforation and a severe infection set in. The same event occured on that 71-year old woman on 60 Minutes who had a colonoscopy. There was perforation and an infection set in (probably E-Coli). IV antibiotics could not control the infection, and she died of Sepsis. Both of these elderly patients walked into the hospital on their own two feet, expecting good results.

Wow, this sums up my Dad in Law's story. He had a triple bypass operation, and when he came out of it, he was very fuzzy for a period of time ( a couple of months). He then convinced himself he was a Broadway singer. He has a great voice, so we've humored him. Unfortunately, his dementia is taking hold of him. We appreciate the good days he has when we visit in the Nursing hone,

Do you know what anesthesia is? It is a substance that puts the brain to sleep! If one is bordering on dementia why would you put that brain to sleep? It can only get worse. The best that you could hope for is that there would be no affectation at all. I personally would not want to take that chance. I would hope that I would have my "facilities", "marbles" whatever you call it, right up until the end of life. I don't even take a sleep-aid like Tylenol PM. The Michael Jackson case is the most severe form of anesthesia delivery that I have ever heard. He wasn't seeking pain relief, but wanted to go to sleep. They over did it and used the incorrect drug. Sad.