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My mother is 94 and up until 2 months ago, she was perfectly fine. Completely independent. She managed her entire life with very little assistance from me. She was hospitalized for 10 days and rehab for another 10 due to a bowel obstruction. Mother came home a different person. She can't remember how to do any little thing, totally confused about days, has to use a walker and wears diapers. She fixates on things and worries way more than she used to do. I do pretty much everything for her now. She will ask me 100 times how to do the same thing. Mother got upset two days ago and asked me what happened to her? I honestly don't know. The hospital changed her medicines and she had to be put to sleep for a procedure. Does anyone have any experience like this?

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Yes is the quick answer.

This is, unfortunately, very very common.

Rather than dementia, this is called *delerium*.

People over 65 are more at risk. Top triggers are
1. infections (UTI, chest infection/pneumonia, Covid)
2. Anaesthetics
3. ICU stay
4. Hospital stay
5. Medication withdrawal
6. Dehydration, electrolyte imbalance, low sodium

All these cause stress on the body & brain.

It can last days, weeks, fluctuate for weeks, or even be the new level of functioning.

Be patient. Be hopeful. But also be practical & arrange more care for Mother, more hands to help you so you don't burn out.
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I’m 58. This past Oct/Nov, after major surgery, I was in the hospital for a total of 9 days for complications.

When I came out, I had trouble getting ideas from my brain to my tongue. I literally couldn’t find the correct words. This particular issue lasted 2 months. It was most upsetting. Apparently, my brain was too stressed to work correctly.

I could type just fine. But, verbally, I was way off. It was so very frustrating.

I can very much understand what an operation and hospital/rehab stays might do to cause delirium in someone who is 94.

I am sorry that this is happening to your mother.
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Everything Beatty said and don’t let her be put on Aricept or Namenda, at least until she has had a LOT of normal routine with time to recover and don’t do other procedures that require anesthesia unless absolutely necessary is my not a doctor advice.

Sadly, delirium seems to fast forward the decline that was inching forward prior to the hospital stay.

She has lived a nice long life and this can be a wake up call to get all essential paperwork and bucket lists taken care of.
Get lots of help. Let us know how she is doing.
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My father recovered 100% from this exact scenario after a hospitalization and 21 days in rehab. Mom too, although not 100% because she was already diagnosed with dementia beforehand. So her dementia got worse with the hospital delirium after rehab.

Give your mom a couple of months to reorient herself before you draw any conclusions about her permanently.

Good luck to you
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My first MIL aged 93 did exactly the same thing. She went into hospital, found it very upsetting, and was never the same afterwards. She lived to 99, and recovered a fair bit, but never to her pre-hospital state. I don’t think anyone did anything wrong, it was just too different, too threatening, too much unpleasant change for her settled way of living. Clearly she didn't 'catch it' in hospital.
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LisaMG7 Jul 2022
MargeretMcken, they have a name for it. It's called hospital-induced delirium.
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Reassure her and give her more time to recover. The medical problem itself, the procedure and the anaesthesia could all together and individually have contributed to her current mental upset, and it's too early to say whether this has to be permanent or not.

Meanwhile, help her keep her tasks and routines clear-cut, deliberate and with plenty of rest breaks in between. Remind her that she is still in the convalescent phase and must cut herself plenty of slack.

Examples of how to help: a display clock showing time with clear day/night markings, day and date. A timetable for each day, and a calendar for the week. If she's struggling with the phone then consider getting one where the speed dial numbers have the person's photo next to them - but go carefully before you replace any devices or appliances that she's very familiar with, and make sure the new one really is easier *for her* to use.

Does she have support with continence care, personal care, and medications? - besides you, I mean?

Above all, lay on the reassurance with a trowel. She's been through an ordeal, God willing this will get better, and don't panic :)

[Did the procedure sort out the bowel obstruction? No residual underlying causes to worry about?]
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My mother was hospitalized with a gallbladder infection at age 92, hospitalized for 17 days, then went to rehab which became her permanent SNF placement. Previously to the hospitalization, she lived "independently" in her own condo.

She descended (further) into dementia. I say "further" because if she could totally control her environment in her condo, she could mask it to many people. I, the local sib, saw her decline (and finally my long-distance brothers did, also).

Honestly, she had only 1 or 2 lucid days after that hospitalization, and she died less than 6 months later in the SNF.
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Check Mom for a bladder infection. My Mom who is 96 was in Independent Living, doing well. Within a week she quit eating, became very confused. She is now in Assisted Living with dementia. She had a bladder infection which the doctor neglected to treat. She was finally treated and doing a little better. I don’t know if the bladder infection caused her sudden decline but it sure seems to be a major part of her problem.
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My mom constantly gets UTI’s requiring hospital stays. After about 4 days or so she gets what her doctor said hospital delirium. After she’s out and home in her surroundings after a few days she back to her normal. The longer you stay in hospital the longer it lasts. Hope this helps. I googled it too so I can make myself more aware and I do see what the doctor says. Wishing you luck. I know it sucks. Earlier this month mom was in and she had delirium times right with full moon. It was a poop show.
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Erikka Jul 2022
Btw, there’s a correlation between low estrogen and UTIs so taking estrogen might mean fewer UTIs.
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Years ago my dad had a knee replacement and came out of surgery a crazy person. Before he was normal. They told us some elderly people have a reaction to the anesthesia that brings on dementia. He came out of it in a couple weeks luckily but was told some don’t. She could of had a mini stroke. It sure is not easy I am on year 4 caring for my mom with dementia. Good luck stay strong and be happy!
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2 factors at work here.
Anesthesia can wreck havoc on a persons brain, and if the person is older it is worse.
There is a condition called Hospital delirium and from what I have read it can take weeks or months to recover.
I would contact her doctor and make them aware of this.
Go on line and read some of the ways to help her recover from this if it is hospital delirium.
Also...check for UTI there are over the counter test strips that can give you an idea.
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It could be what is called post op delirium that will clear up with time OR your mother could have already had some cognitive issues going on and the anesthesia from the surgery brought it to the forefront...or worsened it... for lack of a better word.

Give her several months and be patient. She may pull out of this.

Take care.
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Anesthesia stays in your system up to a year.
It can have mental side effects that should go away over time.
It can also cause constipation, which they just dealt with.
Let her doctor know.
Maybe he can reassure her so she’s not so anxious. (I’m basing that on her saying, “what happened to me?”)
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Demand an MRI to see whether she could have had a stroke (sometimes strokes can be mitigated if treated immediately).

Get a copy of her medical records and review them. (Any medical mistakes will be white washed). Look specifically for medication changes.

Check her medications upon admission and discharge. Did they add anything? Remove anything? Change dosages?

!!Do not make any changes yourself without the advice and supervision of a doctor!! Some medication changes must be slow and “weaned.”

Chart out side effects, drug interactions.

My mom was discharged once as a completely different person also. The culprit was medication changes.
My mom was prescribed medications that should not have been prescribed together in dosages that were not appropriate for her size. The changes happened during a hospitalization. Her doctors were reluctant to admit this, standing behind their expertise, and refused to remove her medications or lower her dosages. I was sure something must have happened during that hospital stay.

I switched doctors. Mom came back, 100% after the slow weaning process that was closely supervised by a cardiologist.

The medical records from the doctors who would not make the changes when I asked read “daughter is in denial.”

Follow your instincts.
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Perhaps being put under exposed something else going on like the beginnings of dementia. When my dad had the same surgery (we did not know at that time that he was in the beginning stages of dementia) it took him several weeks to overcome the effects of the sedation. Might want to have a chat with her doctor about this.
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Yes, definitely long stays in hospitals or rehabs plus anesthesia can have a brain fog side effect. It took my dad about 6 weeks for his head to clear up and he was 85. Your mom is much older. The change in medications may be contributing also. You may want to speak with her primary about the changes.
It takes them a long time to rebound. Ask about setting up home PT to get her up and moving better. Good stimulation.
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At 94, a hospital stay can completely disrupt an elder's life. Anesthesia can trigger changes in the brain that may or may not dissipate with time. A 20-day hospital plus rehab stay may have also induced delirium as can changes in routine and medications.

IMO, there is little else to do right now but to give her time. Slowly return her to her pre-bowel obstruction routines. If she cooked for herself, cook with her but coach her through the process. Hopefully, she will gain confidence.

And I would not put your mother through any more hospital procedures. Too many doctors do not consider the toll a hospitalization or outpatient procedure takes on elders.

My MIL had her knee replaced and regretted it because she was never the same after the surgery. In fact, she was diagnosed with a neurodegenerative illness around that same time. But whether the surgery triggered the illness or the illness triggered the failure of the knee surgery we will never know.
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" The hospital changed her medicines and she had to be put to sleep for a procedure."

Ask for a copy of MAR (Medicine Administration Record) from the hospital and the rehab. This should show every medicine that was prescribed and how it was administered. Review them with her regular doctor to get advice on readjustments. She may not be able to return to the exact regiment she was on prior to the hospital, but she very possibly does not need to be on the medicines they changed her to. This may take a few weeks to make the adjustments but hopefully she can become more like she was.

As others have said, the anesthesia may take some time to completely leave her system. Her doctor should be able to give you insight to this too. Our geriatrician recommends only local or regional anesthesia and sedation (you don't remember anything) whenever possible and if not, then decide how urgent is the procedure because as we age we do not respond and recover the same way as we did when we were younger.
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The anesthesia used during surgery can definitely cause a condition called delirium, which many lay-people might interpret to be dementia. The difference is that delirium usually wears off, while dementia gets progressively worse. It can be very bad—to the point where the patient is not only confused about where she is or how to do things, but also has hallucinations. This often occurs after prolonged surgeries such as heart procedures.
Because of your mother's age and fragile condition, it's entirely possible that the combination of anesthesia, surgical stress, and changed medicines could have caused this change in her behavior and cognitive function. Have you reported these changes in your mother to her doctor?
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My mom was 80 years old when she needed a skin graft for melanoma. It was a large graft from the bottom of her eye to the top of her lip. The plastic surgeon told me about the risks of dementia from anesthesia. He told me any surgery will carry that risk. My mom was never the same after the surgery. It’s possible she had the beginning of dementia but it was unnoticeable before the surgery. She went downhill in the past few years and is now in memory care. I had no choice, she needed the cancer removed but I feel so guilty about the surgery I gave consent for. I hope your situation is different and your mom continues to improve. Hugs
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That is a familiar story the same thing happened to my wife she went into an assisted care facility after a fall and broken wrist. After 30days she returned home. she was never the same a month later she was diagnosed with dementia. It was the worst place ever which may have worsened to case
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A little over a year ago my mom had to go for a consult for surgery. She's 88. The Doctor told her due to her age, medical condition, etc that the surgery alone could kill her (due to bleeding) and that the anesthesia could do this to her. He refused to do the surgery but suggested a second opinion. The last time my mom had surgery was over 20 years ago. It takes healthy adults some time to recover from surgery. Giver your mom some time and consult with her PCP if she continues with this.
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Yes … I believe every time you have anesthesia you can lose a little mentally … my 90 yr old father had hip surgery and was just like your mother… study up on dementia … it is rough … like becoming a toddler … and angry spells sometimes…very sad. She may not have Alzheimer’s ( my mother had)… probably a different dementia… maybe TMI… small stroke.
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irwind45150 Jul 2022
Your comments align 100% with what occurred with my Mom after hip replacement back in 2019. She was 85 at the time. She was in quarantine situations in the hospital and then rehab during the beginning of Covid (no visitors allowed timeframe). The family would visit through the windows and talk to her on the telephone, but it wasn't the same (no physical contact - and we are huggers). CT Scans, EEG's and a host of other screenings with a group of specialists including a Geriatric/Elder Care physician have produced NO reasons. To DONTKNOW 20: Patience, Perseverance, and Faith in yourself and your supreme being will be needed to get you through this day by day.
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Please delve into this with her medical team. It may be medications but, one thing for sure something something trigger this change… Hoping you get the answers you need💕
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I believe it definitely worsens any existing dementia or senility. My mother was slipping a little bit, but nothing of major concern for her age last November, but she went into the hospital in April with congestive heart failure and started exhibiting all of the symptoms of dementia. I had to make all medical decisions because she was deemed unable to do so, she lost track of time and place, started hallucinating and had to wear depends as well. She improved some once she got out but was still sundowning, confusing day and night and becoming more irrational. She went back into the hospital a month later and went even further downhill to the point they had to have a babysitter in her room. She was calling me and my husband all hours of the day and night claiming she was being held hostage, or was kidnapped as part of a medical experiment. She even grabbed a metal IV pole and ran into the hallway brandishing it at people. I ended up having to place her in the memory care unit of a nursing home, and two weeks later she was back in the hospital completely delusional, aggressive, incontinent and refusing to eat. She passed away in hospice last week. This all took place over a 4 month period. Each time she entered a hospital her mental state dramatically deteriorated.
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"The hospital changed her medicines and she had to be put to sleep for a procedure."

Everyone who goes through surgery can lose oxygen, which can alter the brain. All medications can have side effects. Perhaps it would benefit you and Mom to meet with a Geriatric Psychiatrist for an evaluation.
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Is your Mom in pain? Work on eliminating the pain first. Once the pain is significantly reduced, then work on the physical and mental. If your Mom is on meds, check for side effects.

I have noticed in myself and also when I was full-time care of my Mom, when I am in pain, I have a tendency to forget things, can’t stay focused, not really do much, because my brain is so focused on the pain that nothing else matters. In my Moms case, she was on such high dose pain killers that she was addicted to pain killers and the pain killers were no longer managing the pain.

Once the pain is at a tolerable level, then she has a chance on being able to concentrate on minor tasks like walking, eating, sitting, etc.

Regarding pain pill addiction, the way we found it was that we went to ER when my Mother was crying because the pain was so intense. Yet her doctor had said that the injury sustained was completely healed and she should be free of pain. We gave her a normal injection dose of oxi (yes, that one), and one hour later, there was no change to her pain. The doctor asked if I wanted to give her another injection or try morphine and I said no. He did tell us that she had severe arthritis which was news to me! With the assistance of her PCP, we immediately changed over to OTC pain killers and CBD (no THC) and the pain became manageable over a few days. Two months later, we went to a Pain specialist who tweaked her meds for long term use of Tylenol and Alleve. Within 4 weeks, she could finally balance and stand up. Within 3 months she could walk with a walker and in 6 months completely out of the wheelchair. However, certain mental issues remained and she could no longer live completely independently (she is over 100 years old now)

I will tell you that my path was not easy as Doctors and PT were telling me that my Mom was doing exceptionally well for her age and the pain was to be expected. However, I did manage to find snippets of good info amongst them all and continue to use what they showed me even today.
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PeggySue2020 Jul 2022
When I had my breast cancer reconstruction, I ended up rehosped because I got pleurisy.

I demanded the diluidid pain pump I had back. Didn’t get that but all sorts of pain meds. Morphine. Demerol. None of it cut the pain.

I have previous ulcers so declined Torodol until I could get the hospitalist to talk to my md sister. When both of them said yes, I took the shot. The pain went away.

Torodol is dangerous for routine use, however.
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Something similar happened to my hale and otherwise healthy father when he was 83 and nearly died from sepsis. He was hospitalized for a month, had to have a kidney removed since the sepsis destroyed it, and then rehabbed for a few weeks followed by weekly dialysis. More than one nurse assured us that his lack of coherency, forgetfulness, hallucinations, and inability to do the smallest things (like shave with an electric razor) often occurred in extreme cases like dad's. They called it 'hospital-induced delirium' and told us that patients can recover once they are back in their normal routines and the remains of all the chemical therapies have left their bodies.

And once dad was back home, he did gradually become himself again after a couple months. I think the combination of so many drugs (he had no less than a dozen different bags hanging off the IV tree at any given time), the sense of losing time from laying in the same hospital bed day after day, the operation, and just the ravages of the illness itself altered his mental state.

Give your mom time... as their family we're anxious for them to resume their normal lives immediately but she has gone through a lot and is elderly. Keep reassuring her because she's scared (my dad was, too, even though he wouldn't admit it). Help her to eat good food, stay hydrated, and keep her primary care physician involved (they know her better than anyone). I think one of the hardest things for the family to do is to not lose patience, so when mom is asking you the same thing for the twentieth time, take a deep breath, smile, and patiently reply.

You said the hospital changed her meds... I would call her PCP immediately and ask them to review the changes, this could account for some of the issues she is having.

Good luck to you and mom.
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My mother developed hallucinations. The meds they are given are usually too much. My mom came back to herself when back home and meds adjusted
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