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Hi,



I have just joined the forum after visiting for many years!
Sorry in advance for my long message.



I am based in the UK and help care for my 88 y/o Gran.



She just had a week in hospital after a mild bout of pneumonia and a UTI.



We got her home last night but she didn’t seem to recognise her flat and also was expecting me to do everything, take her to the toilet, pull her trousers down, undress her for bed (although she was quite able to work the TV and check the messages on her phone?)



Prior to going into hospital she was doing these things for herself, but does have carers in two times a day to do meals for her, laundry and give her a shower etc.



This does sound awful but she has, for at least the last 20 years, been a very lazy person. My Grandfather did pretty much everything for her until he developed dementia 10 years ago (he died in 2016).
I lived with my Grandparents from age 11 to 19 after my mother died, hence I am more involved in capacity of a Daughter than Granddaughter.



Obviously being in the hospital she got used to the nurses doing everything for her, but she was only in a week, seems a short time for her to completely forget how her life was before hand?
She does not live in the home she shared with Grandad, she moved to a managed flat when he went into care although there are not staff there all the time. There are pull cords etc. in case she falls.



My Dad (65) also helps care for her, he takes her to appointments, deals with her finances. My involvement I mainly do food shopping, a bit of cleaning but really up until now I have only visited once a week to do these things but will mainly spend a few hours just as company for her, chatting.



There is a communal area in her building and she used to go down there herself to meet with the neighbours for coffee etc. but when the pandemic struck it closed for two years and when they reopened it this year she decided she wasn’t able to do that any more so spends all day at home. I think she is still able but just lost confidence. But try as I might I can’t convince her, even if I offer to walk down with her (she has a walker too which she can use well).



My view is that if she wants to continue living independently in the way she has been then she will need to start doing things for herself again as neither my Dad or I or her carers can be there 24 hours a day.



Maybe she will bounce back again, just wondered is this a normal thing after a stay in hospital or is this usually when the conversation about a nursing/care home needs to start?



I personally think she would enjoy a care home but has a mental block about it as my Grandad’s was a specialist unit for dementia and it was upsetting for her when we would visit.



Sorry for long message, just be nice to be able to chat to folks going through the same thing, as I don’t think people who aren’t currently in it appreciate how stressful it is and how much mental space it takes up for us.



Thank you,
Jennifer

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My 95 yo mother had surgery. The day after surgery, while still in the hospital, she started showing signs of memory loss/confusion/hallucinations - which, prior to being admitted, she did not have. The doc and nurses kept saying she had dementia, yet, I would show them videos of mother engaged in conversations that were I took of her days/weeks/months prior - which did not show any signs of dementia. Yet, they insisted.

When she was transported to rehab, the paperwork showed that she had 'dementia' which I protested but they would not listen. She continued to exhibit the behavior and so it was kind of like she reinforced what they 'thought' she had. But I kept being a b#!*% about it and showing anyone and everyone who she had been even the day before hospital admittance. A kind nurse who finally listened to me suggested that mother had 'post operative delirium' due to the drugs and medications they gave her in the hospital and that hopefully, it would wear off. Yes, it did gradually wear off every day over 3 weeks time - she never was 100% again, but at least she was 85%.

It could be this is what your gran might have?
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Hi! I do know when my mom was in the hospital (mental illness) for 2 months she came to live with us afterwards, and unfortunately, suffered from delirium when came out and had issues bouncing back for a while. She was left in the hospital too long but that's not your case with your g-mom. Maybe your grandmom did in fact enjoy being taken care of. Does she have dementia or any other mental instability? Maybe it's time for a caregiver (we have that now part-time and it's great for socialization, oversee safety, etc.) or even a facility if you feel the time has come, which would be a relief to you and your dad. I hope it works out for you whatever you decide.
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A UTI alone will cause confusion and definitely a hospital stay causes delirium. Google it. I’m dealing with it now with my husband who was in the hospital
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My mom had a bout like this and it did not get better.

Then it got worse. She literally went (and I’m not kidding or exaggerating) overnight from getting around (not well, but getting around) to not being able to walk or stand or doing anything. She was extremely confused.

The doctors said it was lingering effects from her recent hospitalization for bacteria pneumonia but I felt otherwise. Shes my mom and I think I knew her better than the doctors and I had watched her decline over the last several years. The dementia took a cliff dive and she was not going to get better.

I don’t think your gran is trying to get attention by having you do all those intimate care tasks. I don’t think anyone of us wants that kind of attention.

It may be time to start planning for some other care options. DONT WAIT until you are ready . Get things in place now because (at least in my case) it was a messy, lengthy, expensive process. Covid did not help. My mom died in October 2021. This dementia stuff is horrible.

Good luck.
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Katefalc Jun 2022
I’m so sorry for your loss. This is heartbreaking. Im going thru it now with my husband. He took a nose dive since he had Covid in April. He’s currently on hospice care.💔
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Why there s so much resistance for accepting a very common fact that an 88 year-old lady might be developing dementia? It would be perfectly acceptable at her age.
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DreamerJen Jun 2022
I do feel like she might be, but when ever she has been assessed we just told there is “no sign of cognitive impairment”.
In my view she hasn’t had enough extensive testing for them to say that with confidence!! But then again what do I know?
Doctor is visiting again today so will see what comes of that.
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She probably is a little weak after her bout with a UTI and pneumonia. She would probably benefit from everybody "encouraging her to do more for herself" and helping only if she needs assistance. If she continues to need a lot of assistance after a week of extra help, she may indeed be ready for a move to a unit that provides more nursing care.
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DreamerJen Jun 2022
Thank you Taarna. This is what I feel. So far there is not much improvement. I try and chat to her or ask her opinion on things (I was putting a clock on the wall for and asking where she wanted it) I just get “I don’t know” to everything which is not like her.
Perhaps there is the beginnings of dementia there.
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If her doctor says her UTI symptoms have resolved, maybe you could set up a therapist or counselor to come and speak with her, or a pastor if she would respond better to that. I'm sure the illness was frightening for her, and it sounds like she has also been through a lot of loss and change in the past few years. I hope she is better soon.
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Thank you all so much for your thoughtful replies! I read them all.

I do feel I have been a bit harsh in expecting her to bounce back to normal so soon. Probably down to my own selfishness as I’m not ready to lose her and I want her life to be as good as possible.
She has not been home yet for a full week so will continue to monitor how things go.
I have tried (pre hospital) taking her down to the communal lounge, with her walker and in the wheel chair but after about 10 minutes she just says take me back again. I think she agrees to humour me more than anything.
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Katefalc Jun 2022
This is not easy. It’s very sad for all of us. God Bless her and you 💜
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I'm glad you talked to her doctor about her memory problems. Everyone today has heard of Alzheimer's and other types of "dementia". Many care givers on this forum struggle with the tragedy of dementia in their loved ones. And it is important to diagnose it correctly. But doctors also recognize a condition they call MCI- Mild Cognitive Impairment, much more common than Alzheimer's, but still problematic for many people.

Alzheimers is a fatal disease with distinct behaviors.. Dementia is caused by different types of progressive brain damage. MCI causes some disability but is considered part of normal aging.

An older person who has slower reflexes, often forgets, sometimes repeats questions or favorite jokes, is likely suffering from MCI. Elders have difficulty adjusting to the unfamiliar--a hospitalization or using a cell phone. They often insist on rigid schedules, even rituals, and consistent places to keep certain items as a way of remembering. They may temporarily forget familiar words (but not likely family members or a childhood best friend).

Younger people sometimes find MCI disconcerting, but should avoid considering such behavior "dementia" unless medically diagnosed.. Every stage in life has it own difficulties from toddler-hood to old age. We will all likely have MCI if we live long enough. We all learn to walk... but someday we may need a walker or a cane to do it.
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My mom experienced the same thing. Went in for a surgery perfectly 'normal' (for an 80 year old)

Came out of anesthesia disoriented, freaked out, and somewhat violent. She didn't know where she was or who anyone was.

A good rule of thumb is that for every day in the hospital/rehab, it takes roughly 3 days to recover. So a 30-day stay can result in 90 days of recovery.

Unfortunately, my mom continued to get worse. We thought she would be ok in independent living but was quickly moved to AL after we installed a camera and saw what she was going through. (Unable to go to the bathroom by herself, would forget to pull up her pants, the list goes on...) and Sundowning like crazy... constant pacing, doing loops around her apartment, throwing things, opening the front door and yelling down the hall for help... It was a sad situation.
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asfastas1can Jun 2022
Please make sure she is checked for a UTI. These are insidious and evil in the elderly because the only symptom can be cognitive disfunction. My mother just had her seventh one in two years, but mental symptoms happened so gradually this last time, that we were chalking it up to getting older. The last two weeks the decline was so dramatic that we knew it was another UTI. She gets tested every two weeks, but this past week she had three tests, and the last one was the only one that showed an infection - and it was mild. She is now on an antibiotic, and it seems she is already showing some improvement. I wish they would just keep her on maintenance doses of antibiotics, but doctors seem afraid of antibiotic resistance (even in a 92 year old). I hate to think of her last days on earth of being bounced between UTI's and their ability to rob my mom of having any peace or pleasure.
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Yes between the hospital room, the noise the constant awakenings for medicine and whatnot, it can drive many people to disorientation at any age.
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It sounds like your grandmother may also have dementia. Everyone with dementia is different, and even from day to day her condition can be different. Memory loss, loss of orientation (space and time), loss of judgement, loss of capabilities, are expected with dementia, and her condition is likely to decline. It's not unusual for a change (such as being somplace else for a week) to take a toll. Assume that your grandmother is doing her best, so it's best not to get angry or frustrated with her and it's usually not helpful to try to get her to improve. Accept her for what she is day to day, and in a gentle way you can try to reorient her to things that she used to do. Maybe it will work for a time. Have a plan B for the time when she needs more care. Make sure that your father (and maybe you as the secondary person) are set up to be able to make decisions for her if she becomes incapacitated. In the U.S., she'd need to set up powers of attorney, a living will with her advance medical directives, and a will if she has assets, etc. While she is still capable, see if you can get her advance medical directives and wishes about her living conditions. If caregivers, plus you and your father are not not enough to provide adequate home care for her, she may have to move to an assisted living/memory care facility. There are advantages to them: professional staff who understand the aging process, people to shop and prepare her meals, activities, people her own age around, etc.
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Hi, my 95 year old mom has a hospital stay and developed hospital psychosis , a real thing according to the docs , totally disoriented & hallucinating & took a while to get back in the groove , my doc said,
“ we need to try & keep her out of the hospital if possible “ also it’s good to have people to take shifts if possible to stay with them there, or an aid
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TChamp Jun 2022
You probably meant delirium instead of "hospital psychosis". Delirium is indeed very common among hospitalized elderly patients. Many factors can precipitate it, such as reactions to medicines, infections, stress, metabolic changes, lack of sleep, fatigue, etc. It may last from a few hours to a few days. Fortunately it's a reversible condition. It's not caused by the hospital, but by the health conditions that brought the patient to the hospital in the first place.
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DreamerJen: Welcome to the forum! Imho, your grandmother may take a while to recover fully from the pneumonia and the U.T.I. that she was hospitalized for. Yes, it is perfectly normal.
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Sometimes, when elderly people or even disabled people, which I am, have trouble getting over a UTI especially if their body is also fighting another ailment, it takes a toll in different forms.
The fact that she's 98 and had to go through two ailments at once, is a lot to handle. I would check with her Dr. for retesting to see if the UTI has cleared completely. It's possible she had two UTI strains instead of one and it's hard to detect the second one.
Also, at 98 she could also be suffering from a memory impairment which can also alter a person's personality. Lastly, you may want to check into getting her a companioned during the day until she goes to bed, or look into a facility for her to move to so she can have around-the-clock care.
Good Luck.
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Llamalover47 Jun 2022
OP states that grandmother is 88.
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Whenever my 89 yr old Mom has any sort of change she becomes “befuddled” for a few days/ week

car trip to visit family, stayed in hotel and she seemed like she’d lost her marbles. She slowly readjusted once in familiar surroundings but I’ve realized any schedule/location/unexpected trips even to a restaurant mess her up for days. Then she’s fine

just my own experience, but I can see her failing faster each month :(. She even has me tuck her in bed each night now. I’m trying hard to cherish our time but it can be frustrating sometimes.

best wishes to you
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Delirium is very common, whether thru surgery or ICU stay; even if your gran was 'lazy' in the past her body chemistry is now out of whack so she needs time to recover. All the best.
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Completely! I've been told by many doctors that the anesthesia can be detrimental and sometimes not recommended for people her age. It affects the body differently in an elderly person more so than a young person.
At 88 she deserves to have people take care of her, personality excluded. Do as much encouraging her to do for herself what she can and focus on enjoying her as long as you can and be thankful to have your dad for help. Don't allow ridiculous narcissism, but if that's not her personality, realize that she is old and may never be the same or get better.
At this point in my life, I'd do anything to have my Daddy back to wait on. Just know you will someday look back and you don't want any regrets.
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Allow a bit of time for adjustment. Consider an OT evaluation if that will be allowed. Encourage to act for herself and be certain no one is enabling the behavior. Time will tell.
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It's inconceivable that a hospital would have discharged a patient suffering from acute delirium. It makes more sense to think that an 88 year old lady is suffering from a severe cognitive impairment due to her advanced age and possible an early stage of dementia. Delirium is an acute condition that produces sudden inattention and a global, cognitive dysfuntion. It has many causes, including acute infections, metabolic and chemical conditions. Medical personnel at the hospital wouldn't have missed it. It would have been considered a gross negligence.
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lealonnie1 Jun 2022
The hospital discharged BOTH my father and my mother with acute delirium. It happens all the time. They were both discharged to rehab where they continued with the delirium until they were released from rehab, and then it took a while longer for things to get back to normal.

"Medical personnel at the hospital wouldn't have missed it......." They may not 'miss' it, they just discharge elders ANYWAY.
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elderly can develop delirium after hospital stays. My mom spent four weeks on the COVID ward and it has been a journey over the last twelve months getting her back to normal mental state.
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Yes. Any type of change is rough especially if there is dementia involved
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Well, it's not unusual for older people, especially, if they have had any kind of anesthesia or pain medication. Possibly other drugs could play a role. The elderly are more sensitive to some medications. Don't let it slide, however. Report this to her physician, who can change drugs and/or dosages if that's needed.

If medication doesn't seem to be the problem, you may be correct that she has lost confidence in her abilities. Would it be possible for you (or someone), to request one of her "coffee group" to visit your mother and personally invite her back to coffee time? If they say they have missed her, it would be harder to resist.

You could offer to accompany her there if she seems fearful. Expect her to feel weak after so long a stay in the hospital. Anyone can feel "weak" after some days in bed with just a cold or flu bug! Don't deny her feeling of weakness, but encourage her that, with a little time and patience, she may resume her life as before.

As a last resort you might tell her (use your own judgement about this) that you don't think she's ready for a nursing home. Don't make it a threat, but if nothing else motivates her, the thought of this just might.
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As an 82 yr old I’m very familiar with returning home from a hospital stay in a state of confusion. Once, after a UTI, was the worst. Thankfully I had a friend who spent a weekend with me and after that a SIL stayed for a week. After a period of my diabetes being out of control I experienced the same thing. When is a period of confusion transitory and when is it the “new me?” No way to know until time passes. But in any case, I’d support you finding other caregivers and/or I place where should be would be safer. Dropping out of prior social activities may just be a normal reaction to the complexities of aging.
I know this is a difficult time for you but your conclusions about her behavior - possibly lazy, attention getting - is likely to come thru to her. And possibly getting the way of helping her make heathy decisions about her living place and care needs. Even if you’re absolutely correctly assessing her condition and motives. The best to you.
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It is definately hospital delerium and it is a very real thing. I can tell you this from experience with my loved one. It will happen everytime with the elderly. It takes time but she will get over it. Please be patient with your grandma and give her all the love and kindness she deserves and please include a big hug from me. Please try your hardest to not put her in a nursing home. They are the worst. At this stage of the game she deserves to have her loved ones around her to love and take care of her if you can. I say "try your hardest." Theres no turning back when she's gone.
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That's completely normal anything after 5 days in a hospital, they will forget they'll even forget how to walk! It happened to my dad who has Alzheimer's; you are basically starting all over again usually they do bounce back but it does take time be patient and make sure they're staying physically active! My dad forgot how to walk and he went in with a UTI and a swollen scrotum (stayed a week in the hospital). I am blessed to be his full-time caregiver cuz he is the best daddy in the world but you have to be mindful that you are dealing with Alzheimer's they are reverting back to children.
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Confusion after hospitalization or rehabilitation is quite common.
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Perhaps starting with a geriatric doctor and geriatric psychiatrist may get you the answers you need and, hopefully, lead to the care that she needs. If respite care is offered near you, that may help her through this time of uncertainty. You also have to figure out if you want her residing with you and that you're willing to go through some very frustrating times: you need to be clear whether you're a victim or volunteer in your present relationship.
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Hospitalization can take a toll on the elderly, to include disorientation. Besides the disorientation, your gran may also enjoy being waited on and then it becomes a question of can't vs. won't. I'll give you an example of what happened with my mom. She had a short hospital stay a while back which left her on an antibiotic drip. The antibiotic made her very delirious, but it subsided about a day or so after the drip was stopped. From there, she went into a nursing home rehab for a while. After she arrived, she would be laying in her bed with a napkin right in front of her and act like she could not get to it, needing me to hand it to her. That was just one of many examples. It took a while and a bit of tough love to get her to do what she could for herself and I still have to encourage her that "you can do it" every day, as she just doesn't have much initiative. Dementia in my mom is probably a factor, but she does seem to do better, be more alert and perk up a bit as far as doing things when she's around people other than me, lol.
I would say monitor your gran and see if she really can't do things- which would prompt more care- or if she just won't. It may take a bit of encouragement on your end to see what she can still do.
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MaddieMae Jun 2022
You made me smile. This sounds just like my mom. She used to call me from downstairs to come up and change the tv station on the remote.
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I do believe things like this can be brought on being in the hospital especially in the elderly. It could be a result of "hospital delirium." Please look it up because I probably can't explain it as well as I want to.
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