At a Loss

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My 92 year old father-in-law is currently in a very nice rehab facility after a 5 day hospital stay for pneumonia. He is doing well physically, but had a dramatic change in his cognitive function starting the day after he entered the hospital. He goes from being fairly rational to being very irrational, paranoid, trying to leave the facility, accusing us of trying to take all his money, etc. In the mornings, he is more normal...to the point it's hard unless you really know him to even know anything is wrong. We've heard it called sundowners, but regardless of what it's called, the rehab facility says they are not equipped to deal with this, and after one night of it threatened to discharge him immediately. We had his doc call in some ativan (which they had to use at least one night in the hospital), have a sitter staying with him tonight so we can hopefully get a little sleep without being called at all hours to come and calm him down, and are moving him to a memory care facility tomorrow and praying that he can settle there. If the memory care facility (locked unit) winds up not being able to handle him, what other options are there? He cannot go home due to the confusion and fall risk, and we are at a loss if this doesn't work out. Would appreciate any ideas.

3 Comments

I always hear the first thing to check with the elderly is a uti, and yes I know that he was in the hospital when he started acting this was but thats a good place to get it when you are sick. Second I have heard also of a type of dementia that occurs while institutionalized, maybe somone else here can help with a name for it. and third, is it possible he was already having problems but it wasnt brought to anyones attention until he became sick and was the center of attention?
Thanks allshesgot! I really appreciate the quick reply. Yes, we checked on the UTI angle, and that's not it. He was actually pretty amazingly "with it" prior to his hospitalization. He had a bit of trouble finding the right words and was somewhat forgetful at times. But for his age, or even someone much younger, he was doing extremely well prior to this. My husband had lunch with him almost every weekday, and I also saw him frequently. I've read up on hospital delerium, and the shoe fits, and while we want to understand why, we are really struggling with what to do. They discharged him from the hospital without a lot of notice, and so we scrambled to find a good rehab facility so we could help him get a bit stronger physically and also see if his mental status would settle some. Now he's got to leave there (per the rehab directors threat to discharge him immediately), and our only choice seemed to be a locked memory care facility where he can't leave when he gets manic and frantic in the evenings/nights. Since he gets paranoid about us in that state, bringing him to our home is not a good option, and taking him to his home is also out of the question.
What a very hard situation, on one hand taking him home might cure it but without knowing that for sure its scary to do it, I undeerstand. Have they done mri to see if they can get some idea on if he has somthing going on in there that they can have an idea of a diagnosis?

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