A Caregivers Asks: Does Anesthesia Make Dementia Worse?

It can. It doesn’t always. This ambiguous response is true of many questions regarding what happens when someone has Alzheimer’s disease or one of the many other forms of dementia. What is true for one person is not true for many others.

Some factors that can have an effect on whether or not someone experiences cognitive decline after general anesthetic are:

Age – The older we are, the more vulnerable we are to side effects of anesthesia. Our brain, like the rest of us does not respond in the same way it once did.

Medical Conditions and Medications – The more health issues one has and the more medication one requires the greater the chances of cognitive decline with the added stress of surgery.

Loss of Blood – Blood loss during surgery can reduce oxygen flow to the brain resulting in cognitive impairment.

Type of Anesthesia Needed and What Procedure has to be Done – Depending on the circumstances, the surgeon may need to use heavy sedation over a relatively long period of time increasing the chance of a negative reaction.  For less extensive procedures, he or she may opt for a spinal block and twilight sleep. Doing this could lessen the risk of cognitive decline.

Pre-existing Dementia – Dementia is a devastating brain disease and any procedure that causes increased stress on it could result in changes in function.

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It is important to note that often the cognitive changes seen immediately after surgery and anesthesia are temporary. For some patients there can be a partial return to pre-surgery state with more minor losses remaining.

It is also important to speak openly about your concerns and to work with the physician to formulate the best plan for the needs of the person requiring surgery. Despite the risks, the procedure may have to go forward in order to save the person’s life. And remember, the surgeon and medical staff want the best possible outcome as much as you do, and will do their best for their patient.

For more information on anesthesia and dementia click on the following links: http://health.sunnybrook.ca/brain/surgery-and-dementia, https://www.scientificamerican.com/article/can-general-anesthesia-trigger-dementia/; https://www.dementia.org.au/files/helpsheets/Helpsheet-DementiaQandA20-Anaethesia_english.pdf

Bobbi Carducci The Imperfect Caregiver

A Caregiver Asks: Does anyone else think the person they are caring for is faking to get attention?

It can seem like that, especially in the early and moderate stages. This is when behavior can be off the wall one moment and seemingly normal the next.

  1. A family member or friend drops by and suddenly the person in your care changes. Someone who can rarely speak engages in conversation again.
  2. There is light in his eyes that’s not been there in a long time.
  3. He may not remember your name but recognizes the rare visitor immediately.
  4. As you approach his doctor’s office he stands straighter and walks with his head up.
  5. He convincingly denies symptoms and behavior you encounter daily.

You watch, amazed, and perhaps convinced, you are being taken advantage of. What you are seeing and hearing is the person in your care using every resource he can draw upon in order to appear normal. He is aware that something is very wrong and wants to convince others that he is still himself. It can’t last. It’s exhausting and the strain will take everything out of him for the rest of the day and possibly for the next several days.  You will both be in for a difficult time for a while.

As frustrating as it may be for you, try to understand that what you are experiencing with him are some of his last efforts to be retain his dignity and be seen as he once was.

Be prepared for some visitors to insist he’s not as bad as you led them to believe. Understand that the medical staff will listen to him first and may question your perceptions of his progression. On some occasions, you may question your own sanity.  Know this, it’s not you. You have the facts, they don’t.

You may want to have a brief video of what really goes on stored on your smart phone to share with those who need to know the truth. It could lead to getting more help for both of you.

For those you rarely see or will always question what you do, let them believe what they will and vent as needed to other caregivers who understand what it’s really like.

To learn more about Bobbi Carducci, the Imperfect Caregiver, click on her name. To contact her  directly send an email to bcarducci@Comcast.net . Comments and questions are always welcome.