My mother is 94 and up until 2 months ago, she was perfectly fine. Completely independent. She managed her entire life with very little assistance from me. She was hospitalized for 10 days and rehab for another 10 due to a bowel obstruction. Mother came home a different person. She can't remember how to do any little thing, totally confused about days, has to use a walker and wears diapers. She fixates on things and worries way more than she used to do. I do pretty much everything for her now. She will ask me 100 times how to do the same thing. Mother got upset two days ago and asked me what happened to her? I honestly don't know. The hospital changed her medicines and she had to be put to sleep for a procedure. Does anyone have any experience like this?
This is, unfortunately, very very common.
Rather than dementia, this is called *delerium*.
People over 65 are more at risk. Top triggers are
1. infections (UTI, chest infection/pneumonia, Covid)
2. Anaesthetics
3. ICU stay
4. Hospital stay
5. Medication withdrawal
6. Dehydration, electrolyte imbalance, low sodium
All these cause stress on the body & brain.
It can last days, weeks, fluctuate for weeks, or even be the new level of functioning.
Be patient. Be hopeful. But also be practical & arrange more care for Mother, more hands to help you so you don't burn out.
When I came out, I had trouble getting ideas from my brain to my tongue. I literally couldn’t find the correct words. This particular issue lasted 2 months. It was most upsetting. Apparently, my brain was too stressed to work correctly.
I could type just fine. But, verbally, I was way off. It was so very frustrating.
I can very much understand what an operation and hospital/rehab stays might do to cause delirium in someone who is 94.
I am sorry that this is happening to your mother.
Sadly, delirium seems to fast forward the decline that was inching forward prior to the hospital stay.
She has lived a nice long life and this can be a wake up call to get all essential paperwork and bucket lists taken care of.
Get lots of help. Let us know how she is doing.
Give your mom a couple of months to reorient herself before you draw any conclusions about her permanently.
Good luck to you
Meanwhile, help her keep her tasks and routines clear-cut, deliberate and with plenty of rest breaks in between. Remind her that she is still in the convalescent phase and must cut herself plenty of slack.
Examples of how to help: a display clock showing time with clear day/night markings, day and date. A timetable for each day, and a calendar for the week. If she's struggling with the phone then consider getting one where the speed dial numbers have the person's photo next to them - but go carefully before you replace any devices or appliances that she's very familiar with, and make sure the new one really is easier *for her* to use.
Does she have support with continence care, personal care, and medications? - besides you, I mean?
Above all, lay on the reassurance with a trowel. She's been through an ordeal, God willing this will get better, and don't panic :)
[Did the procedure sort out the bowel obstruction? No residual underlying causes to worry about?]
She descended (further) into dementia. I say "further" because if she could totally control her environment in her condo, she could mask it to many people. I, the local sib, saw her decline (and finally my long-distance brothers did, also).
Honestly, she had only 1 or 2 lucid days after that hospitalization, and she died less than 6 months later in the SNF.
Anesthesia can wreck havoc on a persons brain, and if the person is older it is worse.
There is a condition called Hospital delirium and from what I have read it can take weeks or months to recover.
I would contact her doctor and make them aware of this.
Go on line and read some of the ways to help her recover from this if it is hospital delirium.
Also...check for UTI there are over the counter test strips that can give you an idea.
Give her several months and be patient. She may pull out of this.
Take care.
It can have mental side effects that should go away over time.
It can also cause constipation, which they just dealt with.
Let her doctor know.
Maybe he can reassure her so she’s not so anxious. (I’m basing that on her saying, “what happened to me?”)
Get a copy of her medical records and review them. (Any medical mistakes will be white washed). Look specifically for medication changes.
Check her medications upon admission and discharge. Did they add anything? Remove anything? Change dosages?
!!Do not make any changes yourself without the advice and supervision of a doctor!! Some medication changes must be slow and “weaned.”
Chart out side effects, drug interactions.
My mom was discharged once as a completely different person also. The culprit was medication changes.
My mom was prescribed medications that should not have been prescribed together in dosages that were not appropriate for her size. The changes happened during a hospitalization. Her doctors were reluctant to admit this, standing behind their expertise, and refused to remove her medications or lower her dosages. I was sure something must have happened during that hospital stay.
I switched doctors. Mom came back, 100% after the slow weaning process that was closely supervised by a cardiologist.
The medical records from the doctors who would not make the changes when I asked read “daughter is in denial.”
Follow your instincts.
It takes them a long time to rebound. Ask about setting up home PT to get her up and moving better. Good stimulation.
IMO, there is little else to do right now but to give her time. Slowly return her to her pre-bowel obstruction routines. If she cooked for herself, cook with her but coach her through the process. Hopefully, she will gain confidence.
And I would not put your mother through any more hospital procedures. Too many doctors do not consider the toll a hospitalization or outpatient procedure takes on elders.
My MIL had her knee replaced and regretted it because she was never the same after the surgery. In fact, she was diagnosed with a neurodegenerative illness around that same time. But whether the surgery triggered the illness or the illness triggered the failure of the knee surgery we will never know.
Ask for a copy of MAR (Medicine Administration Record) from the hospital and the rehab. This should show every medicine that was prescribed and how it was administered. Review them with her regular doctor to get advice on readjustments. She may not be able to return to the exact regiment she was on prior to the hospital, but she very possibly does not need to be on the medicines they changed her to. This may take a few weeks to make the adjustments but hopefully she can become more like she was.
As others have said, the anesthesia may take some time to completely leave her system. Her doctor should be able to give you insight to this too. Our geriatrician recommends only local or regional anesthesia and sedation (you don't remember anything) whenever possible and if not, then decide how urgent is the procedure because as we age we do not respond and recover the same way as we did when we were younger.
Because of your mother's age and fragile condition, it's entirely possible that the combination of anesthesia, surgical stress, and changed medicines could have caused this change in her behavior and cognitive function. Have you reported these changes in your mother to her doctor?
Everyone who goes through surgery can lose oxygen, which can alter the brain. All medications can have side effects. Perhaps it would benefit you and Mom to meet with a Geriatric Psychiatrist for an evaluation.
I have noticed in myself and also when I was full-time care of my Mom, when I am in pain, I have a tendency to forget things, can’t stay focused, not really do much, because my brain is so focused on the pain that nothing else matters. In my Moms case, she was on such high dose pain killers that she was addicted to pain killers and the pain killers were no longer managing the pain.
Once the pain is at a tolerable level, then she has a chance on being able to concentrate on minor tasks like walking, eating, sitting, etc.
Regarding pain pill addiction, the way we found it was that we went to ER when my Mother was crying because the pain was so intense. Yet her doctor had said that the injury sustained was completely healed and she should be free of pain. We gave her a normal injection dose of oxi (yes, that one), and one hour later, there was no change to her pain. The doctor asked if I wanted to give her another injection or try morphine and I said no. He did tell us that she had severe arthritis which was news to me! With the assistance of her PCP, we immediately changed over to OTC pain killers and CBD (no THC) and the pain became manageable over a few days. Two months later, we went to a Pain specialist who tweaked her meds for long term use of Tylenol and Alleve. Within 4 weeks, she could finally balance and stand up. Within 3 months she could walk with a walker and in 6 months completely out of the wheelchair. However, certain mental issues remained and she could no longer live completely independently (she is over 100 years old now)
I will tell you that my path was not easy as Doctors and PT were telling me that my Mom was doing exceptionally well for her age and the pain was to be expected. However, I did manage to find snippets of good info amongst them all and continue to use what they showed me even today.
I demanded the diluidid pain pump I had back. Didn’t get that but all sorts of pain meds. Morphine. Demerol. None of it cut the pain.
I have previous ulcers so declined Torodol until I could get the hospitalist to talk to my md sister. When both of them said yes, I took the shot. The pain went away.
Torodol is dangerous for routine use, however.
And once dad was back home, he did gradually become himself again after a couple months. I think the combination of so many drugs (he had no less than a dozen different bags hanging off the IV tree at any given time), the sense of losing time from laying in the same hospital bed day after day, the operation, and just the ravages of the illness itself altered his mental state.
Give your mom time... as their family we're anxious for them to resume their normal lives immediately but she has gone through a lot and is elderly. Keep reassuring her because she's scared (my dad was, too, even though he wouldn't admit it). Help her to eat good food, stay hydrated, and keep her primary care physician involved (they know her better than anyone). I think one of the hardest things for the family to do is to not lose patience, so when mom is asking you the same thing for the twentieth time, take a deep breath, smile, and patiently reply.
You said the hospital changed her meds... I would call her PCP immediately and ask them to review the changes, this could account for some of the issues she is having.
Good luck to you and mom.