Hospital delusions?

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My 73 year-old father had back surgery almost a month ago, and although the surgery went well, there have been some complications and setbacks in his recovery, such as blood pressure and blood oxygen issues, blood clots, lower extremity numbness,etc.

He has gone back and forth between hospital, Rehab Unit and ER over the past few weeks, including an emergency 2nd surgery to relieve a hematoma which formed at the original surgery site, and has made ZERO progress ... one step forward, two (or 3, or 4) steps back.

One symptom Dad is having is what his doctors call "Hospital Delusions." He dreams/imagines/hallucinates things, such as he's being held in the hospital against his will, he's being treated in a combat hospital (he's never been in combat), claims he gets massages on the lawn, etc. the doctors say this is "normal." And it all makes sense, I suppose ... Doctors/nurses coming in and out of his room at all hours, staring at the same walls day-in, day-out. But the doctors seem so dismissive of it, and, as his daughter and primary caregiver, it is NOT "normal" for my very with-it father to swear up and down that these things (and many others) happened, when they clearly did not.

Anyone who has had experience with this -- how do/did you handle it? Play along with it? Try to gently correct him that the said things did not happen?

The longer he's in the hospital, the worse and more frequent these delusions occur. I live 2 hours away, and get calls all during the night from dad saying awful things he thinks are happening to him. This is so disheartening, frustrating, and it seems there is no end in sight ...

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I know this is very common but it is still extremely worrisome, stressful, and heartbreaking for those who care. My husband went through this; claimed he was held against his will, begged me to call the police, at times was back in a job 30 years ago. It is very upsetting to hear, especially if you love, care and want to provide comfort. I agree with the calm approach, and especially reassuring the patient that you love them, you are there for them, they WILL get better, and you are looking out for them. Let them know they are not alone, that you care and are vigilant (especially if they are a bit paranoid). You can talk them into a more calm state.

The other half of this is the impact on you. You love them and you may be also scared and heartbroken to see them in this state. It's OK to feel bad, to cry, to wish this wasn't happening. It's OK to mourn and to question if you're doing everything you need to. Take time for yourself; talk to friends; advocate for your loved one and also for yourself. Find a patient advocate. Enlist the aid of a social worker. Spread the burden. Find a support group. Don't feel you are alone and have to bear this by yourself.
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It may be common in an ICU or acute hospital setting, but that does NOT make it "normal"! This is delirium, or near to it, and if it was not his baseline mental state either medication side effects or an infection or other major physiological stress could be behind it. These are two pretty good references: medicinenet/icu_psychosis/article.htm and www.health.harvard.edu/blog/the-dangers-of-hospital-delirium-in-older-people-201111163810
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My 87 year old dad had this when he was in medical ICU for an allergic reaction to a medication. The staff there said to try to orient my dad to what day it was, what time it was, what was actually going on in the world. It was a Sunday and pro football was on TV so I tried to orient him with that. He came home and it persisted for another day or so, with me repeating often: it is Tuesday, you are in Gina's kitchen in Houston... The staff at the hospital were not that concerned either. I was very upset until they explained what it was and how to deal with it.
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It's also called "hospital psychosis" and it's a very real thing that elderly people can experience while in the hospital.

It sounds like he's been moved around a lot because of his health issues which can discombobulate an elderly person. Having a couple of surgeries can definitely contribute to these delusions (elderly people have difficulty with anesthesia) and a hospital is a 24/7 institution which can mess with someone's sense of day and night. All of this together can definitely cause an elderly person to be confused and agitated.

I hope the Dr. who told you that this is hospital delusions also prescribed an anti-anxiety medication for your dad. You don't want him knocked out but he shouldn't have to go through these delusions either because to him they are very real and very scary.

As far as how to handle it, when my dad went through it I made sure I told my dad regularly that he was safe, that I wasn't going to let anything happen to him. To your dad these things are very real and try to imagine how scary it would be if someone were telling you what you were experiencing wasn't real, that it was all in your head. Now that's scary!

Don't reinforce the delusions by giving them any weight, just keep reassuring your dad that he's safe, that the staff is there to take care of him and that they aren't going to let anything happen to him. Be very confident when you reassure him, don't let hear that you're upset. I use to tell my dad that I would never have him stay in a place that I thought was unsafe and if my dad trusted me (which he did) he could trust that I wouldn't let anything happen to him. In time my dad would calm down.

But your dad shouldn't be left to flounder in his delusions all night by himself. I know there's staff there but your dad needs to feel safe and calm. He should have an anti-anxiety med at least at bedtime so he's not tortured by the delusions all night and he can get some sleep. Sleep deprivation will only make things worse.
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When his delusions involve his safety or accuse other people of bad acts, I'd just listen calmly and re-assure him that his brain is playing tricks on him. He's had more than his share of trauma to his body and brain. I'm sure doctors and nurses are quite familiar with it. It's not uncommon.

My sister-in-law had to be moved to a different section on the cardiac floor after her heart surgery. She was absolutely convinced one of the nurses was going to kill her.

My uncle thought he was back in Korea in combat and kept going on about the medivac helicopters being so noisy. 'Course we did finally find out his room overlooked the heliport. Ha!

If you can, try to explain to him why he might be having a particular delusion.

"Nurse Ratchet tried to kill me this morning!!! She put something in my IV!!!"

"Oh, you must mean your Day Nurse Cathy. I just spoke to her in the hallway. She refilled the bag with more antibiotic. Sometimes, when they do that, it can cause confusion. Everything's okay, dad. She's a nice lady."

Personally, I would try to avoid calling him on too many of them. Why? It just confuses him more. If he says his dead brother stopped in to see him? Just ask him what he had to say. *shrug*

It's all about re-assurance. There can be NOTHING more frightening than having one's mind playing tricks.

Good luck to you!
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