My Dad has a lot of health issues which is why I've moved him down to assisted living near me, because I was on a plane every other week this summer. I know he had some short term memory issues that have become increasingly apparent as I spend more time with him, but no diagnosis.
He had an episode related to one of his chronic conditions about 10 days ago, was in the hospital, and is now moved to a rehab. But I feel like his cognitive abilities have gone downhill very, very dramatically. Some of it might be meds, but it still feels very sudden. It's like he went from being a little confused but able to have a nice conversation over the dinner table with my family, to screaming inappropriate things and pulling out his IV and not even knowing where he is or why. In less than two weeks!
I feel like it's an uphill battle with the doctors because they meet him and think "agitated senior with dementia" and I'm like, but no, this is NEW.
You need to get the doctors to listen to you. Keep saying this is new. Ask for a Neurological consult.
My father was so bad with his hospital delirium that my daughter slept in his room during his entire stay so that every time he woke up agitated, she was there to calm him down!
All the changes, new meds, the illness itself and the hospital/rehab environment contribute to the delirium these seniors experience, and it's a terrible thing to witness!
Wishing you the best of luck dealing with a difficult situation.
Everything I have heard is to try to keep them on their normal routine as best as they can - sometimes I will give mom a small 1/2 dose of the lowest level Xanax (but she is allowed to have that as needed). You could speak with his doctors to see if they will prescribed something very small to take the edge off and not knock him out. I find even a 1/4 of the lowest dose just helps mom with the agitation and she can still fully participate in her day while she balances out. It usually balances out after a few days. Again I was told to keep mom on her regular schedule - remind her of the date and time and doing her normal routine. If you feel he needs something to help for daytime or even nighttime to sleep - even a small dose may help as they need sound sleep and that is hard in most anywhere outside of your home. Wishing him a speedy recovery 🦋
"I feel like it's an uphill battle with the doctors because they meet him and think "agitated senior with dementia" and I'm like, but no, this is NEW."
doctors often don't want to admit that they're in any way the cause for this.
as others have mentioned:
anesthesia while in hospital can definitely affect cognitive ability.
other drugs, too.
delirium is also possible.
moreover, sometimes the elderly are drugged, so they cause less "trouble" (ask for less help).
my LO -- every time -- after hospital has less cognitive ability; also slurred speech.
very luckily it's always been temporary, and 2, 3 weeks later, my LO is back to the same level as before.
i always gave my LO lots of water.
flush things out.
keep your father hydrated. i hope your father will be ok!!
I’m not privy to everything with your situation, but for mine, I knew a lot of his behavior was from anxiety. Children and seniors are actually alike in a lot of ways, because of their cognitive development level. Children’s anxieties can manifest in a lot of ways because they are unable to verbally express what they’re feeling or thinking.
My dad was no question freaking out because he didn’t know where he was or why. You’d tell him, he’d be looking at me, seeming like he understands, but might forget quickly, or be pretending to understand. Take nothing you see at face value.
Might it be because the hospital was familiar. But suddenly, he’s moved and he goes nuts. That happened to my dad. I wasn’t sure if it was because he used to read too many spy novels, but he thought that he was being held against his will, and multiple times tried to escape and attacked the hospital staff.
Patience with him. Give it a couple of weeks so that he can get used to the rhythm of the rehab facility. Everyone is I’m sure trying their best to meet ALL of his needs. Including you.
it sounds like your Mom is suffering from either age related depression, or withdrawal from the procedure she underwent. This forum may answer all this but also I recommend seeing a geriatric physician. Also exercise and visits by loving family members. An anti- depressant may work too. Best of luck!
Just as author describes, not even two weeks. First it was normal to slight impairment, shy of a year ago. All that went was her abilitty to keep track of monthly affairs and the like. Occcasional dreamy talk. Then unexpected hospitalization.
2.5 weeks in and she is a vegetable. I know they give her two anti psychotics.
And she has always been "My way or the highway" sort of person.
"My dad was no question freaking out because he didn’t know where he was or why. "
Yup. I keep telling my mom's doctors that my impression is that they are over complicating things. It's clearly just cabin fever.
Give your dad time to catch up on several nights of good sleep and clearing up his medical issues. If he doesn't return to more of his normal self, then talk to his doctor about an examination for neurological issues.
With my mother, she didn't decline gradually and consistently but instead would take a dive if she was in the hospital (delirium) or there was a big crisis like my dad's death or moving to her nursing home. I finally made the decision at the end of last year that the big dive she'd take when she was in the hospital was no longer worth it compared to the care she received there. She wasn't going to recover from either problem -- medical or cognitive -- so we brought her back to her memory care place and I said we're done with hospitals. From that point on, we brought in hospice and treated what ailed her in place. It was the best decision I made.
I’ve been googling “delirium” and “dementia” a ton. Generally speaking, delirium is reversible, and dementia is not. In my mom’s case, I think we’re looking at delirium - the disorientation comes and goes, and a fluctuating course generally points to delirium. Also, she doesn’t have major memory issues. She had an MRI as recently as April, there was nothing to indicate signs of dementia then. (Although I’ve read there is such a thing as rapid onset dementia.)
The first important thing to do seems to be to rule out infection and dehydration. Secondly, have the rehab MD review his meds, and deprescribe as much as possible. My mom is in hospice, and I had to suggest we try taking her off a diuretic, given her edema has fully resolved for the time being. Also, hospice put her on Ativan to try and control the restlessness, and for her it only made matters worse. They also wanted to prescribe Haloperidol, which I had to research to find would be dangerous for her (long QT). She does seem to be doing better on Trazodone.
Three, nerdmafia posted about “cabin fever.” Not sure how mobile your dad is, but my mom is bedbound, and I know it’s driving her nuts to mostly just be looking at the same three walls. I would be mourning the loss of my independence too. When I saw her “restless,” she was asking me to help pull her clothes off and get her up so she could go take a bath. Just getting her up to sit in a wheelchair in a different room seems to help somewhat.
I’m now waiting to speak to an MD to see if a multivitamin is ill-advised for any reason. In mom’s case, she is cachetic (difficulty absorbing nutrients), and while she has a good appetite and eats well, possibly nutritional deficiencies could be behind the cognitive decline. Probably a multivitamin isn’t going to do much, but I just really, really don’t want my mom to go out like this if she doesn’t have to.
So glad he has a great doctor in his corner! She says it can take time but she believes he will "come back" especially once he can get back to his AL.
My husband developed hospital delirium after being in ICU for several days, and it was ongoing for the remainder of his stay (about 2 weeks). He had no prior history with dementia or other cognitive or neurological conditions.
He had mostly returned to his usual self after a few days back home, though some confusion and anxiety (especially at night) lingered for another couple of weeks.
The neurologist he saw shortly before his release from the hospital (and continued seeing for another 2 months, just to monitor) told us about hospital delirium when she checked him out in the hospital & confirmed it at later appointments. Like the author of the article I linked to above, she lamented the fact that hospital staff don't seem to be aware of the prevalence or seriousness of this condition, much less how to help patients who develop it.
I'm glad things are moving forward for your dad in a positive direction, just thought I'd mention this condition since it was a huge relief to me when I learned about it 😊
My mom has bad delirium in hospital situations; we are talking hallucinations,( ninjas outside windows, dogs roaming in her room), every blinking light, every beep scares her, she's combative, pulls at IVs, etc.
I was scared that she would never get back to her MC, if we went the rehab route, plus this was in 2020, full blown covid, no Vax yet and I probably would have been locked out of rehab, so couldn't gage the situation.
So her MC agreed to let her come back, as long as we paid for caregivers to stay in her room with her. Which we did for about a month, then gradually pulled back to just nighttime, then none, as she improved and could be monitored in the common room during the day. They had in house PT and OT that came to her while she recovered her strength.
It made such a difference, she was back to her usual self in a couple of days, really even saw a big difference the next morning. The caregiver set up the video call and she was actually smiling and eating breakfast in her recliner.
No one believed me at first. I couldn’t easily get the doctors to listen.
When I later saw her records the doctors had attributed everything to dementia.
This is what you should do…
Jot down a list of the changes you have noticed. Confusion? Balance? Dizziness? Loss of appetite? Mood changes?
Gather up discharge directions itemizing a list of meds. (Were there any additional hospital only meds?)
Go to the pharmacy and get those stapled-on printout packets OR pull the same info from the internet.
Sort names of new meds from old meds. And add new meds that were working well to your chart first.
Chart - at least purpose, interactions, warnings and potential side effects.
(When I did this, I couldn’t believe that the pharmacy would even fill the prescriptions! There were so many warnings that drug A cannot be taken with drug D and drug B may cause serious confusion if taken with a class of medicines of which drug G belongs.)
Mom was getting side effects from some, dangerous interactions from others. Her life would have been over if no one would have stepped up.
Her doctor refused to make any changes. She said mom was fine and I was in denial regarding the aging process. Then her doctor went out of town and I took her back and saw the doctor’s partner.
The doctor’s partner listened and, having not prescribed anything herself, had no reason to take personal offense. She agreed with me and started slowly weaning Mom off. The change was a miracle.
A visiting nurse, who watched the whole thing unfold, helped another of her patients who had experienced the same thing.
I ended up moving mom closer to me and accordingly, all her doctors changed. I worked with an excellent specialist who continued to wean her off unnecessary medications. She felt better than she had in years. She lived years happier and healthier than she would have otherwise.
Seroquel is what worked .. but be very careful to stay away from the
newer antipsychotics!!!! Can be very dangerous for dementia!!!
try to get it established while he’s still in hospital … insist on geriatric specialist … and be very patient
Vitamins are safe, easy and maybe worth a try. You will need, though, a vitamin complex with higher doses of vitamins; they will have, say, 2,000% or the RDA for most B vitamins because the body does not absorb them well. A Boost shake with only 25% of the RDA of vitamins might help some, but a person needs larger doses if they have slipped into crisis.
This was just our experience, but something this simple was surprisingly helpful here. Best of luck with this—it seems to be pretty common, unfortunately.
This did eventually clear up for him, however, I think you’re wise connecting with your dad’s PCP about it. Something similar happened to an aunt of ours, and her delirium never went away. She became very hostile and combative.