Oh ShayShay, that is such terrible news! I am so sorry! I, too, hope once the UTI is addressed, along with the pneumonia and sepsis, she the delirium will clear.
My Dad was sent back to ICU around midnight Saturday night after pulling out his feeding tube (,the kind through the nose) even though they had big "boxing glove" type mitts on his hands. His respiratory function declined so that he had to be intubated Sunday mornig. He has steadily improved since, and hope to remove the tube tomorrow. Of course he cannot speak with that tube down his throat. He does well with hand on queezing to answer questions, so at least his brain can do that. I do so hope the delirium will not return again, but who knows.
If he absolutely has to go to rehab, at least the one I chose is right across the street from a park he knows well and loves and can be seen from the windows and porch, so a familiar place and landscape to help orient him. Yes, I read about familiar objects and plan to do that. I may be able to bring his beloved cat to visit him on he porch, and that would help him a lot, I think. Those two are inseparable! She rides on his Rollator and waits patiently for him to finish in the bathroom. He says he gives her "free rides". It is so sweet. I will take a picture of her for his room, too.
With spending so much time at the hospital, I have not been able to do much research, and thank you for sharing yours with me! I promise to share anything new I discover.
Dad is in an excellent hospital where the staff are all well versed in hospital delirium and I am so grateful for that! It is a teaching hospital with a great medical library open to patients and families, so I plan to spend some time there researching once the tube is out and Dad stabilized. On
They have been careful not to give Dad sleeping pills of any kind because they can cause/worsen delirium, especially in patients with dementia -- at least that is what they told me. They have given him melatonin for sleep and it worked for him. (I give him a microdose of melatonin plus magnesium at home for sleep and it works a treat for him -- the magnesium also cured his restless leg syndrome). Your grandmother may need something stronger for sleep. Gotta sleep! Sleep deprivation can also cause delirium. So sad they put her on the lorazepam!
"Drugs such as benzodiazepines or anticholinergics and other known precipitants of delirium should generally be avoided. In addition, benzodiazepine or alcohol withdrawal is a common preventable cause of delirium." Link: www.ncbi.nlm.nih.gov/pmc/articles/PMC3065676/
So, benzodiazepines (such as lorazepam) can cause delirium, but so can withdrawal. Oh dear! Catch 22 for you!
See also: www.ncbi.nlm.nih.gov/pubmed/16394685
And they gave her this stuff?
Keep us posted on how your grandmother is doing ShayShay! Again, so very sorry to read your sad news and hoping she makes a good recovery. This just breaks my heart.
Benzodiazepines are on my Dad's Never Give list because they worsen his type of dementia (FTD), but some drugs that are or might be helpful for ALZ patients are harmful to FTD patients.
Shay, my Moms last stay in rehab was awful for her. I swore I would never put her back there. First, the hospital stopped her Thyroid medicine which the rehab didn't question so she didn't have it for 18 days. Reason, her labs were good. They are goid because she is on medication. No one asked to consult with her Thyroid doctor. (Pet pev of mine) She was in for a UTI. Antibiotic given had Penicillin in it. Moms sensitive to it and thats in hospital records. My RN daughter found that mistake. We thought Mom was dying. Antibiotic changed so on to rehab. Now, I was told by the AL nurse, that for everyday in the hospital, is 3 days in rehab if just there to get ur strength back. Since I was on a tight budget, I told finance that Mom was not going to be there past the 20 days that Medicare pays 100%. OT, PT was maybe an hr in the morning and afternoon. The rest of the time they had Mom in a wheelchair. Then at a care meeting they said she would never walk without assistance. I came back with I don't know how you expect them to walk when they r in WCs all day. She was released in 18 days. I swore I would never put her in rehab again for just getting her strength back. I would have therapy done at the AL. Medicare will pay for it. I think there is a length of time you wait, and you can ask for it again.
If this is all new to you, you will need to be on top of things. If it doesn't sound right, it may not be. TG I have an RN in the family big help. But even then, I made a list of Moms doctors, specialty and contact numbers. Even hilighted the ones with privileges at the hospital Mom usually went to. Her meds. Her operations, when. Allergies and dislikes. Did the staff look at it, not really. But for no other reason it was helpful for me. You tend to forget things when your upset. I had one therapy group call me about limitations for Mom. The rest didn't bother. This is important so they don't do something to cause injury. My Mom had broke her shoulder and she couldn't raise it over her head. She also had neuropathy in her ankles. No amt of therapy would improve either. Question! No what meds are being given and why. Meds given in the hospital may no longer be needed when the problem no longer exists once they r home. Always see you primary ASAP when discharged.
Since your Mom had come around prior to this latest hospitalization, I hope the current delirium is UTI related and after a couple of days on antibiotics you should be seeing her come out of that. My mom is delirious and hallucinates from UTIs as that’s very common. Bad to “normal” in a few days of antibiotics. So try not to panic. Let us know how she’s doing.
Shayshay I am SO sorry for what you are going through. I would be furious that the doctor didn't look at mom's results for FIVE days after they were available. Just know that you are doing the very best job you can to take good care of your mom. And now you know to ask a million questions and research everything and don't take their word without checking on it. {{{Hugs}}}
Laurellel- I hope your dad is doing better. If he is upset being in the rehab I hope you are able to get him home asap. If you did research I'm sure you saw recommendations to bring things from home to make him feel more comfortable. I know how hard it is to take care of someone physically by yourself and I'm sure it being a dad vs mom is a little tougher, but the mental part is SO much harder. I sincerely feel for you and hope both of you are doing OK.
My mom WAS doing better, Sunday and Monday were her best days in weeks as far as being calm, walking, etc., I really was starting to see a light at the end of the tunnel - then yesterday, the day after her follow-up visit to her doctor, she said 'I need to go to the hospital' - she is now in ICU with a UTI, sepsis and pneumonia. Not even sure if the pneumonia ever cleared up to begin with from a month ago. SO very frustrating as she had the urine test a week ago and he didn't look at the results for 5 days after it was available. Now of course we are back to square one with her being delirious in the hospital and them having to sedate her. I know this time there is no way she is going any place but home when she is released.
ShayShay, I am so sorry and hope things will get better. The last day in ICU and first day in regular hospital room, Dad was nearly back to normal. Then today today the delirium returned with a vengeance. The plan is to send him to rehab facility on Monday, but now I am wondering if that is the best idea. On the other hand, he needs two people to help him stand now, and, like you, I am all alone in this. The rehab nursing home is very close by, so hoping it I spend plenty of time there with him it might help. I'm getting scared now, frankly. I hope and pray my sweet precious Dad comes out of this, and your precious mother, too. On
I am going to research this like crazy and hope I can find ways to help him. I promise to share with you anything that might help your Mom. Hope you will do same for me!
Thank you everyone for your input. Mom has not had any real 'outbursts' in a few days, just some crying and a lot of confusion. She says she is crying because her brain isn't working and she doesn't know what is wrong and sometimes she says that I don't like her and I don't care about her. I tell her I love her and hold her hand and that usually calms her down after awhile. I really think she mimics how I am feeling. As long as I stay calm she stays calm, but when I am upset or frustrated she senses it and acts out. If I say I have a headache, she has a headache etc. Surprise I understand what you are saying about giving mom some peace. I just am in shock that she went into the hospital a functioning person who only needed checking in on and came out a totally dependent 'child'. I know if this isn't better soon I will have to consider other things to calm her. JoAnn29 I will try that, I only wish she couldn't undo the seat belt... Laurellel since no one told me about delirium and I didn't know what it was, I don't know for sure when it started. Her confusion and wanting to come home started day 2 in the hospital, but she has had 2 surgeries in the past 3 years where she acted that way and within a day or two she had calmed down and was fine. Nothing like this at all, now going on for over a week that I know of for sure. My sister came for a few hours Thursday and was able to give her undivided attention while I did some grocery shopping; it made a big difference for the day, best day to date, but that was only once and the rest of the time I am trying to manage alone. We have a follow up Monday with her doctor. He called Friday and said her HGB was low so maybe we will have something there. She is off all meds except her thyroid medicine and .25 mg lorazepam to sleep. Now that I have been researching delirium non-stop, I am furious that no one at the hospital or the SNF ever said the word 'delirium' to me or suggested ANY of the things that research has indicated may help. Now I know the best thing for her would have been to come straight home from the hospital instead of going to the SNF at all. It did her no good whatsoever and may have permanently damaged her, and all of those 'professionals' should have known that too.
Your statement about Moms actions in the car made me think of another post where the mother opened the car door while moving. Put your LOs in the backseat where there are child locks for doors and windows. Also, if they act out they are not near you.
My Dad just recovered from hospital delirium after a fall. The hospital was careful not to give him anything that would worsen his dementia and he is now back to baseline (has Frontotemporal, not ALZ). He had the delirium and hallucinations for two nights and days, then resolved in its own.
Was she delirious when discharged from the hospital? Or develop it upon admission to rehab? Or did her symptoms begin after they put her on the Excelon patch, Depakote and Ativan? I
It sounds like you and your poor grandmother have been through the wringer! I am so sorry you are going through this! I know it is frightening. Can you contact the doctor who treats her dementia or a geriatric specialist to consult? It sounds like you need expert help in sorting this out.
Now you know why the doc wanted to prescribe seroquel. I want you to think about the implications of that black box warning: If your very scared, very confused 88 year old mom takes the seroquel to stop being very scared, she may have a side effect that shortens her life that is 100% full of confusion and is getting worse. If it were a black box warning on a fully functional, sharp as a tack person, I would not take the drug. But if I'm in the place where your mom - and my mthr too - is, where we don't know what is going on, where we are scared and lash out like a wild animal, PLEASE someone give me something to make me less scared, even if it takes a year off my life.
Fantastic book: Being Mortal by Atul Gawande about the choices we make at the end of life. After you read or listen to the book, you may well want to pack mom back up and take her back to that doc who is really trying to help her out with the seroquel. My mom's on it too, and sometimes she's too sleepy but that's ok. Dementia seems to progress in jumps and spurts, and I'm so sorry that it's jumped on your mom. I am ok with all those meds that your mom was on and my mthr is on. It's needed because mthr gets so scared, and when she gets an idea in her head she can't let it go. She will stay awake for days without her ativan. I was against them in the beginning but she is so much happier with drugs.
Sorry-first time here and didn't give much info. I know this is long but maybe seeing my circumstances will help someone else at some point...My 88 y/o mom went into the hospital with difficulty breathing-turned out she had pneumonia and sepsis. The day before we were out for the day and she seemed fine!! She spent 3 days in ICU, 2 days in Progressive Care and was discharged to a skilled nursing facility for PT/OT and speech therapy-the doctor attributed the pneumonia to aspiration and the sepsis to the pneumonia. Before this she was on memantine and donepezil for dementia, but was completely mobile with the help of a walker (usually left it on the other side of the room) , toileted, showered and ate on her own. Within days of being admitted to the SNF they added Excelon patch, Depakote and Ativan without my knowledge. When I would go each day to visit she would cry and ask to come home but I couldn't drive her for all the therapies an hour each way, I did what I thought was best and got there every chance I could thinking the sadness would end when she got home. After about one week the doctor called me and told me they wanted to give her Seroquel, but it was a black box so they needed my approval-I googled it, said thank you, please get her discharge papers ready I will pick her up in the morning. As far as I can tell she didn't even get the therapy!! She has now been home 6 days and is still completely delirious. She wont let me get more than 5 feet away from her, can't sit still for a minute, keeps saying she can't breath so we are non-stop up and down from chair to bed to walking around. She cries constantly, keeps saying she wants to kill herself - and that I'm trying to kill her. At times she knows who I am and other times she doesn't. She acts like a spoiled child crying and throwing a temper tantrum if I don't do everything she asks, no matter how ridiculous. I took her to her PCP Monday (she came home Friday) to make sure it was OK to get her off all these meds without withdrawal. He said she needed fluids so started the IV, she was ok for the first bag then she flipped. Started saying we were all trying to kill her and screaming and kicking things. We were able to calm her down enough for me to get her in the car. Within minutes of the hour drive home she tried opening the door, taking off her clothes, beating on me, got her shoes off and tried to break the windows with them. Somehow we made it home and after about an hour she fell asleep. I think it was too soon to take her out but she NEEDED to see him and the fluids. Blood- work and urine tests all came back negative, lungs are clear, everything other than cognition is fine. He took her off all her meds so she has not had anything for over 24 hours but basically just said bring her back in a week. I had never heard of delirium until I started trying to figure out what was wrong with her. NO doctor, nurse or anyone else ever mentioned this word to me-I only found it online when I started looking for answers to her behavior. I now have her on melatonin, stress relieving aromatherapy, meditation music and try to keep her calm and quiet as possible. I don't know how much longer I can do this by myself and am hoping to get some positive feedback from someone who has been here.
More info might be helpful... once they’re home from...the hospital? After a fall? After a surgery? After a UTI? A hospital trip can be very disorienting to someone with dementia. An admission or surgery can be devastating.
My Dad was sent back to ICU around midnight Saturday night after pulling out his feeding tube (,the kind through the nose) even though they had big "boxing glove" type mitts on his hands. His respiratory function declined so that he had to be intubated Sunday mornig. He has steadily improved since, and hope to remove the tube tomorrow. Of course he cannot speak with that tube down his throat. He does well with hand on queezing to answer questions, so at least his brain can do that. I do so hope the delirium will not return again, but who knows.
If he absolutely has to go to rehab, at least the one I chose is right across the street from a park he knows well and loves and can be seen from the windows and porch, so a familiar place and landscape to help orient him. Yes, I read about familiar objects and plan to do that. I may be able to bring his beloved cat to visit him on he porch, and that would help him a lot, I think. Those two are inseparable! She rides on his Rollator and waits patiently for him to finish in the bathroom. He says he gives her "free rides". It is so sweet. I will take a picture of her for his room, too.
With spending so much time at the hospital, I have not been able to do much research, and thank you for sharing yours with me! I promise to share anything new I discover.
Dad is in an excellent hospital where the staff are all well versed in hospital delirium and I am so grateful for that! It is a teaching hospital with a great medical library open to patients and families, so I plan to spend some time there researching once the tube is out and Dad stabilized. On
They have been careful not to give Dad sleeping pills of any kind because they can cause/worsen delirium, especially in patients with dementia -- at least that is what they told me. They have given him melatonin for sleep and it worked for him. (I give him a microdose of melatonin plus magnesium at home for sleep and it works a treat for him -- the magnesium also cured his restless leg syndrome). Your grandmother may need something stronger for sleep. Gotta sleep! Sleep deprivation can also cause delirium. So sad they put her on the lorazepam!
"Drugs such as benzodiazepines or anticholinergics and other known precipitants of delirium should generally be avoided. In addition, benzodiazepine or alcohol withdrawal is a common preventable cause of delirium." Link: www.ncbi.nlm.nih.gov/pmc/articles/PMC3065676/
So, benzodiazepines (such as lorazepam) can cause delirium, but so can withdrawal. Oh dear! Catch 22 for you!
See also: www.ncbi.nlm.nih.gov/pubmed/16394685
And they gave her this stuff?
Keep us posted on how your grandmother is doing ShayShay! Again, so very sorry to read your sad news and hoping she makes a good recovery. This just breaks my heart.
Benzodiazepines are on my Dad's Never Give list because they worsen his type of dementia (FTD), but some drugs that are or might be helpful for ALZ patients are harmful to FTD patients.
If this is all new to you, you will need to be on top of things. If it doesn't sound right, it may not be. TG I have an RN in the family big help. But even then, I made a list of Moms doctors, specialty and contact numbers. Even hilighted the ones with privileges at the hospital Mom usually went to. Her meds. Her operations, when. Allergies and dislikes. Did the staff look at it, not really. But for no other reason it was helpful for me. You tend to forget things when your upset. I had one therapy group call me about limitations for Mom. The rest didn't bother. This is important so they don't do something to cause injury. My Mom had broke her shoulder and she couldn't raise it over her head. She also had neuropathy in her ankles. No amt of therapy would improve either. Question! No what meds are being given and why. Meds given in the hospital may no longer be needed when the problem no longer exists once they r home. Always see you primary ASAP when discharged.
My mom WAS doing better, Sunday and Monday were her best days in weeks as far as being calm, walking, etc., I really was starting to see a light at the end of the tunnel - then yesterday, the day after her follow-up visit to her doctor, she said 'I need to go to the hospital' - she is now in ICU with a UTI, sepsis and pneumonia. Not even sure if the pneumonia ever cleared up to begin with from a month ago. SO very frustrating as she had the urine test a week ago and he didn't look at the results for 5 days after it was available. Now of course we are back to square one with her being delirious in the hospital and them having to sedate her. I know this time there is no way she is going any place but home when she is released.
I am going to research this like crazy and hope I can find ways to help him. I promise to share with you anything that might help your Mom. Hope you will do same for me!
Was she delirious when discharged from the hospital? Or develop it upon admission to rehab? Or did her symptoms begin after they put her on the Excelon patch, Depakote and Ativan? I
It sounds like you and your poor grandmother have been through the wringer! I am so sorry you are going through this! I know it is frightening. Can you contact the doctor who treats her dementia or a geriatric specialist to consult? It sounds like you need expert help in sorting this out.
Fantastic book: Being Mortal by Atul Gawande about the choices we make at the end of life. After you read or listen to the book, you may well want to pack mom back up and take her back to that doc who is really trying to help her out with the seroquel. My mom's on it too, and sometimes she's too sleepy but that's ok. Dementia seems to progress in jumps and spurts, and I'm so sorry that it's jumped on your mom. I am ok with all those meds that your mom was on and my mthr is on. It's needed because mthr gets so scared, and when she gets an idea in her head she can't let it go. She will stay awake for days without her ativan. I was against them in the beginning but she is so much happier with drugs.
I guess it would have a lot to do with how severe they're acting? or how bad their dementia is?
did person spend time in a hospital for an illness? what kind of behavior are you witnessing?