Looking for advice! My 79yo mother with dementia/Alz has to have laparoscopic gall bladder surgery in one week. She will be put to sleep using a general anesthesia. At this point, it is scheduled as out-patient surgery. But I have heard horror stories about how anesthesia has a bad affect on someone who has Alz. Has anyone had experience with this? Her gall bladder attack happened on Nov. 8. She was in the hospital for 4 days. They put a drain in her gall bladder and sent her home with anti-biotics. Her gall bladder was very infected, and was enlarged and full of stones. They couldn't do surgery right away because of the enlarged size, the incision would have to be very large and with her age, the doc was afraid her recovery would be difficult. Thus, the drain and upcoming laparoscopic surgery. She has done so well since she came home from the hospital, much better than we expected. But now her surgery is coming up and I'm not sure what we should prepare for. Also, another question is about the day before, when she has to cleanse her bowel. Any suggestions for this? I am so anxious for her! Of course, I always imagine the worst-case scenario! Just want to be prepared so this can be as stress-free as possible for her and my father.

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Yes anesthesia can be difficult on someone with Alzheimer's
It may take a week or more for her to "recover" from just the anesthesia.
the fact that this is an out patient procedure might make it a little easier for her.
the IV may be very difficult as well, my husband kept trying to rip them out and I had to ask that his hand be restrained. Hospital sure didn't like that!
Ask that you be there while she is being prepared for surgery.
Most hospitals it seems are very ill equipped to deal with dementia patients.
Ask that you be present during ALL conversations.
**and by you I mean you or a member of your family that she is comfortable with.
You want to eliminate as much anxiety as possible.
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I would consider renting a chair potty for a couple days and make her comfortable there for the main flush out and then wearing depends or diaper you don't have to slide up and down her legs. Also, roll up carpets or cover with plastic drop cloth available from Home Depot. Plastic covers everywhere and on all furniture.

Would dr consider admitting her to hospital day in advance so they can bowel prep her in hospital setting? Worth asking especially if it coul make her weak.
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I'm not a medical professional and I don't know whether or not a lighter level of anesthesia than a general could be used. My experience with 2 surgeries has been that the anesthesiologist generally wanted to use a general.

For the first surgery, I was able to discuss the issue before the surgery and the anesthesiologist agreed to a much lighter sedation (I think it was called "twilight" but don't remember for sure). I was a bit drowsy, but wasn't knocked out completely.

For a much later surgery, the anesthesiologist agreed to a lighter level but doped me up anyway. I was sick for a week afterward, and furious with the anesthesiologist.

So it depends on the anesthesiologist, but a lighter level of anesthesiology that just makes her drowsy wouldn't be as difficult to recover from as a general anesthesia.

As to bowel cleanse, I would ask what's easiest tolerated for someone of her age. Colonoscopy prep requires a bowel cleanse, and in my experience something like Colace or another prep (name of which I don't remember) are used.

Not only do they cleanse, but they are exhausting b/c of the repeated bathroom trips and fluid loss. I was so weak the day of the colonoscopy that I was really glad I didn't have to drive. For someone older, that weakness could be a lot more serious.

I'd raise both of these issues with the surgeon's staff. Perhaps you could use something like prune juice or a non chemical alternative to minimize the impact of a literal flush-out.
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You have a good surgeon, because he is not jumping right into a big incision. He is shrinking the problem and using a conservative method to remove it. The next person you want to talk to is the anesthesiologist, to impress on him the importance of avoiding further brain deterioration. For instance, statins—commonly used to treat cardiovascular disease—have been found to reduce cognitive decline in mice when given before an operation.
As for the bowel cleanse, OMG, get some Depends, because it's going to get messy. Gloves. Lots of baby wipes. Handheld shower for rinsing off. Aprons for yourself. Lots of old towels or Chux.
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