You have not completed your profile. What is Mum's health like? Does she have cognitive decline? How old is she?
And most importantly why is she having the surgery? Has she had a second opinion? Does she want the surgery?
My parents were both in their mid to late 80's when they had cataract surgery. Both were fully compliant and wanted the surgery. Both were capable of administering the eye drops on schedule.
My former MIL has cataracts, but she never had surgery. She does not drive, she has a tremor and could not administer eye drops and with brittle diabetes was not a candidate for surgery. She also was not a reader and mostly just listened to her tv.
Eye sight leads to quality of life, but cataracts do not lead to deahth.
Well, if she moves during surgery there might be an issue since they use lasers and depend on the person not moving. My mother coughed a little during hers and they stopped the surgery and didn't finish it. It created a problem. I don't know how they're going to do this surgery...she has to answer a series of questions related to her vision prior that she needs to answer accurately and also after for follow-up and comprehend what's happening to her. Are you aware of the regimen of eye drops that need to follow afterwards for about 2 weeks (like antibiotics, anti-inflammatory, etc)? Who is going to be administering these several times every day? If she has to be restrained, does this mean she has a cognitive issue like dementia or ALZ? What doctor is recommending this surgery for an uncooperative patient?
This all depends on your mothers health and age. If she has Dementia, not sure if I would have them done. She will need to sit still. A local anesthetic is used. Some have patches afterwards. Will she keep it on? Then there are the drops before and after. Will they be given regularly by the staff?
You need to talk to the ophthalmologist doing the surgery.
I was lightly sedated BUT...and this is a biggie. She has to be able to follow instructions during the procedure. Yes you are sedated but it is a very light sedation. Your arm and legs are somewhat restrained. IV in one and a BP cuff on the other. IF she has dementia I would hesitate about having the surgery. There can be complications. There is a real lag time when recovering from the sedation. Even longer if there is dementia involved. You do not indicate what her medical problems are but even though it is a relatively easy surgery it is still surgery and there can be complications. The biggest question is... Will the surgery improve her quality of life enough that the risks are worth it.
I have worked for over 35 years in ophthalmology and it is worth having your mother's cataract surgery done. I would imagine that poor vision can enhance the problems of dementia. If you are concerned please speak to her eye doctor. At times we have had to use general anesthesia to be sure that the patient does not move. Typically patients are given something to relaxed them and that works just fine but for your mother I would be sure that all avenues are discussed. Cataract surgery is done on patients with many different diseases and if she is going to the hospital for her surgery they will know how to keep her safe.
I had cataract surgery on both eyes near the end of 2019. If I recall correctly, I was restrained, but it wasn't anything drastic, just belts over my arms and chest to keep me immobile.
The anesthetic completely numbed any feeling; I was semi-conscious, enough that I could see beautiful star like scenes, as if I was staring into space at a collection of planets and stars. I remember thinking that I needed to figure out how to capture that image as it would make a beautiful quilt.
The issue already raised of the need for eyedrops is something to be addressed. My regimen was 4x daily for the first week, dropping down to 3x, then 2x, then 1x over the next 3 weeks. If your mother has both eyes done, the doctor (and depending on her health) may perform the second surgery 2 weeks after the first, assuming all goes well with the first surgery. That was my situation.
I think you need to have a discussion with the long term care staff (DON if possible) to determine if they can or will give the eye drops. It's critical that they be given, so the commitment on the facility's part needs to be serious, not just if they have time.
A discussion is also appropriate with the doctor performing the surgery; I had pre-surgery discussions so I had a good idea what to expect (the starry skies were a surprise though).
I will warn you; the drops sting. My ophthalmologist told me they contain an anti-biotic or something (can't remember fore sure) that prevents infection, so the drops are critical.
My first question is why. Does she need to have an elective procedure ? Does the doc understand the severity of the dementia and her ability or inability to be involved independently with her post op care? Will her quality of life be significantly improved by having her cataract removed or will she still have a terminal disease? Who will be liable or responsible for her care post op?
Just a few nurse questions. Will be thinking of you, best wishes
What does mother say? Does she understand the procedure and that the restraints are to ensure she doesn't move suddenly and the surgeon cause her some eye damage? Has she been shown how the restraints work and how the operation will be done? If not then explain it to her (or get the medic who should have done so already to do so). If she is not able to understand due to dementia or cognitive decline then talk to the planned surgeon and see if they can use a light general anesthetic instead of local and a bit or sedation, and how she will cope with the after care -which is not strenuous but may cause stress to your mother if she doesn't understand. You do not say how old your mother is or what her mental capacity is. But it is also worth considering how much this operation will improve her quality of life which can be dependent on mental capacity. I am not suggesting we should leave people to live with cataracts just because they are in long term care, or getting old, the operation makes a huge difference to standard of life for many many people, but every case has its own "differences" which need to be taken into account as well as the simply improved vision ones.
My mom is 92 years old. She had cataract surgery on one eye 15 years ago and had not had the other eye done and so it was affecting her perception and balance. When she moved near us I took her in to have the other one done … she kept asking why ??? I’m 92 ! She’d say … well - big mistake! At 92 cataracts are hard and crusty and need to be chiseled out. She couldn’t see at all out of her eye for six weeks and needed eye drops put in seven times a day! Three months later she is seeing better but still needs eye drops twice a day. Think about it carefully!
My mother developed inflammatory breast cancer at the age of 93. She was still of sound mind, and she opted NOT to treat. It was so difficult watching this cancer eat up her body, but there is no way I could have gotten her out and about to treat for this. She was on hospice already and they came to the house for dressing changes often.
The moral of the story is that there is always the procedure which could be painful and also the follow-up care. This could take her down more. We stopped all my mother’s visits to the ophthalmologist for her macular degeneration and glaucoma, plus cataracts. More torture for her to endure and she just made-do with what little eye-sight she had left. Tough decisions that are hard on them and the care-givers.
And most importantly why is she having the surgery? Has she had a second opinion? Does she want the surgery?
My parents were both in their mid to late 80's when they had cataract surgery. Both were fully compliant and wanted the surgery. Both were capable of administering the eye drops on schedule.
My former MIL has cataracts, but she never had surgery. She does not drive, she has a tremor and could not administer eye drops and with brittle diabetes was not a candidate for surgery. She also was not a reader and mostly just listened to her tv.
Eye sight leads to quality of life, but cataracts do not lead to deahth.
You need to talk to the ophthalmologist doing the surgery.
BUT...and this is a biggie.
She has to be able to follow instructions during the procedure.
Yes you are sedated but it is a very light sedation.
Your arm and legs are somewhat restrained. IV in one and a BP cuff on the other.
IF she has dementia I would hesitate about having the surgery. There can be complications. There is a real lag time when recovering from the sedation. Even longer if there is dementia involved.
You do not indicate what her medical problems are but even though it is a relatively easy surgery it is still surgery and there can be complications.
The biggest question is...
Will the surgery improve her quality of life enough that the risks are worth it.
The anesthetic completely numbed any feeling; I was semi-conscious, enough that I could see beautiful star like scenes, as if I was staring into space at a collection of planets and stars. I remember thinking that I needed to figure out how to capture that image as it would make a beautiful quilt.
The issue already raised of the need for eyedrops is something to be addressed.
My regimen was 4x daily for the first week, dropping down to 3x, then 2x, then 1x over the next 3 weeks. If your mother has both eyes done, the doctor (and depending on her health) may perform the second surgery 2 weeks after the first, assuming all goes well with the first surgery. That was my situation.
I think you need to have a discussion with the long term care staff (DON if possible) to determine if they can or will give the eye drops. It's critical that they be given, so the commitment on the facility's part needs to be serious, not just if they have time.
A discussion is also appropriate with the doctor performing the surgery; I had pre-surgery discussions so I had a good idea what to expect (the starry skies were a surprise though).
I will warn you; the drops sting. My ophthalmologist told me they contain an anti-biotic or something (can't remember fore sure) that prevents infection, so the drops are critical.
Does she need to have an elective procedure ?
Does the doc understand the severity of the dementia and her ability or inability to be involved independently with her post op care?
Will her quality of life be significantly improved by having her cataract removed or will she still have a terminal disease?
Who will be liable or responsible for her care post op?
Just a few nurse questions.
Will be thinking of you, best wishes
If not then explain it to her (or get the medic who should have done so already to do so). If she is not able to understand due to dementia or cognitive decline then talk to the planned surgeon and see if they can use a light general anesthetic instead of local and a bit or sedation, and how she will cope with the after care -which is not strenuous but may cause stress to your mother if she doesn't understand.
You do not say how old your mother is or what her mental capacity is. But it is also worth considering how much this operation will improve her quality of life which can be dependent on mental capacity. I am not suggesting we should leave people to live with cataracts just because they are in long term care, or getting old, the operation makes a huge difference to standard of life for many many people, but every case has its own "differences" which need to be taken into account as well as the simply improved vision ones.
The moral of the story is that there is always the procedure which could be painful and also the follow-up care. This could take her down more. We stopped all my mother’s visits to the ophthalmologist for her macular degeneration and glaucoma, plus cataracts. More torture for her to endure and she just made-do with what little eye-sight she had left. Tough decisions that are hard on them and the care-givers.
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