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My mother (91) lives with me. She is wheelchair bound, stage 6 dementia as well as heart and kidney failure. She complains about her eyes. She has a bad cataract in her right eye, but can see out of her left eye. She sleeps 20 hours a day. My sister who lives 2,000 miles away thinks I should have her cataract removed and mom agrees. Suggestions on how I tell my mom it isn’t going to improve her quality of life? I don’t want to put her through the surgery. She doesn’t read and has no interest in any activities. She can see the TV but doesn’t stay awake to watch it. Thanks.

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Sister is irrelevant and you should tell her so.
She doesn't get a vote in this. It isn't her FAULT she is 2,000 miles away and disconnected; but it IS a fact.

IF your mother can go through this surgery without it being a catastrophy (such as itching at newly operated eye CAN and likely WILL be-- I think any MD would concur) then the decision is hers to make UNLESS you as her POA realize that she is no longer CAPABLE of making this decision. She is only risking the loss of site in an eye that can already not see in a body that is, I think you recognize, failing now.

I wish you the best. This is your mother's decision if she can make it.
But fact she is sleeping twenty hours a day sounds as though she is not thinking clearly about this.
AND if she cannot make it, then it is your decision. For me that decision would be NO. But I am not you.
Your sister should never have been brought into the discussion at all until it was scheduled or mom talked to her about it. Too many decisions from those who really cannot judge something adds confusion.
Like I am doing.
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sp196902 Feb 24, 2024
Alva she has stage 6 dementia is she really capable of making this decision? I don't think so.
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Agree with everything AlvaDeer posted and also there are many appointments with the ophthalmologist prior to the surgery and if your LO can't cooperate in looking into the equipment and accurately report what she sees, then she won't be considered for the surgery.

Also, after the surgery there are many different eyedrops she needs to have for about 2 weeks and the dosages and types change almost every day, so it is complicated for the caregiver.

She needs to be able to lie still during the surgery because in my experience they don't put you out completely. Then she cannot rub her eye at all afterwards.

I personally would not attempt it.
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Cataract surgery is not bad but like Alvadeer said it's the aftermath that is the problem. Itchy, drops, not bending over, etc. If her medical doctor can clear her to get it, and you are willing to deal with the aftermath - do it. Its not fair to her (having trouble seeing) or to you (listening to her complain). My daddy went through it no problem and I thought he wasn't reading because of the cataracts but it was because he was done. Even after I took him to get the reading glasses he was just done trying. But even knowing what I went through for it - I would do it again because it gave him an option to read if HE wanted to.
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Reassurance about cataract surgery: I've had cataracts removed on both eyes in different years. The procedure, which takes about half an hour, goes smoothly and there is no pain. The aftercare is easy and also pain-free. Vision improved immediately.

I disagree that cataract removal wouldn't improve your mom's quality of life. She may not read because she can't, due to the cataract. TV watching must be difficult with a cataract. Stage 6 dementia is serious stuff, but she may be declining cognitively because she can't see well. Hearing aids and good vision correction are necessary to prevent acceleration of decline, according to my DH's doctor.

I'm not saying she should have the surgery, not saying she shouldn't, but I do think you should confer with the ophthalmologist who would do the surgery before you completely rule it out. That's probably the best place to look for guidance in your mom's situation.
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funkygrandma59 Feb 22, 2024
Fawnby, most folks with any of the dementias, even with good eye sight, cannot read let alone comprehend the written word, so I have to disagree that having cataract surgery would improve this woman's quality of life.
If anything the OP may need to get hospice on board since her mom is sleeping 20 hours a day. Sleeping that much is often a sign that end of life is near.
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Talk to an Opthamologist and see what he says. It will cost her nothing if the lens is just a plain one. She will need to wear glasses for correction.
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Thank you community for your opinions and comments. I’m just trying to do with what is best for Mom. She is on palliative hospice and the nurse and social worker told me the goal is to help her be comfortable. She is not in a state of mind to read anymore as she does not comprehend the basics. She even sleeps while watching TV. I’m fortunate her eyes are her only complaint. Blessings to you all.
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sp196902 Feb 24, 2024
Yes you are doing the right thing by not taking mom in to get cataract surgery.
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I would speak with an ophthalmologist about doing the surgery. Cataract surgery is a piece of cake! It was the easiest and fastest surgery that I have ever had.

I was legally blind in my left eye to do a different type of cataract. My right eye had a typical cataract that was due to normal aging. I had excellent results from my surgery. 20/20 vision in both eyes.

When I told my ophthalmologist that she really worked her magic on me, she said, “You are the exception to the rule because many people will need glasses for reading.

It seems like I read something about an age limit for cataract surgery to be successful. I could be wrong about that. It’s worth talking to the doctor to find out if she can be helped by having the cataract removed.

My surgery was finished in 15 minutes! The anesthesiologist asked me if I liked music. I said, Yes, I do.

He said, “Great! I will play some music for you and after a few tunes, everything will be over.” It was completely painless. They scheduled the second eye surgery to remove the remaining cataract and I could see perfectly.

Wishing you all the best.
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I had to pass the DMV test, so had both eyes done in 2020 (at 67), and it was super easy with immediate results. I was beyond thrilled.

Yet I wasn't 91 and slept 20 hours a day. I could see considering it being done if she was not sleeping so much. Why exactly does she want it?

Ignore your sister. Someone not caregiving Mom has nothing worth listening to.
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TopsailJanet Feb 24, 2024
I can't wait to have mine done, they've been very bad for several years, getting slowly worse. The doctor tells me they are not yet bad enough for Medicare or insurance to pay for them. I have to squint to read, though. I know it will be a delight to live without cataracts.
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I would tell your sister to shut the hell up. Mom has stage 6 dementia, sleeps 20 hours a day and doesn't watch TV or read and is on palliative care. I agree this will do nothing to improve moms quality of life so I would leave it alone. Too bad your sister can't do the same.
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Wow, this would be a really tough one for me as I've always been a reader and would seriously miss being able to read. Although my vision has deteriorated with age, it's one of the few enjoyments I still have. However, I'm "only" 87 and do not have dementia as far as I know. In retrospect I should have had cataract surgery on both eyes 10+ years ago. (I had it on my right eye but not my left--bad decision but I was still working then and thought I could do it "later". Now I am very reluctant to have surgery of any kind.)

If I were 4 years older with dementia, other life-threatening health issues, on palliative care, and already sleeping 20 hours/day, it's a strong possibility that I would derive no benefit from cataract surgery. If I had the capacity to choose, surgery would probably not be my choice. However, everyone is different, and improving quality of life may be a consideration. My surgery did not involve full anesthesia, but I did need to understand and follow the post-surgery procedure.
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NeedHelpWithMom Feb 24, 2024
Elizabeth,

I just love how you say that you are only 87! You remind me of my cousin who lived to 101!

She was our ‘energizer bunny’ in the family. She always looked towards the future, went on many trips, out to lunch with her friends, etc.

She read a million books during her lifetime and was an absolute delight to spend time with. I never, ever saw her as an ‘old lady’ because she was so young at heart!

She died not that long ago. I miss her terribly.
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If she has stage 6, she really has no say. Just tell her the doctor determined she's not a candidate.

Too bad, though, because cataract surgery takes maybe 15 minutes and you're on your way home. I don't think she could follow the instructions and follow-up care, though.
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If this increased quality of life - yes. Eg 91, no or little dementia, or some dementia but still reading & watching TV.

If unable to read or watch tv due to lack of vision only - yes.

But if unable to read or watch tv due to brain (cognition changes, mental &/or physical fatigue) well, it isn't going to improve QOL as you have pointed out.

Your sister may mean well, want the best for Mom, have heard it's a simple surgery etc but is she looking at the bigger picture?

Does your sister bake? Maybe she could bake Mom a nice cake instead (only half-joking). If she wants to bring cheer to Mom, she can find a different way. Maybr sit & read books to Mom instead.
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TopsailJanet Feb 24, 2024
Agreed. My Dad's doctor told him even after his terminal cancer dx that he'd gladly approve the surgery if my dad thought it would improve his quality of life in the time left. Dad decided it wouldn't be worth it. It doesn't seem that it would improve your mother's life at this point.
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NeedHelpWithMom: Ha! I say "only" 87 tongue-in-cheek. My body represents every day of it! Living to 101 is SO not on my agenda, but I'm glad your mom did and am so sorry that she is no longer with us.
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NeedHelpWithMom Feb 24, 2024
Elizabeth,

Not my agenda either but my cousin was in great health, no wheelchair, no walker, no dementia, no major issues. She was able to enjoy life!

Her body just gave out at 101!
Most people aren’t so lucky as she was.
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With dementia, mom is no longer in charge of making her own decisions. Since she lives in your home and relies on you for everything, as you said in your profile, YOU get to make the decisions FOR her now. And the decision is No. Eye surgery for a woman who sleeps all day is ridiculous. And if your sister doesn't like it, how about SHE become chief cook and bottlewasher for her mother to see what stage 6 dementia looks and feels like, up close and personal? The armchair critics always seem to be The Experts while they DO nothing for their loved ones, having no idea what they're even talking about! Maybe mom would like a set of veneers on her teeth after the cataract surgery too!
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