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Cataract surgery??
DEBSII
Posted: Tuesday, March 26, 2013 11:10 AM
Joined: 5/29/2012
Posts: 12


My mom has been at a SNU for 2 years. I feel that she is in stage 6-7. My question is regarding having cataract surgery.

She has an appt. coming up to check her vision, we already know she has cataracts.

She may now have no vision or very little.

When she looks at us, she is not 'seeing' us.

frequently keeps eyes closed, even when awake.

Wheels wheelchair, frequently, with eyes closed.

Over reaches and sometimes reaches for things not there.

My opinion is that alzheimer's already has impaired her quality of life, so SEVERELY, that I see no benefit to restoring her vision. She doesn't seem to notice vision loss (if that's what they find)

Please post opinions and things to ask/look into. I need other's point of view, in order to make the best decision.


Unforgiven
Posted: Tuesday, March 26, 2013 11:21 AM
Joined: 1/28/2013
Posts: 2659


DEBSII wrote:

My mom has been at a SNU for 2 years. I feel that she is in stage 6-7. My question is regarding having cataract surgery.

She has an appt. coming up to check her vision, we already know she has cataracts.

She may now have no vision or very little.

When she looks at us, she is not 'seeing' us.

frequently keeps eyes closed, even when awake.

Wheels wheelchair, frequently, with eyes closed.

Over reaches and sometimes reaches for things not there.

My opinion is that alzheimer's already has impaired her quality of life, so SEVERELY, that I see no benefit to restoring her vision. She doesn't seem to notice vision loss (if that's what they find)

Please post opinions and things to ask/look into. I need other's point of view, in order to make the best decision.

You need to consider risks versus benefits. Any kind of eye surgery is traumatic, and would require general anesthesia.  Perhaps you need to ask for the opinion of both her eye doctor and her geriactric care physician -- the one  who is dealing with her cognitive issues.  Between the two of them, they could tell you whether it's a good idea or  not.

SunnyCA
Posted: Tuesday, March 26, 2013 11:21 AM
Joined: 2/14/2012
Posts: 1752


OK, I'll play devil's advocate ...  Perhaps the cataracts are affecting her vision so severely that it's severely affecting her quality of life.  How would you like to be cognitively impaired and blind on top of that?

 

The question, to my mind, is whether she is stage 6, or might not be that far along but is unable to function well because she can't see.

 

Next question:  would she be able to comply with post-op care if she had the surgery?  Basically, she shouldn't bend over or pick up anything really heavy, and she shouldn't rub her eyes.  (You can put a patch over the eye -- they operate on one at a time -- or have her wear a pair of glasses. I had my husband wear the dark glasses that they give the patient to wear going home, to protect them from the sun, and that worked surprisingly well.)

 

I'd suggest that you discuss such issues very frankly with the surgeon.  My husband's ophthalmologist and surgeon were very helpful in going over the pro's and con's, and quite experienced in working with dementia patients.  My husband was not as far along as your mom, but still, I was worried how he'd handle the surgery -- which he was very reluctant to have.  He did extremely well, and was absolutely thrilled with how wonderful the world looked once his eyes were healed.

 

You'd want to be with her during prep, and waiting for her in post-op, to help her feel calm and oriented.

 

(The mild sedation they use was not a problem.  They don't do what I'd consider "general anesthesia".  They use a mild sedative to keep the patient calm, and a local to prevent discomfort.)


terromari
Posted: Tuesday, March 26, 2013 12:26 PM
Joined: 12/15/2011
Posts: 859


We are looking at the possibility of cataract surgery. His cataracts are extremely dense and he tries to see. He is communicative. I know he would want to see better. We will see what the docs say.
Tomc5592
Posted: Tuesday, March 26, 2013 12:51 PM
Joined: 11/17/2012
Posts: 1203


She will be awake for the surgery, will she be able to follow instructions during the procedure?

Will wear an eye patch at least 24 hours.

Will need multiple eye drops every day for 4 or more weeks.

Do you think she will be able to comply?


terromari
Posted: Tuesday, March 26, 2013 2:35 PM
Joined: 12/15/2011
Posts: 859


I just had cataracts done. Only was patched during prep. I believe facility where cataract surgery would be done has ample experience with dementia pts and I would think they might do a mild sedation. Nurses will instill drops. It must be scared for him to not be able to see well. I know he would want it, and he is in otherwise good health (other than d) and he is young (69).
HollyBerries
Posted: Tuesday, March 26, 2013 7:27 PM
Joined: 2/7/2012
Posts: 98


Do your homework and make an educated decision, but go with your instinct. You know your mom better than the doctors.

 

My mom is full of anxiety whenever she has to go through some sort of procedure. She had cataract surgery a few years ago when she was in an early stage of dementia and was dreading it. Afterward, she was glad she did it. But now that she is in stage 5, I would definitely think twice if she had to do it. The worst part of any procedure is trying to get her to understand what is about to happen, and she just can't process the information. Because she is always anxious about any procedure, however simple, it's always a traumatic experience for both of us.

 

My biggest problem is always educating the medical staff about my mom's dementia.  I want to make sure they all know her special needs.  You would think hospitals and medical staff in general would be used to dealing with dementia patients, but it's surprising how many are not.  My mom was in the hospital twice this year (first time in her life at age 85 - other than when her kids were born) - each time at a different hospital - and one hospital was much better than the other at understanding her needs.

 

Don't just ask they doctor if they have experience with patients with dementia.  Ask your eye doctor if he/she understand patients with dementia and what their needs are.  Ask the doctor how he handles dementia patients differently than other patients.

 

 


EMMA'S DAUGHTER
Posted: Thursday, March 28, 2013 5:18 PM
Joined: 6/17/2012
Posts: 47


My mom, stage 5, had laser cataract surgery last December and January.  Her drs urged me to get it done sooner rather than later while she could still understand /follow directions during the surgery.  They only use a light anesthesia and needed her to understand she had to lay still.  As for the strict regimen of drops I handled all of that.  Every time they had to be done she asked what they were for.  The day after surgery she did not remember she had had it done so it took constant reminding not to rub her eyes.  The surgery was a terrific success...her eyesight is 20/30 now.  I am glad we had it done but you have to know your LO can handle it.  Make an educated decision with the dr.  I have a friend whose mom's cataracts were not discovered til stage 6 and the dr would not operate.  So now she is stage 7 and her eyesight is virtually none existent.  Heartbreaking.
Maral51
Posted: Saturday, March 30, 2013 5:21 PM
Joined: 11/3/2012
Posts: 91


I can say that i struggled with the same thing. I took mom to a specialist when urged by her ophtolmologist that her pressure in her eyes was extremely high. I then took her to the specialist and the specialist said her pressure was fine that day.. He then sent her to another Dr. we were to take her there but she got progressively worse in later stages of her dementia. She swore she could not see a thing completely blind in the morning then we would notice that she could see something cuss she would comment on the color of clothes we had on. Anyway I believe her Alzheimer's was so advanced her brain told her she could not see and she couldn't . Anyway we were not able to take her and also i thought about how old she was 89 and what she would have to go through  and her stage of her dementia and decided not to take her. that was two months ago and I am glad I didn't cuss now she is in her final days. So you know better than anyone what the benefits vs the risks would be and if it would be worthwhile.
Juvenilecop
Posted: Saturday, March 30, 2013 6:54 PM
Joined: 1/10/2013
Posts: 234


I'm struggling it's a vision issue as well. Got Mom examined for new eyeglasses and the doctor said I need to get her check again for glaucoma, or the optic nerve cold rupture and she wouldn't see. At least with glaucoma, it is usually just an eye drop regimen, but I also struggle over the quality of life vs quantity...
SunnyCA
Posted: Saturday, March 30, 2013 7:09 PM
Joined: 2/14/2012
Posts: 1752


Vision is very important to quality of life.  I'd have the glaucoma checked ... the eye drops are such a simple thing to do to ensure better vision for a loved one.
rosesandthorns
Posted: Saturday, March 30, 2013 8:39 PM
Joined: 1/22/2013
Posts: 164


My family and I have to face the same decision.  

 
My mother has a cataract in the left eye. She is 82 with stage 5-6 Alzheimer’s.  At least five times a day, she states that she cannot see well.  

 
She had a cataract removed from her right eye about 5 years ago.  I took her to the eye doctor 3 years ago about her left eye and he suggested surgery.  

 
But she did not want to have it at the time. And every time the subject was brought up she had a reason she did not want to have the surgery.   My family and I believed she was anxious about having another eye surgery. 

 
When I took her to the doctor three years ago she was in the beginning stages of the disease.   But now she does not remember having the surgery.  Also she is not as anxious has she has been.  She has been on anxiety meds for about 7 weeks now and the meds have really kicked in.  Her mood has greatly improved.  And for the moment her Sundowning   episodes are 80% better.  
So I am going to take her to the eye doctor again and talk to him about the pros and cons of her having her cataract removed.  

 
The reason I am thinking about it is because I don’t know if the things she has done lately are because of the Alzheimer’s or the cataract.  
For instances, she wanted to empty her cup of water in the sink but poured the water on the stove thinking it was the sink (the sink is stainless steel the stove is white).  She wore her cardigan sweater as a button front skirt (she button the sweater from her waist all the way down to the last button at her knees…she looked kinda cute) 

 
Another reason I am thinking about taking her for a consult about her cataract is what was discussed at my caregivers meeting. In January a spokesperson from one of the Hospitals in my area came to my caregivers support group meeting.  


The topic was: Alzheimer’s Disease & Cataract Removal Research Study.  

 

 
 
The information from the printout stated: In the study, we will learn more about how cataract removal impacts Alzheimer’s disease patients in their daily activities, their quality of life, their mood, and their performance on memory, cognitive, and visual task.  
Also here is some more information I found on the subject: 

 
……………………… When Grandma stops reading books, watching television or recognizing faces, family members often blame mind-degenerative disease such as Alzheimer's or dementia.  

  

But it may not be memory loss alone. Vision deficits -- those that are untreatable with corrective lenses -- could be making it seem worse……………………………………………………………… If untreated, Alzheimer's patients who suffer from both visual acuity issues and cataracts can be left virtually blind, researchers said, making recognition of family more difficult, increasing risks of falls and increasing combativeness.…  

  

 
 

 

 

 

 

 
 

Fad marie
Posted: Monday, January 17, 2022 12:29 PM
Joined: 7/30/2021
Posts: 33


I know this post is years old, but it's helping me very much in considering cataract surgery for my mom who has Alz and is likely Stage 5.
toolbeltexpert
Posted: Monday, January 17, 2022 3:02 PM
Joined: 4/17/2018
Posts: 436


I have read all the posts and the ending commentary. My DW Is probably  stage 5 or 6 she has a cataract in one eye and it is very blurry in the eye the other is good with a prescription that's 1 yr old, she never wears them. The eye doctor gave me the paper work to get her setup for a surgery. I left it up to my wife. She doesn't want anyone to touch her eyes. Now for me I am ok with that decision, it may have unintended benefits. We have 6 cats now 1 has been missing for months she can't see well enough to know them all anyway. She also is worried she's gonna loose her license, she hasn't  driven in a yr. The last time she went in the car I went into panic mode. I called everybody to be on the lookout. I drove everywhere I thought she would be. She showed up an hour later and didn't  know where she had gone. I have since given her fake keys. I know there are 2 sides to this, maybe she would know where she is if she had good sight. But I know someday I am gonna have to make other decisions that will not be easy either. I have ministered to other folks who were their spouse's caregiver and when there LO got pneumonia  they made the hard call to let them go. So many on here have already been down this road. I think we all have to make calls that not everybody is gonna like, but in the end we try our best. I can say when family doesn't  help, they probably won't like any decision we make.
Fad marie
Posted: Sunday, February 20, 2022 3:08 PM
Joined: 7/30/2021
Posts: 33


I wanted to give an update on my mom's cataract surgery...  After reading your posts, I had been leaning against cataract surgery for fear that my mom (Stage 5 Alz) wouldn't be able to keep the post-surgery goggles on and that she would rub her eyes and ruin the lens implant.  But I talked to my siblings and they both thought it was worth it to get her the surgery factoring in quality of life with vision and hopefully leading to fewer falls (she isn't falling yet but her balance is sometimes shaky).  Fwiw, my mom also seemed to want to do the surgery, but it wasn't clear how much she understood when we were talking about it.  

My mom got cataract surgery on her right eye over two weeks ago, and she's doing well.  She did NOT keep the goggles on more than the afternoon after the surgery.  My dad put them on her while she was asleep but by the time she woke up, they were off again.  He didn't try after that.  We didn't notice her rubbing her eyes much and she just wore her normal glasses and seemed to keep her hands off her eyes.  She is compliant for eye drops every day post-surgery, and she surprisingly has gotten used to the routine of my dad having her lie down to put the drop in.  So... so far, so good.  She will have her three-week post-op visit next week, and then she'll have surgery on her left eye the following week after that.