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

My husband was 71 when he had back surgery. He was in the early stages of Lewy Body Dementia at that time. He had been having hallucinations before the surgery but during his time in the hospital they became worse. His doctor said it was due to the Anastasia and was not unusual. When I took him home he was no worse off than he was before. Of course the disease continued to progress. I do not know if the Anastasia caused it to progress more rapidly or it was the natural order of progression. It seemed like the progression was slow until about 2 yrs after the surgery, so it seems to me that the surgery had little affect aside from the confusion and hallucinations in the hospital.

Agingparents, your Mom probably has had the surgery by now? How is she doing?

It’s going to affect her mental status. It did for my mother. She had a mastectomy, hip repair & a CABG in her 80’s.
The last one, the hip surgery anesthesia, tipped her over to where afterwards she forgot who we were about 4-6 months after this surgery. She was never mentally the same.

I wish my mother didn't have her triple by-pass heart surgery a few years ago. Maybe it did contribute to her Alzheimer's, maybe it didn't.

The point is that my mother would have died of heart disease when she was in her late 70s having lived a full life. But no, she's going to languish for the next 10 years having no quality of life and die in diapers and bed-ridden with half a brain. Not a choice she would have made if she knew. Not a choice I will make for myself.

You say the surgery is a fusion above and below the original fusion. Did they tell you that once you start with fusion you are chasing it all up and down the spine. She will require a third surgery when her weakened back starts hurting and it will be above and below again and again.

My husband was very blessed to have a surgeon explain why he as a world renowned back doctor would not do any fusion surgery. He said that the risk is higher for a bad outcome than the possible benefits. Obviously there are back surgeries that are required, but this doctor had the highest level of integrity I have ever witnessed in a medical professional.

Ask the doctor about her future prognosis, Google it, you may find alternative medicines will give her a better quality of life.

Regardless of the route you choose, I pray that she does well and that the dementia is not increased.

My mother in law did not have anesthesia, but she does have Alz/dementia and she did get delirium from the hospital stay.(except we didn't know what it was then)
We moved my 92 year old MIL to a memory care center the first week of Oct last year. Good and bad days, but still pretty with it, just no longer able to care for herself or be left alone.
Third week of Oct she was taken by ambulance to the emergency room and admitted for diverticulitis.
This woman who was up, walking and talking the day before was now almost catatonic, lying in the bed with her mouth completely hanging open. Eyes vacant, unable to feed herself even with help, could barely speak and when she did it was complete confusion. She was only on an antibiotic and her BP pills, So I believe it was the hospital stay and not medication related.
She would scream and cry in terror when the nurses would roll her over in the bed to change the sheets. She would scream in fear in the middle of the night. I and my husband took turns staying with her 24/7 because despite what we kept telling them, that she was nothing like this the day before, the hospital staff gave up on her. They just saw a demented old lady that looked like she was dying.

I had to spoon feed her all her meals. The hospital had palliative care come and talk to us. No one ever mentioned delirium, it wasn't until I was researching what could have happened did I come across it
We got her out ASAP, the Dr was great working with us to discharge her to a rehab facility.

We had no idea what was going on, or if this was the end. In the rehab facility she could get around in a wheelchair on her own, still very confused but eating on her own and doing better. After approx. 3 weeks we got her sent back to the memory center. Now she is back to walking with a walker, eating on her own, still confused, but you can have a conversation with her. I think it made the Alz/dementia worse but she did come a long way back to where she was before the hospital stay.
If delirium does happen, don't give up, it may improve with time.

I think a long hospital stay is more unsettling than the anesthesia. Every doctor coming through May add a new/different pill to her standard regimen. Try to get her out of the hospital as soon as possible. If any medications are added, make sure they are needed.

I wish I hadn't come in on this conversation. I'm 72. I require heart surgery. If I don't have it, I will die of heart failure. I don't need to be more scared out of my mind. What we need here is a professional opinion, not anecdotes. The only comment that came close to professional was sunshinelife. Nurse? Is there are cardiologist in the house?

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!

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 read somewhere one time about giving the anesthesia through an IV instead of a breathing mask.  It made the after effects less?  Maybe research that and talk to her doctor.

I wish I had known about the effects of anesthesia on seniors prior to my husbands recent operation. Perhaps, I could have helped him prepare and perhaps mitigate possible problems and pain.

My husband had a six hour robotic prostate surgery on May 1st. The doctor said the surgery was successful. Some warnings concerning post opt from this doctor were as follows: he might be constipated, have possible urine dripping and possible infections. Further, his doctor bragged that his patients only stay 23 hours after surgery to avoid possible hospital delirium and infection.

His doctor never mentioned anything about the possible effects of anesthesia on my 73 year old husband that already had some cognitive decline prior to the procedure. So, my husband went home soon after the surgery and 2 days later I had to rush him to the ER. My husband was admitted to the hospital with kidney failure, a UTI, malnutrition, and an assortment of other problems.

One of the serious problems was my husband's mental state- he had and still has the following by varying degree's: confusion, hallucinations, and a pronounced increase in dementia traits. The hospital ruled out metabolic reasons for his problems via various blood work and testing. Meanwhile, my poor husband could not sleep in the hospital and he became delirious. He didn't know his name or who I was and his speech was garbled. It was horrible.

After my husband got some sleep he became more clear in thinking and speaking but still exhibited dementia traits. Now he is in rehab and has been greatly weakened by his hospital stay and the host of medical problems that were mostly caused by his May 1st medical procedure. And I don't know if his mind is going to come back. And they put him on Zyprexia.

After rehab, it has been recommended that I put him in a permanent facility. The cost of decent ( not even great) facilities is about 400.00 dollars a day, all of his social security and paying down his/my assets until he /we have no money at all. I don't want to put him in a facility for the rest of his life. And I don't have the financial or physical wherewithal( I was diagnosed with cancer about a year ago) or other resources to get/give him the constant care he needs in our home.

When he was home, I had problems trying to get him to eat enough or drink adequte amounts of water. He is vegan and very picky. And he fell down the stairs a few times. Very scary. Prior to his ER visit he waking me up several times a night for ridiculous reasons like he thought it was trash day and it wasn't or he couldn't find his wallet,etc. He has moments/times of lucidity. But, his overall mental state has greatly declined.

Currently.
To assist him in healing at rehab, I have been bringing him healthy organic foods, smoothies, supplements, certain herbs and spices, pure water, exercise ( gently helping him move his arms and legs), taking him into the sunshine, detox via herbs and spices and some fruits ( like lemon), music ( particular solfeggio and other frequency music) , energy work like massage, reiki and reflexology. I try to get him to watch funny movies. And I'm encouraging social support ( get his friends and my family to visit and/or call and/or send him cards). And I am an active advocate on his behalf. And most importantly prayer. Lots and lots of prayer.

My husband had to have prostate surgery as his prostate was so large it was blocking other organs. And to add to the mix , he also had reconstructive surgery.

However, I would recommend that people consider all surgeries very carefully before doing it. And clean up current lifestyle choices ( eating properly, drinking water, sleeping, dealing with stress, getting in touch with their spirituality, etc)

G-d bless all of you that have been touched by dementia or other cognitive problems. I personally don't believe that this disease cannot improve and/or even be reversible.

As I'm not a medical professional, I urge you to go online and read all that you find on your question - pros and cons. Just yesterday on here, someone posted a negative effect about anesthesia and Alzheimer's.

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.

I'd also consider what she's going to need post surgery. How are the hospital staff going to keep her confined in bed? She may decide to pull out IV lines or bend in ways that the doctors say avoid. Would they use restraints to protect her?

If she wakes up with a decrease in cognition and/or memory, she may need 24/7 direct supervision and most hospitals aren't equipped for that. And, would she be able to process and understand the pain she's going to have. People with cognitive decline may not be able to understand the cost benefit of having the pain to reap the rewards later on, so they just know they hurt and are hard to console. And, they may not be capable of physical therapy.

I'd bluntly confront sister and ask that she discuss in detail with the doctor, all of the practical and very real risk and outcomes. Orthopadic surgeons don't really understand dementia, based on what I have seen, as to how a patient recovers and how they need to be mentally able to follow instruction.

I hope things work out. Please post with an update if you can.

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.

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?

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.

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.

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.....

I have to ask why she is having the surgery?
Even if the anesthesia does not effect her will she comprehend rehab? Will she follow through after rehab? Will having the surgery greatly improve her life?
If you answered "NO" to any of these it might be a good idea to rethink the surgery. If she has a neurologist I would have a talk with him or her and express your concerns. (If it is the neurologist that is suggesting the surgery that is another story)
My opinion if it would not greatly improve her life I would opt not to have surgery.
My Husband had been diagnosed with dementia when he broke his hip and the time he spent in the hospital was a nightmare for him as well as for me.

my husband and myself we told the same thing. He didn’t change to much mentally but he became incontinent. Doctors said it was expected.

My husband had 2 episodes last year that put him in the emergency room for a day. He became dehydrated to the point where he had trouble standing. He went by ambulance each time. After each episode I noticed he was more confused. So more confusion comes when they are sick, I think. Anyone else find that?

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.

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 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.

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.