Knee surgery and concerned about further cognitive decline

Every situation is different. I looked to comfort care with my dad. He had an advance medical directive.Some things that can be considered are is this to treat pain? Can pain be treated in another way? Can he understand why he’ll be in pain and have limited use for a while after surgery? Can he participate in PT? Is he difficult to keep up with and will repairing the knee provide him more stamina to wander?

I thought what you describe is local anesthetic. People with cognition issues sometimes just can’t process what’s happening that well.

I had a growth removed from my cousin’s forehead with light sedation, because it bothered her and she kept rubbing it.

I think it depends on several factors. With MCI is he still active? How much pain is he in? My understanding is that any anesthesia could affect his cognitive decline. Also, there is a lot of strong pain medications to consider. I had a total knee replacement in June and it is a long, painful recovery. 3 months of PT - and then continuing the PT at home.
You say his is a partial replacement, though, so you would need to weigh the pros and cons. It is a hard decision to make. Good luck in your determining process.

Update - I’ve gotten input from two neurologists that my husband has seen and they both said that we should not worry about the knee surgery if the anesthesia is regionalized.

I've had partial knee replacement (I was 75 years old at the time) and had regional (spinal) anesthesia, but there was also conscious sedation (IV medication) given during the procedure, and during recovery as the anesthesia wore off, I had extreme knee pain, eventually requiring IV dilaudid (more potent than morphine). Regardles of what the neurologist said, there is the potential for post op increased confusion and deliirium and possible cognitive decline (I am not cognitively impaired but my wife is). I would only have the surgery if he is in significant pain with the knee or he would have improved mobility afterward. He will also require several weeks of rehabilitation if the surgery is to be successful (is he capable of following instructions and performing knee exercises with and without a walker?).

@grandmajoan, when is he scheduled for surgery? How are you doing?

The surgery is scheduled for early January. Thanks so much for asking.