Dad has been pretty much unconscious for a month in hospital supposedly from a stroke and then seizures while in hospital. Unresponsive, not able to follow instructions. He can’t speak and can’t swallow so there is a stomach feeding tube. Two days ago, he started to make some nonsensical sounds and then started to swear clearly. Now he constantly swears, kicks and punches us when we come in to visit. Then these behaviours translate to the nurses when he is agitated. He has his four limbs tied down to the bed and he is still agitated pulling loose a restraint. How can we bring him home like this? Not only we don’t have the heart to restraint him at home, but we don’t have the equipment. I don’t know if he is all there cognitively. I don’t know if he is mad at my mom and I for bring him in hospital in first place? Or is it delirium (which he had with prior hospitalizations but never punching and kicking- violent). Or is it dementia symptoms starting. Is he destined to go to a nursing home? Or how can we deal with this behaviour if we bring him home?
That would seem to indicate that he is in great distress.
What meds are his docs suggesting? Is he on anti-psychotics, anti-seizure meds?
Has anyone suggested hospice care?
I am not what his state of mind is…and what is the cause. Dementia starting? Confusion post stroke? I am in there tonight and he is fully restrained, 4 limbs with heavy duty restraints. Apparently he was kicking and hitting when they did in-out catheter. He did not like that!
I was able to talk to him and just when i thought that he might be able to understand that i am his son so don’t hit and kick me or the nurses…he seemed calm and as if saying okay as well. 10 minutes later the swearing and kicking at me starts again.
Seizures, lack of oxygen - the cause may not be known as yet.
Let his medical team look after him through this crises stage. Keep getting updated.
This sounds like a very primitive life/death response from damaged perception of reality, resulting from some sort of brain damage.
This may sound cruel, but I would consider staying away while your poor dad is in this state, especially if your and mom's presence sets him off in some way.
Your job is to ask the docs questions--what is causing this symptom? How do we address it medically?
Probably yes.
If he has confusion - he has confusion.
Don't overthink it.
Don't read meanings into it.
Don't leap to conconclusions.
Certainly don't assume he is mad at you or anyone else or wishes to die.
Confused patients pull out all lines, tubes & remove their clothing too. He is showing basic flight & fight instincts.
Things have improved some.
Stay patient.
If he and your mom cannot afford a skilled nursing facility (SNF) then you will need to initiate applying for Medicaid for him. They will pay for SNF.
I wish you and your family the best outcome possible. I had two grandparents who passed away after massive strokes. It is difficult to witness and deal with.
You might as well know that it is an unsafe discharge and taking him home would be a tremendous problem unless you have a few caregivers. You should speak to the social worker to at least look at long term care. You say you do jot have the money, you need to learn about Medicaid
We don’t have Medicaid here. We thought initially that he would be best home but now my mom cannot manage him; his violent behaviours, if it continues he can easily harm her with his strength. He already accused her of putting him in hospital last year when he was delirious.
Do I detect any *no nursing home* mindset? Forget that. At least for now.
Please listen to what Dad's medical staff is saying about his condition. If there are terms or things you don't understand, ask & keep asking.
I do understand wanting to wrap someone up & just bring them home.. to show your love. This is a valid emotional reaction. But don't panic or rush. He needs acute medical care at this time. Be patient. Keep common sense front & centre.
I'm so sorry for all the pain and anguish you're going thru with dad. May God bless you and guide you thru this leg of his journey with grace and kindness towards yourselves in the process.
He'd just had brain surgery. So his body woke up like ALARM ALARM IM IN DANGER DEFEND SELF.
This is a horrific thing to witness. Likely more horrific to him at the moment cause he really had no idea what's going on. I had to witness it through an iPad cause this was Dec 2020 so no visitors. NO visitors in the stroke ward is bad. The patient will have a hell of a time re-orienting with only strangers around. He thought I was a fake me, because he could very plainly see the real me in the room with him. (hmm. :D)
Hubby burbled like a toddler, barely understandable... until he got angry. Same thing. Then he would pop up, rip against the restraints (4 point also) perfectly clear words. He spent five minutes insulting me horrifically because, he said, I refused to open the door for him while he was trying to empty the "trash basket" (which apparently was a mild aphasia grab a synonym thingie). The restraints are also for the patients protection so they don't mess up their head/ surgery sites / etc. Also the urge to get up and use a toilet is super primal for us for some reason, so. My hubby wept like a baby cause he had to poop right in the bed. It was heart-wrenching.
After it was all calmer, his brain recovered from it's craziness, and he gained lucidity, hubby explained that he felt like he had been kidnapped, and was being shifted from building to building by some sort of enemy organization. In his memory he was tied up and endlessly throughout the day he was questioned, over and over. He didn't understand the questions and it didn't matter what he answered, they would ask, walk away. Come back, ask, walk away. This was the nurses/drs trying to check if he had re-oriented or not. He did not :D but he still remembered the being asked *something*.
(today he has no first-hand memory of this time, but as I was hooked to an ipad able to talk to him 13hrs a day I was able to hear some of his recall of the incident before his brain jettisoned all of those memories as "a bad time that doesn't need remembering". )
If he remembers names, it is a great sign. being angry could also be a great sign. You'll see the nurses and drs saying a lot of things that look super distressing are great signs. I am hoping for the very best for you and your family. Just wanted to respond here to point out that restraints can be used on ppl who pretty much fully recover. Strokes are terrible, TBIs are all terrible, and I think the body reacts with a level of instinct if the brain is aching. The fact that my hubby was calmed by my voice versus flying into a rage or something else, I kind of got the impression that was not as common as the latter.
Tell him you love him, they're doing the best they can, etc.
I know seeing restraints is heartbreaking, just remember - its there so he doesn't throw himsef out of bed to, pee, poop, escape from random enemies who appear to have captured him, etc, whatever it is his brain is constructing to try and make sense o all the crazy inputs its currently getting.
But without like. seeing a film etc, no one can predict. Even seeing films, no one here can really predict well from that. If he's using words, recognizing people, etc, you're already in a good place.
Also neurolyptic malignant syndrome is a thing. trembling fever mental disruption are symptoms
Home can be the plan if/when safe & appropriate.
Otherwise other options are discussed: eg sub-acute, rehab, long-term care.
Good luck!
Has he been tested for a UTI (again)?
Are they giving him meds for agitation? That would seem preferable to physical restraints.