Cockroach cafe - summer

No way would I recommend surgery for anyone already on the dementia track.

I entirely agree with this.
Anaesthetics are very hard to recover from when someone has dementia, and they can make things much, much worse.

Knee ops are a bugger and the prehab and rehab are very important.
Weirdly hips aren't quite as bad (though the same still applies).
I have had news from my elderly relative, that her skin biopsy was clear. Which is good - I mean I'd pick an aneurysm or maybe a massive stroke if something has to polish her off.

I've heard knee surgery recovery is hard. I wouldn't have wanted my mum to have it early on in her dementia. In fact she fell and broke her hip at that point so she had to have surgery on that and after 4 weeks in hospital afyetwards, her dementia had progressed alarmingly. She couldn't go home and moved into a CH.

@Isitsticky I think you have it right there, a new knee isn't going to fix the ongoing issues and I do worry that she'll end up in pain and refusing to do the physio if she forgets why she had the surgery. The delirium earlier this year took us all back, it was very alarming to witness. The knee isn't very mobile due to an accident years ago, but its not sore.

@turkeyboots my MIL had a knee replacement and Parkinson's but not dementia. She was absolutely crippled with the knee and it was tough afterwards but transformed her quality of life. Sadly she died of unrelated causes a few months afterwards though.

But also, my mum broke her femur 2 years ago and had to have surgery and physio, no dementia but the delirium afterwards was absolutely shocking, it was as if she had gone from no dementia to fairly severe overnight and it lasted several weeks, I do think it was the start of her memory going with hindsight (also precipitated by my Dad having a catastrophic fall 6 months later).

So, not ideal. What I would want to try and establish, is how likely she is to comply with her physio and walking aids afterwards, I think the outcome depends massively on this. My MIL did her physio diligently and had a good outcome. My DM did not comply with hers in the first few weeks because she refused to believe she had broken her leg, had only vague recollection of being in hospital, etc. Refused to use walking aids. Fortunately for her she was prior to the break as fit as a fiddle physically and very active and she made a good recovery despite this but it could have been very different if she was frail and inclined to just sit around all day.

Oh dear. I wonder, given the dementia, if this might be one of those "solving yesterday's problems" things. Unless she's in pain with it of course. Is she likely to forget she's had a knee replacement and try to do too much too soon? Definitely worth letting the staff know. DH had a hip replacement at a time when he had terrible memory problems. I was terrified he'd forget he'd had it done and walk off without his crutches on day 1.

I do a fair bit of good listening, and have realised that a lot of the time her anger isn’t aimed at me even though it sounds like it. ‘No one helps me!’, apparently means ‘no one but you’.

But quite often she gets into a total mess that’s really hard to sort out retrospectively. Books a holiday she can’t actually get to

Thanks @PrizedPickledPopcorn better brace for her forgetting she'd been divorced for 30 years again. And prime her nursing team.
Hope you have a better conversation with your DM today. I feel my DM just wants an audience for the drama, rather than actual help in similar situations. Smiling and nodding and not offering an opinion seems to help her more. Its immensely frustrating.

Had a difficult conversation with DM last night where she was very angry that she is having to deal with all the difficult bits of life, including some business stuff. In her anger she said there’s no point getting PoA because she needs help now and it will be no use, and that she’s going to give her most valuable asset to charity now so she won’t have to worry about it any more.

Thing is, I could help with most of it if she’d let me, but thinks I have to be physically present and go through all her papers to do so. I’m not driving 3 hours each way to sort out her huge pile of paperwork, take her out for lunch, visit a couple of elderly relatives and vacuum her curtains just to do jobs like renew some insurance!!!! 🤬

I could do so much if she’d just loosen her grip a bit. And having LPA certainly wouldn’t hurt!

Anyway she’s calmer this morning, so we’ll see whether I can have a sensible conversation with her. She gets so overwhelmed she can’t do anything, and then drags me in to also do nothing for a while.

I’m no expert, @turkeyboots , and maybe things have improved in the anaesthesia field, my experience has been that anaesthesia is hard on the brain. DM and DGM were both prone to extended periods of confusion. It took a while for them to be back in the room.

Anyone have any experience with knee replacements for those with mild dementia (and Parkinsons but the knee replacementis supposed to help her balance and mobility) ? DM is powering ahead with this and I'll bet she hasn't told them about her dementia diagnosis. Last time she was sick in hospital she had a major issues with memory and aggression, which her team put down to being away from home and being ill. Am I right to worry that its likely to flare up again?

Hello all… checking back in after a while. Mil is now in a community hospital to try and rehabilitate her a bit. Her dementia is proceeding and she can be quite vicious to DH at times, and about the staff when she thinks they aren’t looking. Sweetness and angelic light when they are. Really nasty. I can’t tell if it’s a mask slipping or ‘just’ dementia. She still doesn’t have a formal diagnosis but the nurses talk as though it’s a given.

The Golden side of the family can still do no wrong and seems to be asset stripping the house at a rate of knots. Yuck. It’s quite possible that the ‘carers’ were at it too previously but either way loads of stuff is gone and no way to prove who took it now. It’s just very depressing.

Seems there’s now finally agreement that a home is the only option, so finding somewhere suitable is in progress. All a bit grim and stressful really, not helped by the lack of certainty with timescales etc. At least she should be safer in a home.

It’s really difficult as well because the DM I knew 10 years ago would not choose to be alive the way she is now, I absolutely know that. But today’s DM still appears to want to live despite being more or less bedridden and not able to do any of the things she used to enjoy, so I am relieved that I am not required to make a decision on that, but I have said no to heavily assisted feeding and make individual judgments on use of ABs etc.

Not really apropos but the care home runs a knit and natter session, old DM would have loved that. She used to run the machine knitting society and drive the old dears as she called them when she herself was in her 70s.

There comes a point where you have to decide whether it's helping someone to live or forcing someone to live and I suspect if you asked 50 people when that point is reached you'd get at least 30 answers. But some people seem to see someone they love/a patient dying as a personal failure on their part even if that person is 99 and has been totally incapable of anything and in pain/distress for an extended period.

I couldn’t agree more. MIL in identical situation with vascular dementia following strokes. Now 93 bed bound unable to do anything yet this week has had another blood transfusion and had a picc line fitted so she can have more antibiotics. I asked the doctor again if this is really the right thing and they look at me like I’ve got two heads. They are trying to get her stable enough to be able to move her to a care home. It baffles me

I am not hugely in favour of legalised euthanasia. Someone had mentioned either in this thread or another about adding to your health POA no aggressive medical treatments after a certain age plus no flu jab or antibiotics. When I think back DM had a mastectomy age 80 and was treated with a lot of antibiotics for a very serious covid infection about 2 years ago. With the benefit of hindsight it would have been far kinder to let either of those run their course, rather than have her be in her current state.

@NeedMoreTinfoil how frustrating for you ! I remember the flip flopping stage well. I would get DM to agree to have a cleaner then she would say it would happen once she had tidied up or after Christmas when it was less busy or some other crap designed to stall it without saying no.

Only managed to get one in when she was bed bound and DF was happy to do so because the floor was getting sticky. But then we had the same charade all over again when they agreed with DH they needed a cleaner in twice a week, but then subsequently back tracked once I had arranged it. It was hugely frustrating and upsetting to me because it was obvious that she expected me to fill in the gaps even though they have hundreds of thousands in the bank. To be fair she has the type of dementia that means you lose empathy so that was likely happening too.

Yes, I agree with you about that @GnomeDePlume it needs to be a sort of meeting in the middle, prolong cognitive ability whilst letting nature take it's course on the physical front

We really need to sort out ‘dying well’. Legalised Euthanasia has terrible risks.

There was a distressing story on social media- so it may be one sided etc- concerning an elderly lady who was euthanised under MAID in Canada, despite her having refused it when she had capacity, and no longer having capacity to change her mind. Her family were very upset. Hopefully more information will come out in defence of the staff involved, because otherwise it was murder. 😕