Dad with mild to moderate dementia refuses to have cataract surgery

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Hi folks. Haven't been here in a while due to rehabbing new/old house and moving.

Dad is 87 with ever so slow progressing dementia. He's been treated for macular degeneration for sometime and now the doc says he needs cataract surgery on both eyes. Of course to dad, he's fine and refuses to talk about surgery.

I'm caring for my folks from 3 states away. If he had the surgeries it would be a logistical nightmare trying to wrangle him through the procedures and post op care. He's still fairly high functioning but executive reasoning skills and short term memory are not good.

Couple questions :

I know his vision will continue to get worse with out surgery. How fast will it progress?

If he waits till his vision is really bad then consents to surgery would that make the procedure more difficult? Impossible?

Answers 1 to 8 of 8
Hi Windy.....
I, too, have been gone for the most part, since Mom passed. Good to see you back. I can only tell you that my Mom had cataract surgery in her 90's with dementia (2 years ago) and it was pretty much a quick, painless, outpatient surgery. There were eye drops, as I recall, and a follow-up visit. But, generally, it was a non-event given everything else medical that had taken place.
Of course, Mom was in AL and had nurses to see to the eye drops.....understand this is not your case. Hope you get some better responses than mine to help you decide what to do.
Best of luck!
Degeneration because of cateracts or he has degeneration and cateracts? Will removing them really help or he will get worse because o degenerations meaning he will go blind eventually? Like said, the surgery is pretty easy. But, there is a series of drops that will be needed.
Top Answer
Windyridge, glad to see you on the forum. Hope the projects for the new house are going smoothly.

Regarding your Dad's eyes, what does the eye doctor feel the outcome would be? I know the cataract cloud would go away, but what about the macular degeneration gray center dot? Does the doctor need to remove the cataracts so he can help more with the macular? Last year my Dad was getting shots in his eye for the macular and Dad did say it was helping.
Thanks to all for your responces. In thinking this through its really kinda hopeless. Dad is in that grey area of legal competency. He knows his soc number, address, date of birth etc but can't remember if he had breakfast. He doesnt want surgery, he ain't gonna have surgery. Period. Nothing we can do.

So I'm back to the question of how long before he loses sight. I'm going to try and call the doc Monday. Among other problems, long distance care etc, the doc has a very heavy foreign accent. Neither of my parents can understand a word he says.

Maybe as he dementia increases we will get past the stubborn/ruler of my domain crap and just get it done.
I'm sorry to hear your situation, but, I would keep in mind that a person with significant dementia may be more manageable, but, they also may be more prone to be unable to follow directions, like be still, don't rub your eye, etc. Of course, if he flat out refuses the surgery, at this point, I'm not sure what your options are. It would be sad for him to have severe dementia and be blind. That would also require much more assistance. If possible, I'd discuss it with his doctor in detail for guidance.
Sunny, sound advice. I will try to discuss this with his doc. They are so hard to get on the phone. My mom was able to go to his last appointment. Usually he won't allow that but she's getting a little assertive. But neither of them have a clear idea of where this all stands.

I do hate to think of him being blind with later stage dementia.
When my mother first got cataracts she was probably in the beginning stages of dementia. I, at the time didn't know much about dementia and it never occurred to me that - that might be a contributing factor to her "why should I have surgery? I'll be dead soon" decision. I might have been more persistent in trying to get her to having the cataracts removed had I known. 

Fast forward four years and mom was in a nursing home with pretty sevear dementia. Mom had stopped reading, which had been her lifelong passion. Whenever I picture my mom in my head now that she's gone, the image is always of her sitting - reading a book.

Anyhoo- she stopped reading or even looking through magazines so I figured it was her eye sight. Again, it never crossing my mind it was the dementia. So I took her to the cataract doctor. After he examined her eyes and tried to talk to her, he determined she was not a good candidate for surgery even though it would have helped. Although mom lived in a nursing home where they would manage her pre/post care - the doctor felt she would do things like rub her eyes or refuse the drops and therefore would not do the surgery. I suspose I could have pursued the matter with a different doctor- except this doctor said her vision was such - that if she wasn't reading anymore it wasn't because she couldn't see the words on the page.

I next took my mom to her regularly glasses eye doctor to ask about a stronger prescription. He said my moms vision was like looking through a dirty windshield- that stronger glasses would only magnify or more clearly define her view - of the dirty windshield.

So that where it was left. Mom continued to not read and to decline both mentally and physically. She passed away four months later.

The morale of my story for me - is that I wish I had nagged her just a little longer and a little harder about getting the cataracts removed when the issue first came up. No doubt it would not have done any good however- my mother was the most stubborn person that I've ever known. 

Take what you will from my tale and I wish you more success than I had!
Rainmom, thank you for sharing your experience. It's given me lots to think about concerning my Dad. He would never be able to do the post op stuff unless he had 24/7 supervision. My mom has had a horrible time regulating his meds and eye drops now. I'll be going to visit soon and I might get him to reconsider but with his dementia, Twenty minutes later he wouldn't remember the conversation.

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