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I. How We Work in Washington. Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services. APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
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VI. No Waiver of Your Rights. APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.I agree that: A.I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information"). B.APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink. C.APFM may send all communications to me electronically via e-mail or by access to an APFM web site. D.If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records. E.This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year. F.You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
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Anesthesia is not great for people with dementia. I also have to ask these questions. 1. Can and will she follow direction? 2. Will she and the family follow through with rehab? 3. Does she REALLY need the knee replacement? If it is pain can that be managed with medication and ointments? As the dementia progresses she may not walk in 6 months or a year. Ya never know. And I am guessing if the surgery was scheduled to be done soon I am sure that is on hold. If not I certainly would not undergo surgery at this time. For a variety of reasons. But to be in a hospital now is not a good place to be, rehab facility is not a great place to be with the lock downs not to mention that after surgery she will be more susceptible to picking up any virus that she happens to be exposed to. But basic answer is the recovery from anesthesia is slow and she may not ever get back to the baseline where she is now.
Thank you! This has been weighing heavily on my mind. It’s like damn if she gets it , damn if she doesn’t. No she is not scheduled for surgery. We were informed after an X-ray of her knee. She definitely needs one. She is not able to walk and the grinding and crushing sounds is a true indication. My mom can’t do anything for herself. I have taken over my mom’s care due to my dad passing 2 months ago. My brother stopped because he was no longer getting paid. That’s another question later! SMH!
I can't and won't try to interpret what someone in a later stage could do, as this probably should be answered by the orthopedist who would perform the surgery, but I do think that the post op care might be challenging b/c of the need to exercise the lower leg. I've seen some who manually exercise, and others who've used a device that automatically moves the lower leg back and forth.
The last time I saw this though was over a decade ago, so there may be new and better methods of post surgery rehab for knee replacement.
Another consideration: I'm assuming she would rehab in a facility so she could get not only nursing but PT and OT. Given the massive lockdowns of almost all commercial establishments, I wonder if she would be able to get a bed in a rehab facility at this time? And would you and the ortho doctor want her to be exposed to a closed-in environment, given post surgery vulnerability?
Beside all the other issues about major surgery for elders is the question of physical therapy. Would your mom be willing and able to complete the difficult PT following surgery? If there’s any doubt about this aspect it’s probably not a good idea to have the replacement surgery.
WR, you just said what I was typing! After my dad’s knee replacement the physical therapy was weeks long, very structured, and tiring to him. And that was without dementia. I agree with you, so much depends on being able to the therapy
- nerve ablation (a minimally invasive procedure that cauterizes the nerve sending the pain). The only real down-side is that the nerve can sometimes regrow. I think there is no anesthesia required.
- SPRint PNS System (Peripheral Nerve Stimulation) Minimally invasive, no anesthesia. Requires having a very tiny lead (like a hair) inserted for up to 60 days which sends non-painful impulses and is controlled by a hand-held device. 74% of patients have no more pain after that. Could work sooner than 60 days. Lead is removed after treatment. No real down side. https://www.sprtherapeutics.com
- gel injections. This has worked on 1 knee for my mom but not the other. (My mom is 90 and still very active). You may need to have injections more than once. My mom didn't require more than once in her 1 knee.
- pain clinic. You can get topical anti-inflammatory and pain meds but you will need to administer these creams to your mom several times per day. Not systemic like taking pills which can affect stomach and liver, etc.
My father with vascular dementia did fine with a hip replacement. There is a risk the anesthesia will advance your mother's dementia and rehab is absolutely necessary. As a stop-gap measure, you may want to try gel pack wraps. I think the gentle pressure from the gel pack forming around the knee does as much good to remove inflammation as the icing.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
I also have to ask these questions.
1. Can and will she follow direction?
2. Will she and the family follow through with rehab?
3. Does she REALLY need the knee replacement? If it is pain can that be managed with medication and ointments?
As the dementia progresses she may not walk in 6 months or a year. Ya never know.
And I am guessing if the surgery was scheduled to be done soon I am sure that is on hold. If not I certainly would not undergo surgery at this time. For a variety of reasons. But to be in a hospital now is not a good place to be, rehab facility is not a great place to be with the lock downs not to mention that after surgery she will be more susceptible to picking up any virus that she happens to be exposed to.
But basic answer is the recovery from anesthesia is slow and she may not ever get back to the baseline where she is now.
The last time I saw this though was over a decade ago, so there may be new and better methods of post surgery rehab for knee replacement.
Another consideration: I'm assuming she would rehab in a facility so she could get not only nursing but PT and OT. Given the massive lockdowns of almost all commercial establishments, I wonder if she would be able to get a bed in a rehab facility at this time? And would you and the ortho doctor want her to be exposed to a closed-in environment, given post surgery vulnerability?
- nerve ablation (a minimally invasive procedure that cauterizes the nerve sending the pain). The only real down-side is that the nerve can sometimes regrow. I think there is no anesthesia required.
- SPRint PNS System (Peripheral Nerve Stimulation) Minimally invasive, no anesthesia. Requires having a very tiny lead (like a hair) inserted for up to 60 days which sends non-painful impulses and is controlled by a hand-held device. 74% of patients have no more pain after that. Could work sooner than 60 days. Lead is removed after treatment. No real down side. https://www.sprtherapeutics.com
- gel injections. This has worked on 1 knee for my mom but not the other. (My mom is 90 and still very active). You may need to have injections more than once. My mom didn't require more than once in her 1 knee.
- pain clinic. You can get topical anti-inflammatory and pain meds but you will need to administer these creams to your mom several times per day. Not systemic like taking pills which can affect stomach and liver, etc.
I hope you find a solution that works for you!
https://www.amazon.com/Koo-Care-Flexible-Elastic-Strap-Therapy/dp/B019LOCWLU/ref=sr_1_25?crid=208GWRVHP2QEJ&keywords=ice+pack+wrap+for+knee&qid=1584534853&sprefix=ice+pack+wra%2Caps%2C386&sr=8-25