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Mom is almost 95 years old. I notice that she is becoming confused and hallucinating sometimes. I know cataract surgery would improve her eyesight but if the local anesthesia causes her to become even more confused, I'm not willing to risk that result. Shes says she sees okay and my sister says she seems to see alright. Has anyone out there had the same dilemma? What did you do?

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I had cataract surgery when I was in my 70s. I was only partially sedated and required to be alert, not move my head, not blink and to follow a moving blue light on a screen. To keep me on track following the blue light, the surgeon spoke to me brusquely. I am a sharp 85, but don't see myself opting for elective surgery from now on.
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Actually getting through the procedure, following instructions, lying still, not touching her eye, etc. would be a great concern to me. I'd get a second opinion from another doctor and I would try to locate one who is familiar with patients who have dementia.

From my experience, many doctors do not really realize just how resistant and uncooperative a patient with dementia may be, due to no fault of their own. They don't seem to comprehend that the adult would be similar to operating on an infant with regard to the their ability to follow instructions.

You might ask questions like what if she moves when told not to. What if she touches her eye after the procedure, etc. Would restraints be required? It's a lot to consider.
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I had cataract surgery when I was in my mid-60s, and I thought it was amazing! From being turned down for a driver's license, I went to where I didn't even need glasses for driving, just for reading. It is painless, but if your mom has dementia and can't understand what is going on, then you may have a problem.
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We endured a somewhat similar predicament a few years ago. Ophthalmologist suggested that Dad would benefit from cataract surgery and recommended a renowned facility in a nearby town. After obtaining a full medical history and extensive pre-op examinations and testing, we then set up a date for the procedure. We were informed that he would require sedation due to his inability to understand and follow simple instructions.
On the day of the procedure and as he was being prepped, we were ushered into the office of the Director of Nursing and informed that they would be unable to perform the surgery due to Dad's extensive list of medication sensitivities. We were then advised that he was not a good candidate for the surgery and to retrieve Dad ASAP and, if desired, make other arrangements.
Sadly, what we saw "behind the scenes" was an assembly line of elders being systematically sent along from point A to B to C etc. as quickly as possible leading us to believe that the main object was to get as many procedures completed as quickly as possible.
Subsequent discussions with Dad's PCP have reassured us that he is doing as well as any other 91 year old at this stage of his life without being subjected to this invasive procedure as long as we keep him Safe, Healthy and as Happy as possible.
As for Dad, although he does experience some visual blurring, he still can spot a bluebird on the sidewalk 50 feet away, can read the captioning on his favorite TV shows, and has no problem cleaning every last morsel of food off of his plate.
The bottom line here: Yes, while the cataract surgery might have improved Dad's eyesight, would this have positively impacted his quality of life and daily living or would having him undergo the procedure and whatever complications the anesthesia might have caused and any subsequent confusion caused by same have proven detrimental? In this case, probably not.
So, if you are experiencing concerns, be sure to engage your Mom's PCP in the discussion before making any decisions.
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Keilin, I can fully understand your concern, but it's my understanding that the patient will be awake during the surgery, that only the eye area is numbed.

The only thing is that your Mom might be scared about the surgery and that will put added stress on her. Check with her primary doctor to see if he/she could give her something to calm her down, if it is also ok with the eye doctor.
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Keilin have you consulted an ophthalmologist about your mother's eyesight? The reassuring thing is that if she doesn't actually have what they call a "ripe" cataract they wouldn't undertake surgery anyway. They also won't do it if she isn't able to follow their clear instructions during the procedure - because, as others have pointed out, the patient ha to be fully awake and participating.

I would be very surprised if the local anaesthetic had any effect on your mother's mental state; but the procedure itself is quite stressful though not painful, as described by people who have undergone it.

The bleared vision caused by cataracts could be exacerbating your mother's confusion and apparent hallucinations, on the other hand. If I were you I'd whisk her off to an ophthalmologist for professional advice on the risks and benefits.
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If your mom is able to pick up a dork and glass and walk without bumping into walls then I would not succumb her to this or any surgery unless it is absolutely necessary. My father has dementia and any type of invasive procedure is very scary for them. Just enjoy your time with mom.
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Unless it is an emergency (unlikely), I recommend, if you are considering moving forward with cataract surgery, that you first receive a second opinion from an independent, objective excellent Ophthalmologist. Fortunately, there are ethical medical professionals that will objectively consider a patient's age, cognitive status, medical status, surgical risks, postoperative care, etc., A good eye doctor will base their decision on patient best practices- benefit vs risks vs. receiving money for procedures (I am not suggesting that your mom's eye doctor's motivation was money). Unfortunately, I have met unethical medical professional that may not consider the patient first. As a medical professional, it is important to examine all the factors, for your mom's best possible outcome and quality of life. Ask the second opinion eye doctor, if you/your mom elected not to have cataract surgery, would this impact her quality of life and daily living? It is wonderful that you have followed your gut thus far, and have questioned the appropriateness of cataract surgery for your 95 year old mom. Your mother is very lucky to have you!
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Guess I am stuck with mine. The eye Dr told me she did not want to do it because of the operative risk. The head of anesthesiology he would never give me an anesthetic. Not really sorry as I am terrified of having the proceedure even though being reassured that there is nothing to it. I am still legal to drive but close vision is very poor. Now I have to see the ear Dr - not afraid of her!!!!!!
Gone from being relatively healthy three years ago to being very "old" now.
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My 85 Mother has dementia and also needed cataract surgery for both eyes. I spoke with the Chief of Neurology at the best hospital in Southern CA. I also spoke with the top eye surgeon at UCLA. Mom claimed that she could see just fine but she was used to diminished vision. Both Doctors said that it would not impact her cognition. There is ample medical journals with studies that state folks with dementia will cope better when hearing and vision issues are addressed. She is on a very complex medication regime as she also get seizures etc. She did beautifully with the surgery. I was thrilled as we are trying to reduce her fall risk. Best of all she was shocked at how much better she could see. Our family was THRILLED because the television appeared much brighter to her. This is great as TV is something she watches. I took some days off to make sure that the eye drops were put in at the proper time and that the after care was excellent. It was a breeze. I, too, am HIGHLY sensitive to adding medications or anesthesia. If her health is decent and you think she will live a few more years, I would do it. She will enjoy the beautiful new colors the operation will bring her. Oh and we had them do the eyes a few of days apart rather than a few weeks so her balance would not be impacted. The doctor agreed!
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