Eye doctor wants to do cataract surgery on husband with dementia. Advice?
He will not always follow directions. I am concerned about maintenance right after surgery. Dr. Said cataract is still soft enough to do surgery now. Waiting can cause potential blindness and would be harder to remove.
He cannot rub his eye after surgery. If you don't think he can keep himself from doing this, you will need to discuss with the doctor what the consequences would be if this happened.
To protect what vision he has and keep it from deteriorating, get it done now, or perhaps early in 2021, depending on how fast the pandemic spreads. I procrastinated and my vision deteriorated, not beyond repair, but more than it would have had I just had it done earlier. But I also was concerned about transit, as at that time there was no one who could provide transportation to and from the surgical site.
Someone definitely will have to assist him, not only at the surgery for pre-op explanations and comfort, but in the daily application of eye drops. I had drops before, and after, beginning with 4x daily, then dropping down weekly to eventual discontinuation.
I won't lie; the drops can sting. Be prepared to comfort him, and provide something to keep his mind off his pain. Play his favorite music before and after, or feed him something like turkey to make him sleepy and hopefully he'll fall asleep while the sting wears off.
If it's the procedure itself you're worried about, don't be. The surgeon and nurses will be well used to giving directions to patients with dementia, and if he really can't comply then the worst that can happen is they decide not to go ahead.
You'll want to keep an eyeshield on him using micropore tape; and if he's recovering at home you will need to apply creams/drops. Practise! It honestly isn't that difficult - look up some how-to videos on YouTube.
The procedure, I hear, is not that bad. But there are drops before and after. If in an AL or other facility no problem, the staff can put them in. And the eyes are not done at the same time. My eye doctor does them 2 weeks apart.
Really need to find out from the doctor all the care that is involved.
My mom had cataract surgery just before Covid broke out. Both eyes. It was successful. My mom lives in assisted living and the staff was excellent in giving her eye drops. I admit I did not have a big part in post-op care. Nevertheless both eyes are 20/20. She does love seeing the photos of her grandchildren and reading her magazines again.
I had to stay with both of my parents After they had cataract surgery. Drops twice daily for a couple of weeks. Follow up visit. Trip to optometrist for new glasses after both eyes had been done. Not a walk in the park.
How bad is his dementia? Does he still drive? Read? Watch TV? Is he having any issues with his sight?
My mom needed eyedrops multiple times of a day for weeks after surgery, IIRC. She doesn't do eyedrops so it was my job. Not a biggie but if you are dealing with someone that will not follow directions, you will not have success with the eye drops.
The eye doctors might be gung ho on surgery. $$$$. Yes, Medicare will pay but that is NOT a reason to get it done.
There are also multiple trips to the eye doc. Pre-op. Day of surgery. Day after. Then again in X weeks. It's kind of a lot.
If he is in good condition and using his eye sight, then you should consider it but talk to the doctor about your concerns.
Also most ophthalmologists want documentation from the patient's primary MD that the patient is medically appropriate for outpatient surgery, so that is another trip to MD before actually getting cataract removed. Practicing eye drops with him in advance of surgery (using a store brand generic tears product, as not harmful) will help you get a sense of how easy or difficult it will be to manage the eyedrops. Being able to see faces and places and the food in front of you is important to help stay engaged with the world and having some sense of safety. If a person loses sight completely in one eye, that could exacerbate the distress people have, at different stages of dementia.
There really is not much after care needed for cataract surgery. Unlike oral surgery and other types there will be no open wounds that have to be cared for, no bandages to be changed. He will have anesthesia and that might be difficult and he may not return to his current "baseline" cognition. Or he may do just fine. I recall mine was done with almost twilight anesthesia. Obviously the doctor is aware that your husband has dementia so he will do what is necessary for a safe outcome.
11 Answers
Helpful Newest
First Oldest
First
ADVERTISEMENT
Someone definitely will have to assist him, not only at the surgery for pre-op explanations and comfort, but in the daily application of eye drops. I had drops before, and after, beginning with 4x daily, then dropping down weekly to eventual discontinuation.
I won't lie; the drops can sting. Be prepared to comfort him, and provide something to keep his mind off his pain. Play his favorite music before and after, or feed him something like turkey to make him sleepy and hopefully he'll fall asleep while the sting wears off.
You'll want to keep an eyeshield on him using micropore tape; and if he's recovering at home you will need to apply creams/drops. Practise! It honestly isn't that difficult - look up some how-to videos on YouTube.
Really need to find out from the doctor all the care that is involved.
It was successful. My mom lives in assisted living and the staff was excellent in giving her eye drops. I admit I did not have a big part in post-op care. Nevertheless both eyes are 20/20. She does love seeing the photos of her grandchildren
and reading her magazines again.
My mom needed eyedrops multiple times of a day for weeks after surgery, IIRC. She doesn't do eyedrops so it was my job. Not a biggie but if you are dealing with someone that will not follow directions, you will not have success with the eye drops.
The eye doctors might be gung ho on surgery. $$$$. Yes, Medicare will pay but that is NOT a reason to get it done.
There are also multiple trips to the eye doc. Pre-op. Day of surgery. Day after. Then again in X weeks. It's kind of a lot.
If he is in good condition and using his eye sight, then you should consider it but talk to the doctor about your concerns.
Practicing eye drops with him in advance of surgery (using a store brand generic tears product, as not harmful) will help you get a sense of how easy or difficult it will be to manage the eyedrops.
Being able to see faces and places and the food in front of you is important to help stay engaged with the world and having some sense of safety. If a person loses sight completely in one eye, that could exacerbate the distress people have, at different stages of dementia.
Unlike oral surgery and other types there will be no open wounds that have to be cared for, no bandages to be changed.
He will have anesthesia and that might be difficult and he may not return to his current "baseline" cognition. Or he may do just fine.
I recall mine was done with almost twilight anesthesia.
Obviously the doctor is aware that your husband has dementia so he will do what is necessary for a safe outcome.
If Medicare is paying for it, why not