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I had previously written for advice about traveling with my 92 year old dad who has dementia. Thank you EVERYONE for your answers. And I did talk to the geriatric psych the other day who did not recommend it. Now, a new subject...... My dad fell twice last year and has been having knee trouble ever since. They have put him through several rounds of in-home physical and occupational therapy and he takes pain killers for various aches and pains he has had through the years, including his knee. He does not abuse them. Last fall, they prescribed him a gel to put on his knee 3 times a day for pain. They told him he has arthritis. He is insistent that something else be done. He gets skin tears on his calves and was at the doctor's office the other day to have bandages checked by the nurse. He asked her about having something done for his knee and she told him there was nothing they could do.


Now he is threatening to find a new doctor (he has changed doctors before when he didn't like answers he was getting.) I explained to him that it was the nurse who told him this and to wait and discuss the subject with his primary care doctor at his regular appointment next month. I am very pleased with the care they give him and I would not approve of a physician change. My dad is frail, but he is still mobile. He takes multiple walks with his walker up and down the street every day. The caregivers get him out to run errands every day. I explained to him that if they did agree to do surgery, he would need to go to rehab for a long time to recover. He did not understand this and doesn't understand why he couldn't just come home (not a safe house for someone recovering from knee surgery). In my mind, he may never come home to his house - that he would have a tough time recovering from something like this. I was appointed guardian this fall and if it was my choice, I would not agree to a surgery but then again, I believe that as guardian, I am supposed to do what he wishes. Has anyone dealt with surgery and recovery for someone in their 90's?

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There has been a lot of medical news here about patient problems and tax payers costs from medical interventions that do not have reliably good results but are favoured by some doctors. Knee replacement surgery was high on the list.
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Reply to MargaretMcKen
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My aunt, diabetic, in dialysis and in her 90s had knee replacement surgery. No problem. BUT she had 30 years previously had the same knee replaced. It had worn out. The only choice she had was knee surgery or the wheel chair. She did not have dementia and made her own decisions. It was tough but she made it fine.

But I would not do it with a different aunt (92) who does have dementia.

I would keep the therapy going. It’s a wonderful way to keep the strength in his muscles to support his knee.

Sorry, no disrespect meant, but I wouldn’t have the cortisone shot either unless it was a last resort. There are always side effects.
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Reply to 97yroldmom
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No, I wouldn't do surgery. As guardian you do what is best for Dad. The whole reason for guardianship is because Dad has been found incompetent. I feel the first thing that goes with Dementia is the ability to reason. Your Dad cannot make informed decisions. He just has this in his head and ur not going to be able to change his mind.

The diabetes makes it hard to heal. Surgery will only make his Dementia worse.
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Reply to JoAnn29
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Babs75 Jan 7, 2019
Thank you. I think I will talk to his primary care before his appointment next month. I will ask about a cortisone shot and also see if we can do another round of physical/occupational therapy (we have a great service here that comes to his house).
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How about asking MD to give him a cortisone injection to help with pain?
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Reply to dwilkrn
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Just a question, but if he can take walks everyday & also go out for errands everyday, is he really at the point of needing surgery? Especially for someone in a high risk category!

In May my 89 year old FIL had outpatient hernia surgery. It had gotten to the point that it HAD to be fixed. He was as healthy as someone his age could be, mind still sharp as a tack, driving, cutting his own 2 acre lawn. Four weeks after surgery he was dead. Surgery is very hard on the elderly.
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Reply to mollymoose
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Surgery of any kind for someone your dad’s age is risky. The anesthesia can exacerbate the dementia. I’ve read many times here that when people with dementia have surgery, their condition deteriorated rapidly and poster’s have said its due to the anesthesia. Dad may expect the surgery will.make him 25 years old again and that wont happen. In a way, having had knee and hip surgery myself, I understand that Dad may also have a hope of being pain-free. Rehab after surgery is an incredible amount of hard work, even for someone much younger. If Dad is stubborn and won’t cooperate with the therapists, they will release him from rehab due to lack of cooperation/progress. Then your idea of him not being able to live on his own will, unfortunately become a reality.

Have his doctor speak with dad in terms he will comprehend. If Dad’s dementia is severe, you could also use the therapeutic fib and tell him the surgeon’s schedule is full for now and he has to wait for an opening.
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Reply to Ahmijoy
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