Repost: LEMitch/Surgery for LO with Dementia

harshedbuzz

Reposting for LSMitch who cross posted on another thread. 

Hello,

This is my first post but I've read numerous posts and this appears to be a very helpful group.

My mother has dementia and a mengionoma(sp). We have to decide if she's going to have surgery or just leave it alone. She's 80yrs old and our concern is her recovery. I care for her by myself and work M-F.  Does anyone have any pros and cons of your LO having surgery with all these variables?  She already has outbursts and gets agitated easily. I think with surgery this could be disastrous!

M1

Hi Mitch.  Just fyi I'm an internist.  I'm surprised that they would suggest surgery for a meningioma, unless they think the tumor could be causative for any of her dementia symptoms?  I would question them hard about that--most meningiomas are benign and not operated on, so I would really want to know why they think this one needs to come out.  There are occasionally bad actors though, and could impinge on vital structures.  The anesthesia is another factor that is hard to predict in the elderly.

I would also want to know her stage of dementia (look up Tam Cummings' seven stages), and whether she has made her wishes known in the past regarding end of life care.  Even if the meningoma is life-threatening, so is dementia.  My partner is stage 5, 81, cannot live independently any longer, and has a lymphoma that has been quiescent.  If it recurs, we will NOT treat it.

This is a tough call.  Good luck, and welcome to the forum.

May flowers

Just our own experience- if my FIL was a candidate for surgery that wasn’t absolutely necessary for comfort measures, I would pass. My FIL had a partial hip replacement - just enough to make him mobile again and for comfort, but the anesthesia/surgery has resulted in a permanent decline in his dementia. He can no longer walk unassisted (physically can but cognitively has trouble understanding how to move his feet, turn, etc.), feed himself with a utensil, brush his teeth, dress himself, and went from somewhat incontinent to completely incontinent. He is less communicative as well. We had a month of very bad delirium as well, which has gotten somewhat better during the day, but still persists at night. All of these things were declining before but it was a steep decline after.