Hospitalization and the Dementia Patient


Any time you take a dementia patient out of their home environment, the transition causes a lot of confusion and distress. This can be even more distressful when the patient is hospitalized.

Charlie was recently hospitalized for two weeks with endocarditis. The condition was most likely precipitated by two months of extensive dental work, but that is a topic for another blog. He was running a low-grade fever, had severe pain throughout his body and swelling in his extremities. The symptoms alone would have been upsetting for anyone, but they were compounded by Charlie’s dementia and complete lack of understanding about where he was and why he was there.

He was in a room with one or two other patients on any given day. Their presence in “his” room was disconcerting to him. He couldn’t understand why they were in his room and wanted them removed. The coming and going of staff caring for the other patients was upsetting to him; the voices, beeping machines, and equipment being moved in and out caused him a great deal of agitation. When curtains were pulled to give a patient privacy he responded with feelings of annoyance and/or claustrophobia.

He wanted to be able to look out the windows although, at times, he thought he saw people cutting down trees and that bothered him. It wasn’t happening. He was disturbed because “someone” was taking siding off the building next door. What he actually saw was just shadows as the sun was setting.

One day he thought he saw three birds in a nest on his ceiling; at another time he saw a butterfly sitting on my finger.

Some of the delusions could be blamed on the oxycodone they were giving him for pain, but at other times he was free of any medication but Tylenol. He repeatedly asked for his clothes so he could go out and sit on the non-existent deck. Time after time he started to get out of bed to take a walk, go home or go to the bathroom. An alarm had to be put on his bed and chair so the nurses could keep track of his movements.

He was completely flummoxed over the fact that he couldn’t have a glass of wine. He said to me, “What kind of place is this? I would never come to a place where I can’t get a glass of wine.”

Even as his condition improved, he could not tell the doctors or nurses where he was, what month it was or why he was there. Funny though, he could give them his social security number and his birth date. When asked who the president is, he responded, “Joe Biden.” Close!

It is hard to believe how much his cognitive abilities have changed since he was admitted. I can only hope that, with time and an improvement in his health, some of the brain fog will clear up. He will soon be moved to a rehab facility for long-term intravenous antibiotic therapy and physical therapy to try and restore his physical strength. I can only pray that things will improve enough that he can return home rather than make the dreaded move to a long-term care facility.

Marlis describes herself as a “Gramma who loves technology and has a lot to say.” She blogs about whatever catches her interest: food, books, family and more. For, she writes about the issues facing the elderly and her experiences caring for her husband, Charlie, who suffers from dementia.

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Marlis, I am going through something similar with both my parents. My Mom is the patient in the hospital [she had a bad fall at home] so I decided to let my Dad stay overnight in her room as the hospital has provisions for overnight guests in the same room.

The next day the nurses asked me not to leave Dad alone in the room with Mom as apparently sometime during the night he pushed the "emergency" button on the Code box behind the bed, instead of Dad using the control that is on the bed to ring the nurse. The nurses thought it was Code Blue so it was a mad dash with the crash cart to my Mom's room. I was so surprised at how confused my Dad was in the hospital, and it was the same hospital he and Mom had done volunteer work for decades.

Once I got Dad back home I had to stay the night with him because I didn't know how long he would stay befuddled. The next day his mind was much clearer.

My Mom did develop delirium which I had never witnessed before, that was quite scary. I did some research on that and apparently 80% of elders have this when in the hospital and in some cases it can last a week. It seemed so odd to see my Mom being confused as she is still pretty sharp at 97.

Marlis, hope your hubby has smooth sailing in rehab. Let us know how he is doing. I have been following your blog for over a year now.
I sympathize with this topic. I'm in a letter writing mode with my local hospital over their lack of adequate care for the dementia patient and/or the senior with delirium. Your paragraph about the constant interruption, beeps, and other distractions is dead on. The giant 'Quiet' signs in the halls are a joke. I hope your husband recovers quickly and completely. If off site rehab is recommended, INSIST that a facility specializing in dementia patients is selected. A regular nursing home will be worse than the hospital. Best of Luck. Roxy (Care-giver for my mother)
They said my husband has dementia, he is only 57 years old. He was so bad in the hospital, no rehab would accept him. I had to take him home and he is much better. Can't believe rehab can refuse you.