I am 33 and my mom is 60. She had a hysterectomy on Wednesday, everything went well and she was supposed to come home Friday. I visited her each day and talked to her Thursday before bed. She sounded alert and perky.

Hospital called me at 3 am and said she has had a status change and is being taken to MRI and CT, to get to the hospital. When they found her she was unresponsive, very incoherent, slurred speech. Tests all negative. No strokes or other off results. Cardiac workup, blood cultures, checked her urine.

She regained speech clarity yesterday but has become hostile, is hallucinating (seeing mice on the walls, agitated, thinks she's on the cancer floor with children everywhere) and I would say somewhat delusional. She thinks I've stolen her dogs, am taking her grandchildren from her and thinks I'm my deceased sister one minute and the next she seems lucid.

This is going into 48 hours and she is just getting worse.

What am I missing? She just came out of ICU and they have her in the hospital progressive care.

Does this get better? Is this permanent? Any advice is appreciated.

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I would be very concerned about this. You say that she was unresponsive? That is significant. I am a nurse anesthetist and I would not attribute this episode to anesthesia. However, if she was receiving narcotics for pain, and or anti anxiety medications they could be contributing to these symptoms. Some people have very extreme reactions to these medications.
I would agree that the urine needs to be rechecked and that they need to keep an eye on her white blood cell count. Were her vital signs normal when they found her unresponsive?
If for any reason she did not have adequate oxygen getting to her brain (if her breathing slowed dangerously while she was sleeping due to narcotics) she could have had a stroke-like event that does not show on CT for at least 24 hours after the event.
If her symptoms continue, I personally would advocate for another CT scan.
Another thing I would do if this were my family member, is I would request that she NOT be given anti anxiety meds (versed, ativan, valium type meds) for at least 48 hours to see if that helps her mental state. Some people have an opposite reaction to those meds and they stay in the system for several hours/days especially with repeat dosing. It becomes a vicious cycle where the patient is anxious, is given these meds, gets more anxious, is given more, etc.
Good luck,do not let the staff make you think this is ok. It is definitely NOT.
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I was not yet 60 when I spent 3 days in ICU. No surgery. ICU psychosis? OMG YES! I was delusional and hallucinating. Specifically I saw the room as some kind of agricultural business, and there were chickens on bales of hay on an assembly line. I cried non-stop for an entire day.

The delusions, and to a lesser extent the hallucinations, continued when I was moved into a regular room, but I was clever enough not to reveal this.

The psychosis went away completely when I got home. No meds or any treatment was necessary ... just time.

My case may have been entirely different from your mother's. But as Eyerishlass suggests, ICU psychosis is not uncommon, and I can attest that you don't have to be "old" for it to happen. I'd talk to the hospital staff specifically about that possibility. And look it up online. I did after I got home and was amazed by what I read!

PS that was 14 years ago and I have not shown any signs of dementia or psychosis since then.
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I would also have the re-culture her urine, just to be sure. Sometimes you look for a UTI "too soon" and you get a false negative.

Was she catheterized during her hospital stay?
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Yes, when we seniors undergo anesthesia, some of us have very bad temporary results. My uncle had heart bypass surgery and was delusional for some number of days (maybe even a couple of weeks). He eventually recovered, but it took a while. I imagine your mom is undergoing the same kind of reaction to the anesthesia since they haven't found anything else.
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Being in the hospital can do strange things to you and add anesthesia? Think "brain overload".

I would ask for a psych consult for sure. She may need some meds, at least tempprarily, to get her over this hump
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ICU psychosis. Although it can happen if one isn't in the ICU and is on a regular floor of the hospital.

When elderly people are hospitalized they can become confused. There really is no day or night in a hospital, no sense of time, too much stimulation, and this can cause dementia-like symptoms in people.

Also, your mom had anesthesia and that can cause these symptoms as well. It can take several days to blow the anesthesia off. Surgery can be very difficult and adds to the "psychosis". At 60 your mom is relatively young but I don't think she's too young to experience this. The hospital did a good job in getting her tested and looking for a source. I'd be interested in knowing what they told you about her condition.

She should get better, it should resolve itself however it may not until she's out of the hospital. I don't think it's permanent but that's a question for the Dr. Some elderly people (and it sounds strange referring to a 60 year old as elderly) don't bounce back all the way but your mom has her age on her side. That's good.
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