Postoperative Cognitive Delirium (POCD) is a strongly possible result. I have recently had contact with a number of anesthesiologists who DO NOT believe or UNDERSTAND what can happen to the elderly brain. We must insist that the medical profession begin serious education regarding such impacts (POCD). One man said he'd rather be dead than have no mind.

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I believe my wife's dementia started within months of general anesthesia. Before surgery she is sharp and remembered everything. Within a few months all of it was gone.

My Dad under went heart valve surgery at 65. When 2 yrs later he had to rehave the surgery because the valve leaked, he asked the doctor if he would lose more of his memory like he did the last surgery. Dr. said yes. It happens when you go under especially if its for hours.

You will find on this forum that most of us say not to put an elderly LO thru surgery if possible. Especially those suffering from a Dementia.

Yes, this is a real issue and should be a concern for anyone older who needs to have surgery. I do however believe that most doctors and anesthesiologists are now more aware of the negative impact that anesthesia can have on the elderly, especially those suffering with any kind of mental decline already.
When my husband(who had vascular dementia)had surgery to have his supra pubic catheter put in back in 2018, the anesthesia messed him up big time. I was sacred to bring him home from the hospital, but thankfully in his case it did seem to get better after a few weeks. Sadly that is not always the case, and the effects can remain long term.
I recently had to have foot surgery, and I made it very clear to my doctor and the anesthesiologist that I only wanted to be heavily sedated and not put under the traditional way, as I didn't want to chance the negative effects. Thankfully they agreed, and everything went fine.
I do however realize that sometimes one has no other option than to have surgery. And if that is the case, just make sure you are weighing the pros and cons, and asking the doctor the possible side effects, as even though they know the side effects of the anesthesia, they're not always forthcoming in sharing that info with the patient. Hopefully that will get better in time.

You are so right. Doctors continue to deny what nurses KNOW and see every single day they work. This is real. And it is either more or less permanent. Sadly often permanent. It can also lead a perfectly normal elder to waken out of anesthesia permanently injured. How the doctors can continue to deny in the face of what they see is completely beyond me, and this denial will not be easily changed.

But with all due respect, there’s still this- my mother’s fall shattered her hip bone to powder.

Five years previous to her fall, at age 85, she’d rehabbed HERSELF after a 2 day hospitalization, from a hemorrhagic stroke in the left side of her brain.

The fall required full hip replacement or total loss of mobility.

Seriously? There were NO reasonable choices available to her.

If I’d chosen the NO SURGERY option, she’d have gone from a pretty much self managed lifestyle to being totally bed bound.

If I’d chosen to have her hip replaced, (we did), she’d risk the effects of an anesthetic that might or might not reveal early dementia and cause a different sort of problem (it did).

But for those of us who adored her feisty, do-it-myself-or-don’t-do it-at-all personality, we were beyond horrified by the loss of the woman who the day before she fell, was balancing her checkbook and following the college preparations of her grandchildren.

We had been assured before the surgery was undertaken that the least possible anaesthetic was used for women of her age and diminutive size, (we actually asked the question specifically), and that was probably so. The doctor who did the surgery was an excellent surgeon, still in practice.

There was no possibility that anything but general anesthetic could have been used, and I know that. This enters quickly into the world of damned if you do and damned if you don’t geriatric care.

Leaving my mother’s hip as it was after the fall would have reduced her life to perpetual pain. As it was, she lived a comfortable life in residential care for 5 1/2 years, until her death at 95.

Anyone who looks for easy answers in geriatric care may find them harder to find than they’d expected.

JJ, I totally agree with you. Your profile states that your wife has AD. Having a brain disease greatly complicates the effects of anesthesia. For a disease that's been around for over 100 yrs., you would think that medical professionals would be well educated about it, not only anesthesiologists, but PCPs and even neurologists, who are the primary consultants of AD patients. But it ain't so. Maybe every state should pass a law requiring clinicians to have at least 40 hours of dementia education.

I was lucky to have an orthodontist tell me and my wife he couldn't sedate her because of the chance of POCD. She was in a MC facility when she lost a cap and a dentist told us she needed a root canal. Knowing she would not tolerate a typical root canal, he said it could be done under sedation. When we met with the orthodontist, he said no and gave us some other choices. We decided to do nothing and fortunately, she passed away several months later with no complications.

I was pleased to have this orthodontist tell us of the hazards of anesthesia on my wife. Someone else may have performed the procedure with devastating results.

I understand your concerns. My parents are deceased now. I cared for them for many years.

My mom’s doctor told us that she would never recommend surgery of any kind due to mom’s age. She was a fantastic doctor. I valued and respected her opinion. I trusted her to care for my mother.

I was deeply concerned about my father. He had heart disease. His doctor suggested surgery when my father was elderly. I questioned him by asking, “If this was your father, would he go through with the surgery?” He said, “Yes, because if your dad doesn’t get surgery he will most certainly die.” It was tough to see my father being rolled into the operating room.

He came through the surgery fine. Afterwards. while in the recovery room, he suffered a stroke and his life was never the same again. There are always risks in having surgery. I don’t think his issue was because of anesthesia though. I suppose that decisions must be made on an individual basis. I am not a medical expert.

Others will chime in with their thoughts on the topic. It is a controversial issue and there are differing opinions. I am nearly 65 and I know that I would not want surgery at a very old age. Nor would I want chemo or any life prolonging treatment at an advanced age.

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