Is it viable/wise for Dad (84, dementia) to have operations?

[SheWolf]

Thanks Tristesa, I'm glad you understand. I'm finding the balancing act a bit hard at the moment and constantly worry that I'm getting it all wrong. I know you've got your own worries and some tough decisions to make, so thanks for taking time to respond.

[Anne001]

Sorry, She-Wolf, I am coming late to this. I do know that anaesthetic can worsen dementia symptoms. However, mum had her cataract done as a day patient and coped with it very well. No problems at all. Maybe your dad could at least have that done to enhance his quality of life (all the better to see the booze with!).

[SheWolf]

Yes, indeed Anne! It's funny you should say that, because once when I took him to the pub he became fixated on some bottles of whisky on shelves behind the bar - stupidly I'd not noticed them when we sat down, right opposite them! I never made that mistake again! He can't seem to read what's right in front of him these days, but could probably spot a whisky bottle a mile away!

Sometimes I ponder on the "demon drink" and wonder if alcohol has, on balance, brought more misery than happiness to human beings? Or maybe it's vice versa. For most people it doesn't become an issue, but for the minority who become addicted, and their families, alcohol can definitely be more of a curse than a blessing.

[SheWolf]

Well, the optician checked Dad's eyes and confirmed what I suspected - the cataracts have got worse. Luckily one eye is not too bad yet, but the other eye has worsened and he needs the op. Optician will write to GP requesting a referral to the eye specialist and we'll take things from there. I remember Mum struggled to keep her eye still for the op, so goodness knows how Dad will cope with that aspect, with dementia affecting his short term memory so badly - maybe the consultant will have to constantly shout at him to keep still (Dad is quite deaf), but hopefully if we can just get him through this op and give him decent sight again that will improve his quality of life a bit.

Dad has already forgotten seeing the optician or that he needs the op. Well, at least he won't be worrying about it (I am though).

[Jade]

Dementia risk may be higher for older people who have general anaesthetics.

http://www.theguardian.com/society/2013 ... f-comments

[SheWolf]

Jade, thanks for the link. I read the article but to me it seems a fairly inconclusive study and the fact that the subjects were all 65 to begin with would mean that a fair proportion would develop dementia 10 years later anyway, with or without a GA.

As far as Dad is concerned, I have decided I will push for him to have the op done, even if they have to do it under GA, because I believe that saving his eyesight is vital to maintain some quality of life for him. Dementia is, in effect, brain failure, and there is no cure. I figure that in his position I'd rather save my eyesight, than go blind in a vain attempt not to make the dementia worse, which is going to happen anyway. I'd rather live a year longer with good eyesight, than 5 years longer with poor/no eyesight and end stage dementia. It's very hard weighing things up but I'm convinced that this op is necessary for my father, even with GA.

[crocus]

Shewolf, I quite agree with everything you have said and fortunately cataract surgery is usually done under local anaesthetic Jade.

[SheWolf]

Thanks crocus. I'm so anxious about it all, because with Dad's deafness he will struggle to hear the surgeon's instructions, and with the dementia his short term memory is almost non existent, so I have worries about him not being very cooperative and maybe even trying to get up and leave halfway through the op! On the other hand, they must have many patients who have dementia and hearing problems, so hopefully they've found a way of dealing with them. Also, I've been told that sometimes the procedure can be done using laser surgery, which is quicker, apparently? We might have to go private for that option, but I can think of no better use for Dad's remaining savings, if it is the only way to save his sight.

[crocus]

Ive not heard of laser being used for the actual cataract op SW, although it is often used afterwards if you get cells growing at the back of the new lens. Sometimes people get confused about this and think that the cataract has regrown and the laser is removing this "new cataract".

[SheWolf]

Thanks crocus.

Dad has now been assessed and the doctor said they will do the operation, but due to the added complications (dementia/deafness) they said he has to go to another hospital for the op, which deals with the more complex cases. The waiting list is 3 months, which would take us into the Christmas/New Year holiday period which may well add to the wait, so we decided to have the operation done at a private hospital. Cost is around £2,400 including sedation, for one eye. They will not use GA but will "freeze" the eye completely if necessary, due to Dad not being good with hearing/following instructions (the medics struggled getting him to keep still etc for the tests).

So Dad will have his private op in a couple of weeks and maybe have the other eye done on the NHS when/if it needs doing. The carers will put in the eye drops for him, but I'm concerned about the infection risk afterwards, as Dad is not good on the personal hygiene front (doesn't often wash his hands after the toilet, etc). One thing I can do is to give his nails a thorough clean and cut them short, just before the operation. (He doesn't often let the carers do them and they sometimes get filthy, long and ragged, between my manicure sessions.) I'd hate the surgeon's good work to be undermined by him rubbing his eye with filthy nails and scratching it. (Probably overworrying but have to do what I can to get him through this op.)