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A while back mom fell at home and was acting extremely confused so dad took her to ER to make sure she did not hit her head. She was admitted to the hospital for nine days and released to a rehab facility for six weeks then finally home. All tests came out negative. The doctors said the only reason they kept her in the hospital that long was because her blood pressure dropped each time she stood up and was a fall risk. I suppose one question I have is whether it is normal to hold a person this long due to blood pressure?
Second, all the time mom was in the hospital and in rehab she was extremely disoriented. Nobody mentioned this to us or addressed it. Is that normal? It would have been hard for the staff to miss when she would talk like she was at home asking whether she picked out the bedroom furniture. She talked about how she made cookies for everyone on the floor. Other times she thought we were on vacation at a hotel. Sometimes she would lie in bed with her eyes closed and move her hands around like she was opening up a cupboard, and occasionally mention something about getting a piece of cake.
I am happy her disorientation was not scary or upsetting, but I do not understand how staff did not mention it. My dad was with her most of the time, and he never wants to mention it at all. I did bring it up to one of her doctors and he just said that yes, he agreed she was showing signs of dementia.
It seemed the whole time the medical staff only referred to mom's test results as the only marker for how she was doing. I would just look at her knowing she was far from alright, but maybe that's just me as a daughter. Does anyone have any insights on whether this is just normal practice? Thanks.

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I don’t know if it’s normal Ginger but I can tell you that my FIL’s long hospitalization was because of his blood pressure. It was low and they wanted to get it up. The first month of his hospitalization, if not longer, they only kept him there to try to get his blood pressure stabilized. They didn’t address his cancer or his difficulty talking & swalling during that time. Eventually they did tie all together and start treating all of that.

Do you think perhaps the hospital thought your mom just had hospital delirium? What I have learned from my own experiences is that we really have to advocate for our loved ones in the hospital or things will be missed. We have to be persistent all the time. Medical professionals aren’t perfect.
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Reply to worriedinCali
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Ginger((((hugs)))).

So, when my mom was in rehab after a stroke, she started acting loopy. Paranoia and delusions. I requested a psychiatric consult. A geriatric psychiatrist visited and diagnosed her with vascular dementia.

In my experience, you need to ask specifically for diagnostic tests; otherwise they will not be performed. It sounds as though your dad is being very protective of mom.

Who has healthcare poa?
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Reply to BarbBrooklyn
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GingerMay Oct 4, 2019
Thanks Barb, yes, my dad is protective of mom. Right now my dad is doing alright and is her POA. My sister and I are backup in case something happens to one of them. One of mom's nurses at her PC's office told me she believes my dad is afraid someone will force her into a nursing home against their wishes so that is why he never wants to discuss her issues. When she said that, I knew she had just confirmed a lot.
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My DH has been in and out of the hospital since August. Each time, I make sure to let docs and nurses know if his cognitive skills and energy levels have dropped due to illness. Otherwise, they'll often assume he's at baseline, or they'll assume he'll understand and hold onto new info.

Right now, he's doing better. Not great, but better.
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Reply to Confounded
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Since hospital staff doesn't know Mom they may have thought it was normal. Especially since test came back normal.

There could be all kinds of things causing Moms confusion. Dehydration. Low potassium, low bood sugar and UTI. You have to tell everyone, that this is not normal. My husbands almost deaf and they never mention it to the next shift or does the next shift read his notes. Now Mom is home, have her evaluated by a neurologist. Do you see her often? They are good at "hiding" that things are not quite right. Dad could be covering for Mom too.
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Reply to JoAnn29
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I would say, if family doesn't tell staff during admission intake (there is a whole entire sheaf of papers to be filled out with patient and family) and family says nothing during this long hospitalization, then why would staff feel that "Mom" is any different than she has been at home?
You say that Mom was acting very confused at home, and this, after her fall, is the reason for admission. This admission would be the time for family to tell the Hospital "Mom is here because she fell at home, and she has been very confused. This confusion is new for her". That would then entail an entire workup to rule out brain stroke/bleed, to rule out Acute Urinary Tract infection, and etc. To rule out new trans ischemic attacks (TIAs).
Do also know now that usually it is "Hospitalists" that take care of patients in Acute Hospital now. Not their regular physician. That is truly problematic. It is crucial that your Dad provide them all the information he can conceivably think of in order for them even to know which tests should be run. To hide any symptoms or to not acknowledge them as an acute change is to rob Mom of the care in diagnostics that she needs. Generally families are "desperate" to tell staff "This ISN"T MOM!! This is NEW. SOMETHING is TERRIBLY wrong". In absence of that sense of urgency exhibited by family staff may think that Mom is her normal self save for some blood pressure changes that caused a fall.
Who helped with admission intake? Who is health care POA? Who spoke with the doctors to explain that there is an acute new change, and ask to know possible reasons for it. I would say that what is unusual here would be that apparently in 9 days hospitalization no one mentioned this to staff or physicians? Or am I wrong? If they didn't, what would be the reason not to?
It is, yes, a very long time to be in for low blood pressure. Also it is a very long time to HAVE an abnormally low pressure if she is not on heart of BP meds that lower it. They could not release her with hypostatic low BP or she would keel and fall at once.
Remember, every patient enters as a mystery. The staff is TOTALLY DEPENDENT on the history on intake. If there is no family then they are left with what they see and hear, and there is no way for them to know if this is the patient's "norm" or an acute change. What changes? When? How manifested? Did they ever happen in past? What medications is she on?
I surely do hope your Mom is doing much better now. She likely should have a history and physical sheet to carry in future to explain recent tests, results, mentation, history of illnesses, known problems. This may help on future admissions.
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