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My 82 year old mom with mild dementia fell and broke her hip. Hip surgery was done successfully and after anesthesia wore off she was doing good. Mom was moved to a rehab hospital and in the beginning was doing good with physical therapy. She was very tired but doing well. A week later, mom started sleeping all day, losing interest in food and refused to participate in physical therapy. We started noticing that she wasn't really sleeping, she just wouldn't keep her eyes open and wouldn't feed herself. In our opinion mom was playing "possum". If family was with her in PT, we would have to nudge and prod and fight her to keep eyes open and participate. In mid action she would close eyes and pretend to be asleep.

Prior to the fall, mom could walk on her own, feed herself, dress herself, go to the bathroom, watch tv, go out to eat. She didn't cook, or drive, and we didn't leave her alone. Her overall health was pretty good. Mom had quadrupple bypass 15 years ago, and had been diagnosed with aortic stenosis about 5 years ago. Although she had slowed down over the last couple years, mom still was able to join my dad and brother in a deer hunting trip in the Sierras and go boating on the lake!

According to the Dr, mom is fine and he continues to blame it on the dementia. Supposedly basic labs are good :no anemia, infections, or issues going on. The only meds she gets are those for blood pressure, cholesterol, hypothyroid, blood thinner-for hip surgery, and vitamins. She does have allergies so they were giving her Claritin. No pain meds or tranquilizers.

We have to force her to keep eyes open and spoon feed her. Cognitively she seems ok. Mom does have some trouble with following directions, but if shown how to do things she does just fine. She will tell you if she has to go to the bathroom, but doesn't know to call for the nurse. Mom can walk (with assistance) and does it well when she wants to. Although she doesn't remember the fall, or that she broke her hip, she does know that she is in the hospital and can even tell you the name of it.

We requested the Claritin be stopped in hopes of that being the reason for the grogginess. It was worth a try. So far it hasn't made much difference. There are brief times of normalcy. Mom will laugh, talk, be engaged in the conversation, take a few bites if we tell her to, but then the sleepiness will start. The minute we see her hand go to her head and eyes close we know she isn't going to participate anymore.

Clearly she isn't ready to come home, but we would love to have her there. We are at a loss of what to do. Hospital Dr and staff are disinterested in helping and offer no suggestions. Mom is moving out of the hospital today and in to a skilled nursing facility.

Can you offer any suggestions to what is going on with mom? What can we do to bring her out of this sleepiness?? Is it increased dementia? Failure to thrive? A health issue we aren't aware of? Sleeping disorder?

Thank you for your assistance!

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Broken hips are extremely painful. Often times, people withdraw from daily activities when they are confronted with pain. They may also head into depression from the pain and from their sudden loss of independence. I'm not surprised that she doesn't want to sit, walk and do PT because it probably hurts too much. Has anyone addressed her pain management? Has she been evaluated for depression?

On the other side of the coin, narcotic pain meds and some psychotropic drugs cause drosiness.
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Sounds EXACTLY like my Mom. Has the blood work shown any changes in the thyroid levels. The trauma of the fall and surgery knocked my Mom's levels so out of whack, it took five months to get them back in range. Low thyroid worsens confusion AND causes drowsiness. After an marked improvement at rehab, my mom declined again and it wasn't until I moved her to an AL that she stabilized. Good luck.
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This scenario sounds so much like what I experienced with my mother. Doctor ordered rehab facility for two weeks so that she could regain her strength after a hospitalization. No broken bones or surgery, as with your mother. While my mother participated in PT and improved, it tired her out and hurt her, which then resulted in her complaining about it and not participating in a planned second PT session each day. She already had some eating issues before entering the hospital and rehab, but the lack of eating got worse during that 2 weeks. She became weak, lost a lot of weight, and her "spunky" attitude declined. 2 weeks and 1 day after being placed in the rehab facility...she was gone. She had had no catastrophic health problems such as cancer or heart disease or stroke. Her biggest issues were early dementia and the related symptom of not swallowing food.

I've often wondered if being in the strange environment of the rehab facility (at a nursing home) actually led to or contributed to her death. If she had been home, would she have improved, regained her strength, kept her "get up and go" attitude, and regained her familiar routine?

From your last post, I think you and your family are doing the right thing...a marvelous job in keeping your mother active and engaged. Hopefully she'll continue to improve and can go home soon. As the longer she's away from her home I think it can take a toll. Your family's schedule can get tiring too. I would also keep an eye on her eating and receiving nourishment. Seniors can get weak easily and suddenly and do not rebound well in later life.

I wish you and your family the best. I pray that your mother will continue her progress.
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Thak you for your answers. It is reassuring to know we aren't alone in this situation. Mom was moved to a skilled nursing facility and is doing much better. She participates more and we are demanding staff get her up and around. She is not allowed to eat in bed. We take her to the dining area for all meals. We are able to take her outside and to the PT room on our own to let her do some exercises. A much better facility!!!! We are also making sure she is surrounded by family at all times so she has familiar faces. :) Thank you! And God bless!
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My Mother also does that same thing when she has had to be hospitalized. Three months ago she fell and broke her hip. While in the hospital she started to keep her eyes closed we had to feed her and keep bugging her to cooperate with the therapist.
She likes to be home where its her usual routine. It is like she can protest and get results if she shuts you out by not being responsive. I ended up putting her on hospice so that the doctor would allow me to bring her home. The doctor was not in favor of her going home, he wanted to put her in a skilled nursing facility. I felt that once she came home she would do better. After a few days at home she was back to her usual self. I take her to physical therapy and work getting her strength back. She now gets around pretty good with a walker. Good luck andGod Bless.
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How does anyone know if the problem is psychological or physical without a doctor checking into it? That's where I'd start putting pressure, the doctors. Tell them to get their heads out of the ether bag.
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I'm not surprised that the hospital staff is not particularly interested in this case. There is no cure for dementia; some doctors think there is no treatment, and they'd rather focus on someone they have a chance of helping. Is your mother being seen by a dementia specialist? A behavioral neurologist or a geriatric psychiatrist might show a much greater interest.

I doubt very much that your mother is "pretending" to be asleep. She is more likely in a state she can't control. I have seen my husband like that.

I don't know what is behind your mother's decline, but I know that it is extremely common for persons with dementia to decline with hospitalizations. I don't know if it is the physical trauma that sent them to the hospital, or anesthesia/drugs, or the "unnatural" environment, or some of each that causes this. My husband has been in the hospital 3 times since he developed dementia almost 9 years ago. Each time he became far worse than he had been immediately before his illness. In his case, he did eventually return to baseline. Don't give up hope. It is possible that your mother will improve to the level she was at pre-surgery. Once she is in SNF, I suggest finding a dementia doctor, if she doesn't already have one. It is true that there is no cure for dementia, but there are treatments that can improve quality of life.They don't work for everyone, but in my opinion it is worth trying.

Hugs and best wishes to your entire family. This is very hard on everyone!
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