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My 94 year old MIL recently fractured her hip, had surgery, went to rehab, and is now living with us. Believe it or not, until this happened she lived in her own apartment not too far from us. She is clearly unable to care for herself without some assistance. So far we are able to manage this and it's going well, and we think she's happy with us.


My concern is that my husband has mentioned a few times where she has been a bit confused. I want to say it's when she first wakes up. For example, he told me today that when she woke up, she kept asking him why her face was so red (and it wasn't) and that last night someone gave her a shot. Another time he said she pointed to the ceiling fan concerned that it was a tree that could fall. The only other thing I've noticed is that she talks in her sleep - not mumbling, but what sounds like full on conversations! The first time I heard it, I thought she was on the phone.


For the most part, she is coherent and spends most of her day talking on the phone. (She has many relatives all over the nation and they all call her at various times.) The only medication she is taking is Codeine for her hip pain. She also has severe arthritis in her knees. So it is quite painful for her to walk, but with a walker, she does it! It's quite amazing actually considering all that she's been through at her age.


My husband didn't seem as concerned about this confusion, but I wanted to see what others thought. Thank you.

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Is she on antibiotics for surgery? My Mom gets confused and frail when on them but is normally an energy bunny at 95!
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Also there is an over the counter gel -Voltaren- for arthritis, was recently a prescription. Voltaren works great for her knee and back pain.
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You've been given every answer here from it's absolutely nothing to it's a dire medical emergency!

Call your MILs doctor and ask HIM (or her) what he thinks is going on. It could be anything from a UTI to a stroke to nothing at all, honestly.

You seem quite worried about this situation, and in reality, the only thing that will bring you peace of mind is to have her seen by her PCP and maybe have a few tests run to be certain all is well inside of her 94 year old heart, mind and body. Certainly before you 'place her for the dementia she is obviously suffering from that will destroy your life'. Sigh.

Wishing you the best of luck and sending up a prayer that she's just recouping from her surgery and anesthesia.
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PenelopePitstop: Narcotic pain medication can manifest into auditory and visual hallucinations. I suggest that you speak with her orthopedist for weaning off the narcotic and opting for another medication. The medication that she is taking may also have side effects of constipation, which is ESPECIALLY difficult for an elder.
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It is obvious she is getting dementia which means she should be placed where she can be cared for. Taking on people with dementia is the last thing on earth I would recommend. It is horrible how the behaviors and needs will start to destroy you and your life. Please do something now before it gets worse or you will pay the price. She can't be fixed - it will get worse.
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Narcotics can cause this type of confusion. Narcotics are not the best medication to manage arthritis pain. She should be able to wean off the narcotics to non-opiode medications to mange residual hip pain. Talk with her orthopedic doctor about the symptoms you have noticed and her current medication usage. She/He can prescribe new medications and probably a plan for weaning off the codeine. Many people also find applications of heat (think heating pads) or cold (think ice packs) help with pain. Gentle stretching movements are also helpful. My physical therapist always said that "movement is lubricant" when it comes to arthritis. So, ask her doctor about physical therapy.
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Waking up confused should not be alarming. Even young and normal people have it once in a while. It's called Sleep Inercia. Of course, a 94 year old person has a 94 year old brain, which is not considered at optimum level of functioning. Sleep inercia in an elderly person is surely more severe. Sometimes, we forget that old people have old brains and old hearts which are barely functioning.
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Might also want to have her iron levels checked - lower blood oxygen problem possible.
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Your MIL may still be recovering from anesthesia, and/or having low oxygen overnight due to a degree of sleep apnea or side effects of pain medication (which can suppress breathing, the reason some people die of opiate addiction.) She may need overnight supplemental oxygen, just oxygen, and maybe just temporarily. I agree with everyone here who recommends consulting with her doctor(s). Talking in one's sleep may not be troublesome, but awaking to seeing the ceiling fan as a 'tree' is a sort of hallucination, also a feature of elders' surgery 'delirium'. Even if not a health hazard, these episodes are likely very stressful for her emotionally. All the best.
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When elderly person has had anesthesia it can take awhile for this to dissipate and may not entirely. The best to do is contact her doctor for a medical opinion as none of us know her medical condition and can only provide our experiences. Each one below are valid but only her doctor can help you for her.
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I wouldn't be overly concerned. Have her checked for UTI, just in case. There Are side effects for codeine...including "confusion and unusual thoughts or behaviors ".
Sounds like your Mom is doing very well. When she no longer needs her medications, sounds like she'll be fine.
When I had my knee replaced (I was 69) and I returned home, I was positive that there was a white bird stuck in our tree. There was not!!, but my mind said so. We still laugh about it.
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Early am after deep sleep can cause some mild confusion. Mention it to the MD at her next appointment..at 94 this does not seem very concerning to me. Also surgery can take weeks to shake off. Confusion happens to my mom badly after surgery {she is 88}.
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When my 94 yo MIL had ankle surgery, she was REALLY out of it for a couple of days. Crazy land! Thought there were people on the lower roof of the hospital looking into her room at night with flashlights, for example! Wow. Took a few days to get re-oriented a bit and another week or two for her to be more like herself again.

I would say most (not all) people her age have some level of dementia. It's kind of a roller coaster. Some days/times, it's very clear that something serious is going on. Other times, seems pretty normal. Guess you'll have to roll with it and see what the future brings.

Is she getting home PT? Did she go to rehab after surgery? Don't take on too much yourself. You'll burn out very quickly. Get outside help and services to help with her needs, especially now while she really needs it. Many elders recover very well from hip surgery, as long as they do the PT and stay active.

Good luck!
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About 10 months ago, my 94 year old mother woke me up around 6:00 am and said: "I thought we were going down to the river to pray?" So i called her doctor and she had me pick up a sample hat for a urine test. I brought it back and by the end of the day they called me with the results. She didn't have a UTI.
So I think it was just a very realistic dream because it hasn't happened since then.
Her doctor says she has a normal 94 year old brain.
It is easy to have her tested for a UTI and you can get results back quickly.
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Did she have a catheter in at any point in the hospital or rehab? If so she could very likely have a UTI, and should be checked at Urgent Care. Often in very elder women there are no other symptoms except behavioral/cognitive ones, or she is now less able to express her discomfort or symptoms.
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I just had surgery three weeks ago, and anesthesia really messes you up for a while. I'm only 60, and I can't concentrate on a book, I'm muddy-headed first thing in the mornings, and I can't come up with words. I know this will pass since I had this the last time I had anesthesia 15 years ago, but it'll do a number on an elderly person.
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PenelopePitstop Dec 2021
I didn't know that until today! Thank you for sharing, that does make me feel a little better.
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Your profile says MIL has Dementia. If she has been formally diagnoised with a Dementia what you have mentioned is normal. If she had any signs of cognitive decline before the surgery, the anesthesia will worsen it. She has been thru a lot for a 94 yr old.

If no Dementia prior broken hips in the elderly are serious. Her being under will cause confusion for a while. It takes longer in the elderly for anesthesia to leave their bodies. Being in Rehab can cause problems being out of her familiar surroundings.

My Dad had heart problems and he woke up confused. Took him about a half hour to feel normal. Did MIL have Labs done while in the hospital? To check potassium levels, sugar, thyroid, cholesterol, etc. If not its a good idea to have them done to make sure nothing physical is going on.
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PenelopePitstop Dec 2021
I didn't know my profile says that. Sorry, I must have done something wrong. She does NOT have dementia. I don't remember saying that, but when I set up my profile I thought I was checking off topics of interest to me.
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What would you expect from a 94 year old? She seems to be doing remarkable well for her age. Of course, her heart and her brain might be very close to their expiration date as shown by her symptoms.
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PenelopePitstop Dec 2021
That's pretty much what my husband says... "she's 94!" I guess it's the reality. So far though, her lungs and heart are in pretty good shape (for a 94 year old).
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PP, let me tell you something.

A change in mental status is a medical emergency. In a person of ANY age.
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PenelopePitstop Dec 2021
Yes, it's really scaring me to be honest.
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You shoukd also know that UTIs often cause confusion and behavioral symptoms in elders. It might be wothwhile to get that checked out, especially if this is a sudden onset thing.
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PenelopePitstop Dec 2021
Thank you, I just read that when I searched for possible reasons!
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Sometimes medications like codeine can cause deeper sleep, more vivid dreams and a sort of grey zone upon awakening where it is difficult to separate dreams and reality. At her age she no doubt also has poorer vision and hearing which can also add to the confusion.
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PenelopePitstop Dec 2021
Thanks, that makes me feel a little better. She claims that the Codeine does nothing for her but I doubt that is the case. I was also thinking it's that "grey zone" of separating dreams and reality (and considering her age). As far as I know, she doesn't do this randomly when she's awake. It appears to be after sleeping. I bet that's what it is.
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Often times the elderly after surgery will suffer dementia type symptoms from the anesthesia. I'm hoping her doctor explained all that to you or your husband prior to her surgery. Sometimes it wears off and other times it's permanent.
It's very scary. I'm only 62 years old, but the last 2 foot surgeries I've had, I requested just to be heavily sedated and for them not to use the traditional anesthesia, which thankfully they were able to.
Hopefully it's nothing serious. Bless you for stepping up to take care of her during this time.
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PenelopePitstop Dec 2021
No, that is the first I am hearing of such a thing, but maybe they told my husband. This is all new to me (and him too). Right before all this happened, her primary care doctor retired so currently we are looking for a new one and we will definitely discuss all of this with them, as well as the confusion issue. I think I'm more concerned about it than he is. (When I express my concerns, he just says, "She's 94!" As long as we are able to care for her in our home, we will.
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