I attended an Alzheimer’s support meeting Tuesday, and the topic of anesthesia and dementia came up. For someone showing signs of dementia, it is most important to addresss options with your drs.
I found the links below to be helpful in explaining what the procedure is, how it is done, risk factors, outcomes, etc. I would also ask if there will be any brain monitoring and if a certified surgical neurophysiologist will be present during surgery. It’s good that you and your mom are exploring all options.
http://www.heart.org/HEARTORG/Conditions/More/HeartValveProblemsandDisease/What-is-TAVR_UCM_450827_Article.jsp#.VipbzmRViko
http://newheartvalve.com/about-tavr/about
Most of our evidence is anecdotal and I have one more to add.
My sister’s FIL had valve replacement nearly two years ago, at first they said he was not healthy enough for surgery and he would be dead in a few months from the valve. Then they agreed to do the surgery, huge mistake in his case. He already had some dementia (but his family is mostly in denial about it), he became very demented, could not follow recovery instructions, would not follow any recommendations, ended up back in rehab for a month to teach him to walk about and get him over the hill onto better recovery. He is still the same person he was before, but worse, more angry, more cocky, less cooperative, he is making life miserable for everyone else, his wife is exhausted.
This guy has always been a jerk & he got much jerkier post anesthesia, I guess it is true they say we are who we are, the anesthesia could make some one much more demented and much more whatever their basic characteristics are.
For parents with mild dementia, is travel good or bad for them? Should they just remain in their homes and neighborhood where things are familiar or is it good for them to travel with loved ones to see and experience things? How do you weigh pros and cons?
We took our folks on trips twice in the past two years, but H thinks it may be time to stop taking them traveling. No one has offered to take them on any trips since we returned from our last one in June.
What somemom says here is what I have read- that dementia doesn’t pose the greater risk for coming through the operation, but the issue is attention to (and cooperation during) the complex recovery process (and having to deal with, but not understanding, the tweaks and cringes of pains, limited mobility, etc.) I think this valve decision is quite challenging, my heart goes out to you. But it starts with quality of life.
HImom, any shift in identifiable surroundings can be tough on an elder with dementia. When MIL was just showing recognizable signs, we put her in our van to drive a distance and she badly sundowned on us. Bad. But you’ve said before that your parents are pretty ok-? They aren’t getting disoriented or wandering, are they? Failing to recognize family? Occasional forgetfulness and not knowing new surroundings is one thing. Or tiring easily and getting a little crabby. Dementia, ime, is another.
They ask the same questions repeatedly, difficulty remembering which is their hotel room, continuously lose things (like wallet and ID), can’t pack or dress appropriately for colder weather, get lost easily. Also, not sure if my mom can read or comprehend menus any more and has that deer in the headlights look when she has to order at restaurants–we suggest items we think she will like and she generally orders what the person just before her ordered. She will also wear the clothes that need to be discarded (faded, elastic no longer works).
HImom, it sounds like it may be too stressful for them to enjoy themselves. Maybe it might be time to downscale to daylong outings and visits on familiar territory. From what you’ve written, I know you’re really enjoyed traveling with your parents, and that must make it very hard to give up.
HImom, you could be writing about my mother too-- she’s at that same level of functioning. My siblings and I have traveled with her, and had a wonderful time. Our latest trip was a river cruise in the Netherlands. Someone pretty much had to babysit her most of the time, but we all enjoyed ourselves. Because the ship was small, we didn’t have to be with her every second. The doors to the rooms all looked the same, but my sister put a scarf or something on mom’s room so she could find it.
I was going to suggest the downscaling, too. Because you have done many trips with them, the oversight might be what DH is reacting to. You could do your own trip again or with the kids, then take a new look at whether another trip with your parents is right for all.
My folks so far don’t actually sundown, but dad gets agitated and wants to go home after meals, events. He’s been like this, just getting a bit “antsier” as he ages. Mom smiles and nods and tries to be pleasant but has a hard time keeping track of which grandkids are in town and which are away (tho there are 15 grandkids). At least they know all of us, our spouses and the grandkids. It will be more troubling as they forget us. They can no longer keep track of our birthdays; that’s pretty recent.
Mom writes things in her calendar but then forgets to look in it and forgets about the events. She needs to have frequent reminders. We are grateful they are mostly cheerful and still get along with us and one another.
Here’s a helpful article that H and I have found useful to read and re-read.
http://www.theguardian.com/society/2015/oct/20/the-deviousness-of-dementia
In my experience with frailer elders and slow progressing dementia, the stress and effort we see them experiencing as they navigate challenges may be the tip of the iceberg. Many seem best served by “sleeping in their own beds” and perhaps taking smaller aspects of a trip that work to enjoy locally.
Some may be more prone to falls or accidents in unfamiliar surroundings with a disrupted routine. Air travel is particularly variable, as one has to be prepared for delays without easy lav access, space limitations, turbulence, etc. Big fan of shared, cross generational experiences; we just modified them over time.
Some people I know have skied or traveled with their parents up to age 88. The last trip, well, they knew it was the last trip very early into it. Trust your gut.
Yes, the enjoyment factor seems to go way down when there is increased confusion and agitation. H really doesn’t think it’s a good idea for them to travel any more. I will say it’s more and more work to travel safely with them recently than in bygone days. Fortunately, all my sibs live in HI, and all the grandkids do come to HI for Christmas and as many other times as they can.
FIL (TX) drivers license will be due next year. he is in a nursing home. he does not have a passport. he will not be able to renew the drivers license and he does not drive anymore. Ditto for my mother (PA) in an assisted living.
- do they need a valid ID?
- what to do?
- I looked on their respective states webpage for drivers license /ID card. no info.
- anyone go through this before?
An article I read said that one of the TX congressmen had to jump through hoops to get a state ID through TX Department of Public Safety. Probably you can do the same for your elders, IF they want one. PA likley has something similar. You never know if you need the ID unless you don’t have one. I suspect it is easier to get a state ID while they still have valid driver’s licenses. IDs are needed if the residents want to vote, for banking, signing documents that will be notarized, cashing checks, etc.
Here’s the Texas info for a state ID:
https://www.dps.texas.gov/DriverLicense/applyforID.htm
https://www.dps.texas.gov/DriverLicense/identificationrequirements.htm
Here’s the PA info for state ID:
http://www.dot.state.pa.us/Public/DVSPubsForms/BDL/BDL%20Form/DL-54A.pdf
You just search state ID and the name of the state you’re looking for. It’s really pretty straight-forward.
HImom, it sounds like a trip, say, out of town wouldn’t be a good idea. From what you’re describing, I’m not sure I’d even try a day trip. Perhaps an afternoon outing, and home for dinner. Or what I do with Mom on Saturdays is a little bit of shopping (1 store is all she can handle), followed by brunch/lunch, then home.
Yea, we do a lot of meals and extended family gatherings. It’s working fairly well for now. Dad also likes basketball & football. Mom likes opera and community theater. My sis & BIL drive them to all the college basketball games & we drive them to the college football games as well as operas, community theaters and a lot of meals.
@HImom that is impressive. I’ve been looking for days. Thanks for the start. Looks like PA -can do in mail and TX -needs in person. Need to check on that.
HImom, my parents are at the same place as yours are, but they can’t remember the names of 4 grandchildren, much less 15! I try not to travel with my parents because I then have a miserable time. I spend all my time reorienting them, answering the same questions, and since they are so physically healthy and mobile, making sure they don’t leave their room as they will wander the hotel not knowing how to get back. And what is it about the elderly who have to eat at the exact time every day! I must travel with another person so we are at a 1:1 ratio. Within a week of being back, they don’t remember we even went.
My nephew will be getting married on the other coast this summer. I will need to try to bring them with me for that. I don’t think I will be forgiven by SIL if I don’t try.
Himom, it sounds like the status quo is working and personally, I wouldn’t push it. That’s actually an impressive amount of activity! Frequent but short outings is probably the best way to go.
GT, ugh. Mom keeps asking when D and her BF are getting married (no plans yet). She’s under the impression she would go up to Seattle for that with the rest of us. As if.