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My mom is aware of her dementia, but not the degree of it. Today I told her about an appointment with the neurologist next week, we're lucky to get in so quickly. I told her it was to check in about her meds for Parkinson's and to see what he thinks about her getting a knee replacement, how this potentially can affect her brain. A few hours later she starts asking me about it, but is all confused as to what it is about, so I tell her again. I want to tell her her dementia is getting worse but not sure that is wise. She is 90 and very healthy other than the PD which is controlled by her medication. It is the only medication she takes besides OTC pain relievers and allergy relief. I know she can physically handle the knee replacement but unsure about her mind. She had the right knee replaced 3 years ago and did really well with that. This was before the PD diagnosis. Her left knee is getting really bad - could've been done the same time as the right, but she didn't want to at the time. It is the main source of pain and discomfort for her and is diminishing her quality of life quite a bit. She tries to joke about it saying it only hurts when she walks. She gets sad about her knee and that she can't really do anything anymore.

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Dear angelsiwel: It was 3 years ago today when my mom passed from complications of her dementia. It sometimes feels just like yesterday. When she first got diagnosed with it, I was not familiar with this ugly disease, but before I knew what it was, I thought she was just being difficult, and thought she was doing things to aggravate me. I found out this was not the case after a while. I learned that I should just not try to make her understand things, and I visited her in "her world" - which was the past (long ago when she was growing up). It was hard for me, but made our visits easier because she was happier in the past. I would look at old pictures of family members with her and it seemed to calm her and she seemed to be able to recognize the people in the pictures better than the ones in real-life! After a while, I was able to be more relaxed and less frustrated with myself knowing that this was where she was at the time. I hope some of this makes sense, as I sometimes ramble, but I still get teary-eyed, and writing this brings it all back. Better go now before people ask me what's wrong (I'm at work right now). Good luck and God bless you and all you're going through.
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My heart goes out to you. Dementia is so hard. Not sure who it's harder on. But for the caregiver it can be heartbreaking. Not sure why you want to talk to her about this - but chances are she won't understand or remember any discussion you may have with her on the subject. If she gets upset about forgetting something, just say 'we all forget something once in a while' and go on... there's nothing you can do about it.
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Thank you all for your comments and support. She has selective memory when it comes to certain things and tends to remember that which is negative so it's important to be careful in how things are presented. I talked to her but in a way that minimized the issue and focused on what is going well. We had a visit with the neurologist which went well compared to the last visit which was very upsetting for her. She is more accepting of her decline. She was most disturbed that she couldn't remember what year it was when he asked a bunch of questions. It's weird what she remembers. He said her worst issue was her knee and that if her knee doc said it was okay then it would be helpful for her. She had her other knee done 3 years ago, at which time sedation and a local anesthetic were used and after the initial couple of days she was okay. It did seem like she declined more after that but I think it was more due to depression from no longer teaching her aerobic class after 25 years of teaching. She also stopped driving not long after that. If she is medically able to do the knee surgery, we will do it. It is the one thing that most affects her quality of life and causes her not only physical pain but emotional pain as well. Thanks for being here with me on this caregiver road.
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I don't tell Mom she has appts. or visitors until just before we go or visitors show up. She won't sleep at night if told the night before. She has no preception of time.
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Yep, she's going to the doctor to see about getting help for her memory and her Parkinson's. No need to use the D-word if its upsetting. My mom was, oddly, comfortable thinking she had a "brain disease" and Dad hated the word "confused."

My mom had her knee replaced too, and she never walked real well, BUT eventually, at least it did not hurt her every time she put weight on it. She did seem worse right after the general anesthesia but not really much worse than she had been before - I do think she should have opted for regional and sedation as she'd had for her hip, but at that point they let her decide which she wanted. She got through some minor peripheral vascular procedures with local and sedation after that. I would spend some quality time talking to the anesthesia person to see what they can do to minimize the risk of her getting dramatically worse - there may be a good option and you'd hate to deny a procedure that would help with comfort and mobility.
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Maybe the Reader's Digest version about the dementia, but only if she insists? She may not want to know as much as you'd be inclined to tell her.
Since there isn't anything that can be done about it, maybe calling it "mild memory issues" and choosing some healthy lifestyle activities (5 min of sitting exercise, a word game 10 min every day, "Name that tune", some of the fun online brain games, etc), may help her feels like she is contributing to her own well-being.

Regarding the knee. What I've observed is that General Anesthesia is VERY hard on the brains of the elderly, and even more so for those with dementia. Surgeons deal with the mechanical aspect of the body, so it is considered a "successful" surgery if the knee works, regardless of what condition her mind is in afterward.
Please look into some of the injection options (cocks comb, etc) if you haven't already done so. The pain in the knee is a problem, but not as much as drastic mental deterioration.
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Well, she's not going to remember the discussion.
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I struggle with the same thing. My mom is only 75 but had already progressed to the point of needing 24 hour care and supervision. Her long term memory is excellent. Her short term memory is almost non existent. But I can see it upsets her when we discuss her needs and the future. She is still coherent enough to understand during those conversations and im afraid that she feels like a burden and it makes her sad knowing she cant take care of herself. Idk if I should include her in the mtg we have tomorrow morning with a local home heath nursing agency? But as far as the original question above about surgery for someone that age with memory issues there is a very good chance it will make her mind worse. It did for my mom several months ago when she had her gallbladder out. I only wish my mom hadn't had issues with dementia until she was in her 90's. It's so much harder at her age for our family to deal with and accept.
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If you discuss it with her, she may not even remember the discussion. It is a bit futile. But what you can do is remind her that that is what you are for.... to remember the important things. That worked with my mom to relieve her of her perfectionism. It depends on how your mom is personality wise... if she likes to be in control and on top of things and says so, then you have to deal with her that way. My mom is like that, and I remind her that at 93, she is doing a HUGE amount better than most her peers. It helps her to remember she is 93. And it makes her feel good - like at least SOMEONE has control - when I remind her that's why she has me. Keeping her happy is more important than keeping her intellectually sharp and informed.
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It sounds like she's beyond the point of being able to reason or remember things very well. I don't think it serves any purpose to upset her or argue with her about her dementia. My Dad has always refused any testing, thinks he's just fine, will admit to being a little forgetful but that's about it. This may sound silly, but you can't convince someone with dementia that they have dementia because they are demented. Just try to deal with her reality, fib, tell her what she needs to hear, don't argue and correct and keep saying, "Dont you remember?" Learn how to deal with it using this site. Lots of good info here.
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