My dad, who has moderate and fairly quickly advancing Alzheimer's, fell on Saturday and fractured his jaw and nose. It's a Le Fort II fracture, in case that's meaningful. He's due to have surgery this afternoon, and I'm rethinking it.
From 3 PM to 1 AM, he was agitated and combative, despite sedation and even wrist restraints. I'm worried about the surgery/anesthesia because of the risk of death and the risk of additional cognitive decline. And yet, if he doesn't have surgery, he'll have a significant underbite, his jaws won't meet well enough for him to chew, and he may have significant pain and/or infection.
When deciding about surgery and both options carry significant down sides, how do you make the decision? Any guidelines or personal experience would be appreciated.
Thank you.
Personally, I would go for the surgery. Being able to eat comfortably even in the presence of AD is a basic human function and I think would make him more miserable than if he didn't have it.
My father couldn't eat for 10 months after intubation and a long slow recovery. He joked that dreams of a Big Mac kept him alive while he was struggling to regain his swallowing function. Living on tube feeding was really challenging for this strong man. But he prevailed only because he kept pushing and because I fought to find speech therapists who wouldn't give up, as some of them did quite easily.
Take some downtime for yourself to just relax and help clear your mind before you make the decision. Nice long shower, favorite book or magazines...just something to refocus so that when you consider the issue again (and I'm assuming that will occur soon), you'll feel more comfortable that you've evaluated all the options and chosen the best under the circumstances.
It's true that anesthesia can and does worsen cognition and will probably exacerbate your dad's Alzheimer's. But in the long run, without the surgery, your dad will have problems eating, he'll experience pain, and is at risk for infection, all of which will worsen the Alzheimer's as well.
Since he's in kind of a no-win situation I'd go with the surgery. At least with the surgery your dad will physically improve. Without the surgery you've got the mental issue AND the physical issue to deal with.
Good luck with your decision.