How to deal with 93-year-old dementia mom who insists on every medical "fix?"

Knee replacements are never the same. IMHO, it's her dementia talking. No one loves to go to the doctor. They like going to the doctor when their is resolution for their health issue.

Please don't give in, NO knee surgery!!! You don't say if she is able to walk (but I assume she does), but if she walks now she probably will not after the surgery. She is probably unaware of the pain involved AND then there is the therapy following the surgery. I would be willing to bet she will not do the necessary therapy work so that she can walk again.

We went through this with my MIL at about the same age. She insisted that she had to have the surgery, the doctor met with us several times to make sure we the surgery was not our idea. She had the surgery and never walked again, dying at age 99 1/2. Stick to what you know is right, our parents often become "our children".

Yep. To deal with it, you must redirect. Repeat, redirect. Repeat, redirect. You get the idea. She'll come around eventually.... but it'll be awhile. Hang in there.

You need to educate yourself on dementia. YOU CAN NOT REASON WITH DEMENTIA. You have to live in their world and not take anything personally. Depending where she is in her dementia you will need to address her fear and get a really good understanding on where her pain is at. For instant instead of knee surgery, she gets shots in her knees and you tell her it was surgery. You will have to live with repeating yourself and be accused of stealing etc. If you are worried about that, keep detailed records and use a video to record your moms things. Remember your moms brain is slowly dying. Her personality can change, her memory will fail and then her body will fail. It is hard to watch and scary for the person going through this. You will need help and someone to talk to and breaks from your Mom. If you have to you can get someone in the medical field to comfort her on her fears. As long as she is coherent enough and she asks to see a doctor to are legally bound to bring her in to see one, Just let them know the situation and ask for someone familiar with the disease.

"But mom, you already have your new knees!" (Too cruel???)

Sorry, I just returned from taking my FIL to a totally useless follow-up visit with one of his doctors whose milking Medicare for every "follow-up visit" penny. My FIL LOVES getting all the attention from this doctor in particular. And yet FIL also will complain non-stop all the way there and back. My FIL has mild dementia.

You might want to research and explain to her the dangers of undergoing anesthesia. I won't have it for myself unless my doctor says it's an absolutely necessary surgery.
I've had 2 teeth pulled rather than undergo root canals, and I manage fine without them. And I'm not even 70 yet.
If your mom is expecting you to coordinate the surgery, just tell her no, because her doctor doesn't think it's necessary, and you won't be a part of it.

For future surgery requests tell her that she needs a doctors approval. And just tell the doctor not to give approval. Then the Doctor is the "bad guy" not you.
For dental visits I wonder if she would be satisfied with a good cleaning, maybe a bit of Nitrous Oxide that would put her in a mood that she may or may not know exactly what was done.
What might work..and this is a bit of therapeutic fibbing here...."conspire" with her doctor to get her is a "drug study" say that since she is co-operative and healthy they want her to try a new drug for her...knee..or head..or whatever body part she wants "fixed"
Give her a bottle of placebo pills, Tic Tac is perfect for this or even the little candy Smarties. She should take 1 pill in the morning, 1 at night or make up some schedule and give her a notebook. Then her task is to record when she takes the pill, how she feels, how her XXX whatever body part we are treating. You can make this a 1 month test, a 2 month test. however long you want.
The catch is during the "drug study" she can not have any other procedures done. After that test schedule is done she can either have to wait a month or two before she can schedule any other procedures. And when you go in to see the doctor about scheduling a procedure the doctor can say how pleased they were with her that they would like her to join another study. This sounds convoluted as I write it out but it might keep her busy for a while. You might even get the facility staff involved in the "drug study" and see if they will play along.

Of if she likes the attention maybe scheduling a weekly hair appointment, a monthly mani-pedi take her to a store once in a while to a make up counter and get her "made up".

My MIL demanded new knees from her doctors last year. They just sort of told her that she had to start moving around and they had to address her other health issues first and that surgery would not be good as it might cause her more harm.
So she thinks that things will get better and she will have new knees again for the second time.
She has ALZ and kidney failure combines with CHF. She will never be a candidate for any major surgery again.

I have an idea. Seems to me that maybe she likes to be fussed over. So...weekly hair appointments? Get the nails done? Any other spa type treatment she might enjoy?
I think she would enjoy pampering! I know I do.

My dad is 92 and going through the same thing. He walks with a walker. He has a bad knee because of a couple falls and is insistent he get surgery. I really think they are shining him on, however. The doctor told him they can't do surgery because he has arthritis (don't they do surgery for arthritis? Maybe I'm wrong). Guess it might require a full joint surgery. He is also diabetic. He has this idea that if he gets the surgery, he'll just come home and be walking normally again. I've tried to explain to him that it would be many months in rehab. On the other hand, it would finally get him out of his house. He is refusing to move and I was told the other day he is on the verge of needing memory care. He has said in the past that he expects to live to be 100...........

Hi Can’t Dance,

We are in the same boat! My mom is 93 like yours. Think they will make it to 100? Will we be in a mental ward of a hospital by then, a mental hospital or God forbid, will we be dead, they finally did us in!? HaHa, I am being quite a smarty pants today!

Anyway, my mom’s doctor says no to any surgeries at age 93 and I wholeheartedly agree! It’s not a financial issue but a safety issue, a 93 year old woman with Parkinson’s has no business getting surgery.

My mom has the bone on bone thing too. It is painful and I wish they didn’t hurt. My mom knows better than to even consider surgeries. But they do LOVE telling the doctor all of their complaints which I get. Here’s the thing though. My mom gets the answers how to treat, says yes to the doctor about advice but on the way home in car, says to me that she isn’t going to follow doctor’s advice. I say, “Mom, then why did you ask about it, if you don’t want the answer?” It’s a vicious cycle. They are bored. All her friends are dead. Most of the family is dead. My brothers don’t visit. She just has me. Too much togetherness! Sad. She won’t go to the senior center. I even told her that I wanted to go and have lunch there. She still won’t go but truly amazing how they can hop in the car or in my mom’s case, struggle to get in the car to visit the doctor only to ignore the doctor’s advice!

It must be quite frustrating, but, I'd take comfort that you have considered the options and made decisions based on her best interest. I'd try to remember that as her memory fades, she may forget that she likes medical treatments, attention with unnecessary medical care, etc. and you don't have to keep dealing with this kind of stress.

I'm not sure you'll appreciate this but I do mean it as a compliment: I think you're already handling this in text book fashion.

The root canals: correct decision. You weighed up the risks and benefits, you also gave due weight to the decision your mother would have made on her own account were she able to. One might privately think there wasn't a heck of a lot to gain from it at this point... But, people spend a lot of money on pointless things, do they not? Why not your mother, if there was no major drawback to set against it?

With the knee surgery, the risks are far more significant, and your mother's specialist is not recommending it, and the benefits to be gained are far from certain given that your mother's mobility is pretty good. If she were unable to move because of the pain or the joint were wrecked in a fall it might be different; but as it is your mother is scooting about the place and you can't be nearly sure enough that the surgery would improve matters for her - on the contrary, and that's why her surgeon isn't in favour.

Reasoning is useless; and besides it's exactly because your mother can't do her own reasoning that you have taken it over on her behalf. All I can suggest is that you get a bit creative with the wrangling, if only to give yourself some light relief. E.g., um... the surgeon is waiting for more results. The prosthetics factory has burned down/is being sued/can't get the parts. The insurer is processing the application. A new bionic knee joint is about to get FDA approval (do they do prosthetics?) so let's hold off awhile...

I would hope that you could tell her ( each time if need be ) that the doctor refuses to do said surgery due to her age and complications after. Maybe you could get a simple note from the office. Make copies and tape it to her refrigerator. Copies would be for the event of notes disappearing. She can't force a surgery. Then I would just carry on without being consumed. It is how I handle my mother telling me about the weight she has lost, is going to lose etc. In her earlier years it was what I did when listening to her tell me she was going to move to Paris. She only mainly gains weight and has not moved abroad.

This is called “Factitious Disorder”, formerly known as Munchausen Syndrome and also hypochondria. It is a mental disorder/illness and is seen in those who have possibly been abused earlier in life. Doctors seem to have been making money off your mom and her insurance for years. Perhaps one more doctor, a geriatric psychiatrist, would be in order to save your sanity. You can also play out the therapeutic fib and, if you know her doctor well, stage a scene where the doctor promises to schedule a surgery, for whatever, and the surgery just keeps getting put off. If she thinks it’s going to happen at some point, the “wrangling may stop.

Hi 97,

Thanks for your response. Mom's orthopedist ordered visiting PT for Mom at Memory care. Three times a week a technician came out to help her learn how to use her walker more efficiently. She forgot everything she was taught and continues to hunch over it, but boy can she get around in that thing!

I thought for a moment that you were talking about MY mother.

Never met a surgery she didn't like/want.

She's had over 60 surgeries of some kind in her life (89) and is still on the lookout for something she hasn't had done yet, but might need.

It's a mental condition, I don't know what it's called. At age 86 her orthopedic doc said "NO MORE" and shut her file and refuses to even see her. She's 89 now and looks 100.

She has a permanent catheter (I shudder to even think of living with that!) after about 6-7 surgeries to "lift" her bladder failed. 4 back surgeries. Both knees replaced, one hip, wants the other one done, but can't get a doc to do it....stomach and throat surgeries, shoulders, elbows, appendectomy (her appendix was FINE), and the funniest one--she has not had her gallbladder out, but I had mine out 23 years ago and she has "borrowed" my story about it and tells people this is what happened to her.

So weird.

She adored the attention after each surgery, Just wallowed in it. A lot happened after I left home and I never even knew she'd had them done, I was not that invested in her day to day.

She did receive PT after ALL surgeries that would have messed with her walking or moving. She'd do fine until the PT was done and then she never so much as did one exercise again.

She complains of being "tied" to her walker. but brother can see her in her apartment from his yard and he says he sees her bopping around w/ o the walked all the time. So--impossible to judge what she really NEEDS vs what she wants.

One possible option might be to tell her that if she has the operation she will need to go into care for the recuperation period, and it will be for several weeks as you cannot provide that level of total care. Would that solution solve your problem, or stop the conversations if she doesn't want it?

The fact that her doctor doesn’t recommend the surgery would give me pause. My aunt had hers replaced at that age. No problem but no dementia either. My mom, sister to the aunt above, used therapy instead to strengthen the muscles supporting her knee and a rotator cuff issue. Ask your mom’s primary to order the therapy. Your mom sounds like she has a good attitude and could benefit. It will also help with her balance.