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.