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My mom is in her mid-70s and she has significant dementia. She is undergoing her second back surgery next week. It is my understanding that the anesthesia could likely worsen her dementia exponentially. Any input on what we might expect mentally, post op? I'm not her POA, my sister is, and she does not seem concerned about the dementia element. I'm trying to prepare myself for the inevitable.

As a nurse I saw many seniors have dementia after surgery who did not have it going in. Recent studies show this not to be true or lasting, but I would swear to it. And I did hear from families that some of the dementia that seemed hospital induced improved at home for those seniors who had really bad episodes in the hospital. But I think to be aware that she will DEFINITELY be worse at least IN hospital is wise. I don't think you can in any way predict how this will go. Is the surgery ABSOLUTELY needed?
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anonymous882484 May 17, 2019
Apparently so. I just know it is going to be awful. I appreciate your answer it helps a lot.
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From my experience only. My mother at age 85 went in for carpel tunnel. Left my side, came back not 15 minutes later. The woman that went in , was not the woman she was when she came out. My mother, as we knew her, was gone. Then 2 yrs after that, she had a knee replacement. By this time we pleaded with the doctor that this was not a good idea due to what happened previously. She was insisting on the surgery, the doctor “saw no problem as she was relatively healthy and had a few good years on her yet”. My mother insisted very loud she WAS going to have the surgery. The surgery was done, then they sent her to rehab for a week for therapy. She did great in rehab. When she came home the problems started. She refused to do the exercises “it was too painful”. A month later they had to put her under again to bust up the scar tissue that formed because she didn’t do the exercises. To make a very long story shorter, My mother has been a pain in butt since. She is selfish, thinks of no one but herself, argues to get her way about every little thing! This is not my mother. She went from the quiet little lady who would give you the shirt off her back, or anything else she could, to being manipulative to get what she wants regardless of if it was safe for her or not. Her reasoning skills are totally gone. We have had fires in the kitchen, stove, oven even in the microwave. She is so mixed up about things at times it is hard to deal with.
Since the surgeries she was diagnosed with dementia. Something she did not have before. We are 10 yrs down the road now, she can not be left alone, she can not do anything that she did in her pre-surgery days. She was a fabulous seamstress, cook, Baker, Now everyday is a struggle with her. She can not follow directions, physical or verbal. She thinks nothing is wrong with her, only a little forgetful. So she tries to do everything she did before, which leads to a lot of frustration. Both for her and me! She lies to make herself look like it’s everyone else and not her problems. And she could be Oscar worthy for her “Showtime” performances. It has been a very tough 10 years. I moved in 5 yrs ago after my father passed so she wouldn’t have to move out of her home. My life is constantly following her around the house making sure she doesn’t do anything to harm herself, Yet she still wants to do everything she did many years ago. Make quilts, food for everyone, travel and anything else she can think of. If your mother has the surgery, make sure you have help. To take her on yourself, is literally a 24/7 job. 4 hours sleep a night is a luxury that does not happen often. Just prepare yourself if things go downhill. And from my perspective, the only way is downhill.
I wish you Luck. Stamina. Patience. And everything else good. And stay on this forum. It can literally be a lifeline for you.
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Why is your mom having her second back surgery? Is it really necessary? Is she in constant pain? Or life or death? It seems that there is a lot of unnecessary surgerys going on with the elderly, especially with alzheimer's and dementia patients. My mom is 85 and could use a knee replacement, but her doctors have not reccomend it, because of her age, and she doesn't have dementia or alzheimers. She does therapy and takes occasional shots. I would have a talk with your sister and let her know your concerns, if she doesn't listen, then all you can do is say you tried. Maybe you could look up articles for your sister about the effects of anesthesia on patients with dementia or alzheimers. Hope this helps.
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anonymous882484 May 17, 2019
Constant pain is the issue. The first surgery was a fusion and this second one is another fusion - one above and one below the original fusion.
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i went through this with my stepmom. After surgery, she went down hill quickly. Her short term memory was gone. Her motor skills were bad and had to learn simple things again. She has never been the same. It’s been a year and a half and she is now in memory care with my dad. As they say, prepare for the worst- hope for the best. Good luck.
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Reply to Bobandflo
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What does mom’s neurologist say? S/he is the best person to advise you. Other docs are not trained on dementia to know the full effects.

I agree with the previous poster that many people with dementia have surgeries too. From my experience, my husband’s neurologist is always reluctant to advise anything that would negatively affect the mind, esp anesthesia. But how can one have surgery without it???
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moms2nddaughter May 16, 2019
He said he did not think it was going to make a difference one way or the other. When I told him about the carport tunnel surgery he just kind of snickered and said well I don’t think they’re gonna have a problem. Along with a few other comments he made, and back to him since that time!
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I'm dealing with this issue right now. My 84 yo mom had cataract surgery on both eyes at the beginning of this year. Up until then she had not been diagnosed with dementia, but after the second surgery she became much more forgetful and obsessive. It was this forum that alerted me to the concerns about anesthesia and dementia so I contacted her doctors immediately. Her neurologist examined her and diagnosed her with the beginning stages of dementia and ALZ - something he did not do just a month before at her previous visit. We cancelled a scheduled colonoscopy and opted for an MRI that gave us the same information without anesthesia. Not only have both my mom's MD and her neurologist strongly warned against sedation, so did our lawyer (an elder care specialist who personally handles several clients' affairs). Today we have an appt with an oral surgeon - her dentist says that her teeth are failing and she needs them removed and replaced with dentures. All well and fine if you don't have dementia. My mom has had two visits to the dentist already this year for infected gums, but I don't know what the oral surgeon can offer as suggestions. We shall see.

Please don't take the idea of dementia and sedation lightly. I'd also suggest you make sure, now, that you (or whomever is/will be her agent) have all the appropriate paperwork including your mom's POA and Powers of Health Care or living will. (At a recent visit with our attorney I found out that our state just created a new, stronger form of POA and it was recommended that we switch to it.)

I'm not sure what the answer is regarding surgery that isn't absolute essential. Get all the additional, informed and professional opinions available, I guess.....
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cetude May 16, 2019
There is increased risk with anesthesia. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3939441/
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In my opinion anesthesia kills the mind. My friend’s memory test score was a 14 and lived in AL memory floor. I could even take him to FL for a couple weeks at a time. He fell and broke his femur at the hip and had to have surgery. After 6 weeks in rehab he scored a 6 and ended up in Skilled Care. I could never take him back to Fl but at that point with his decline in memory he really didn’t remember it. It was downhill from the point of surgery. Fortunately he remained a fairly good humored person throughout his dementia. If the surgery is not an absolute necessity, I would say do not do it.
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Reply to Barb53
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Delerium is a big concern but it is the timing and ability to come out of it that could have lasting effects. Keep in mind that many Alzheimer's patients have surgery. Staff will deal with the medications to reduce her anxiety. If there is a possibility of a better quality of life then go for it.
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Reply to MACinCT
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In my opinion, it's more about taking longer to get out of their system. Plus whatever pain meds they use post op. It's best to stop the pain meds as quickly as possible and it still may take a couple of weeks before you see the old normal again.
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Reply to my2cents
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It is a risk you have to take, and yes anesthesia may have issues-- once they go into delirium they do NOT recover and becomes a new level of disability. I do not think it is the anesthesia so much as to hospital delirium which drugs can exacerbate.

Your doctor should discuss risks vs benefit. Let me assure you surgery has risk.
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50sChild May 16, 2019
Cetude, it's possible that delerium often precedes the outcome you describe and the following experience may be rare and extremely lucky. But my husband (87) had lengthy surgeries in 2015 and 2016 (heart, spine). Though he experienced delirium, he stabilized and actually somehow his brain adapted. He experienced terrors, etc., but he came fully back within six months. His doctors now think he's in his 60s cognitiively. I know this may be rare, but I'm just not sure that delirium always leads permanently downward. However, hospital delirium ("failure to thrive") quickly brought my mother down (1 week in hospital, then died).
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