Worried about dementia worsening after anesthesia. What might we expect?

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?

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.

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.

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.

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???

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.....

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.

My mother (age 83, mild dementia) had shoulder replacement surgery in mid-March 2019. Her cognitive function took a deep dive in the two weeks immediately after surgery when she was in rehab. Now that she's home it's gotten slightly better but I think it's leveled off at a worse point than before surgery. We knew this was a possibility prior to the surgery but her shoulder was in so much pain and she doesn't have any chronic ailments it seemed worth it for her to go ahead with it. Now that she's ended up worse than where she was I am definitely having second thoughts about whether she benefited enough from the surgery. The silver lining, I supposed, is that. as with good and useful memories, her memory regarding her pain level is also pretty gone too.

On a related subject, throughout my mom's process I realized that it no longer makes a lot of sense for doctors, nurses, or rehab people to ask her to rate her pain level. She would tell me it was excruciating one minute and then when they asked her a short time later if she needed anything for pain she would say, "No, it's only about a 2." After about 3 days of that I asked the nursing staff at the rehab to just give her whatever was prescribed.

Your intuition is accurate. It Always is.
The anesthesia drugs used are Highly toxic, and put an added load on an already compromised system. Therefore her health should be as close to 'optimal' for someone in her age group as possible before surgery
I work in medicine, so can give you a few simple insights and suggestions
a. a full blood work up is standard procedure before any surgery. You are entitled by law to a copy of the test results. Carefully check
a. Haemoglobin (iron complex that carries oxygen to the cells of the body)
It should be a 'optimal' levels not 'acceptable'. Low hemoglobin &/or iron make
it very difficult for the body to heal/recover.
b. Liver test. The liver is an organ that is responsible for making all toxic substances in the body water soluble so they can then be eliminated
Enzyme levels for the liver should be relatively close to "ideal" before surgery
You can google for acceptable & ideal levels. And blood test result sheets are easy to read (believe it or not :)
If results of the above are low I highly recommend you have the surgery delayed and work on building up your Mothers health until the results Are ideal
Waiting a month (or two) will not add to her health problems, however doing surgery while her health is suboptimal Will most defiantly add to her rapid decline
Also, Turmeric Power is a powerful pain reliever...and very beneficial in those with dementia. It is more powerful pain relief than any of the pain relief and anti inflammatory drugs (other than narcotics eg percodan, morphia, vicodin's etc)
So giving your Mother Tumeric 3 times daily before her meals will
a. relieve the pain from her back markedly
b. improve her mental clarity ie. reduce the dementia
Do not give her capsules with added pepper (black or white) or standardized etc
Just the plain organic turmeric powder....a wholesome food...the way it comes from the earth
Mix 1tspn with 1/4 Cup of warm distilled water
1teaspoon raw honey
2Tblspns plain full fat yogurt (goats is best yoghurt)
This will not interfere with any of the medications she is currently on. Has no side effects, and many side benefits
There are numbers of medical studies on the 'pain relieving and anti inflammatory benefits of tumeric". "the benefits of turmeric for people suffering dementia"
I have a grandfather with dementia and large helpings of denial. Some days he can't wash a cup in the sink or remember how to stack plates in the cupboard.
And is very mean, irrational and critical to & of me. Sometimes I tell him I am not going to spend time with him anymore he's so irrational and spiteful
Its very painful. I have cried, begged, screamed, slammed doors...the whole gamut
On the days he takes the tumeric as described above (I also add 1tspn of Moringa for him) he loses the dull grey blanket like effect in his face and brain and is bright, vivacious , and my grandfather & friend again
I have no doubt if he did this daily he would be stable. But unfortunately he doesn't . However, I am grateful that I have the knowledge and herbs to help him
Do the research and trust yourself. And remember the drug companies own sites like webmd.com and drugs.com So look further afield. The NIH ..national institute of health have impartial (not paid for by drug companies) studies that worth reading. Do not expect your surgeon to concur.
Last point: You may be warned the tumeric interacts with blood thinner medicine and can cause problems. It does not in my clinical experience, and that of a number of other medical professionals I know
Good luck on your journey
Your Mother is fortunate to have such a caring daughter

I know anesthesia is dangerous for all ages, but especially for seniors. I would arrange for a consultation with a highly qualified anesthesiologist and also with your doctor - and get another opinion beyond that. I don't know about mental issues but I know there is a great danger of a stroke. I for one, even though I need two surgeries, will never allow them - far too dangerous. I don't care if I died but what if I had a stroke and I become a worse misfit than I am now where I can't walk. NO way!