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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?

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Change of medicines, anesthesia and a hospital stay could easily affect someone's mental capacity, IMO.

I'm also going to guess that they've put her on a daily dose of Mira Lax which seems to be the go-to for elderly constipation and is horrible for people with dementia.

My 95 yo mother was put on Mira Lax after extreme constipation following a hip surgery in early 2020 and I was giving it to her daily. Very quickly, her dementia got worse with delusions and sundowning for hours every night. After some research, I took her off of the Mira Lax and began to give her Milk of Magnesia. The difference has been amazing. No more sundowning, no more hallucinations or delusions. It took a few months for her to recover from the Polyethylene Glycol that was in her brain, but it's so much better now.
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It could be hospital induced delirium My mom had the same thing happen and it has been a long stretch back. Ask for cognitive therapy to help with the confusion. So sorry you and your mama are experiencing this. Sending good thoughts
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Talk to her doctor about this. Does her doctor agree with the change of medications? It sounds like the old ones were better for her. Do you think it would be helpful for her to get physical therapy for walking if she didn't need the walker before the hospital stay? This is very sad. Hopefully she'll recover and be back to normal soon. Changes of location and routine take a lot out of seniors, hospitalization and anesthesia also often take a toll. If things don't get better soon, you must be prepared to evaluate how much caregiving your mother needs now and how much you can do for your mother as a caregiver. It may be necessary for her to have additional in-home caregivers or move to an assisted living facility. Talk to her right away about taking over her finances, if you're not already doing this. It may be a relief to her. Have all bills sent to your address (if you are not living in the same place). Make sure all of her paperwork is in order if this is not already done. She needs to set up powers of attorney for medical and financial matters, a living will with her medical directives, and a will if she has assets. I'm assuming you are her POA. You also need to be on file with Social Security and Medicare to be able to speak on her behalf. You can do this with a phone call with her sitting beside you. All the best to you both, and best wishes to your mother for a full recovery.
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if the surgeon used general anesthesia, it may be POCD, post operation dysfunction.
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My mom is 92 and had the same thing happen to her after being in Transitional Care for 10 weeks during Covid, after a hospitalization from a fall and broken wrist, that was 16 months ago. I am afraid the isolation and having absolutely no control over anything for that long caused my mom's decline and delirium.

Emotionally she is still struggling and came home just like your mom wearing incontinence briefs, using a walker and needing constant care, feeling helpless and sometimes, hopeless. I have tried everything but we just can't get back where she was.

My mom also fixates on things, has OCD behaviors and is getting to the point that she can't do anything for herself. I hope that your mom recovers. If I could do things over I certainly would never allowed her to stay in the TCU for so long.

She was hospitalized twice in the past 8 weeks, suffered delirium both times and came home with more decline. At least this time I was keenly aware of delirium from hospitalizations and did everything possible to advocate for her for a quick release, home, I will never put her in a TCU again or allow anyone I care about to go to one. I was pleasantly surprised that most of the doctors we had these last two times were keenly aware of what hospitalizations can do to an elderly person and were in agreement about getting her home. We have also decided that if something happens we will not be going back to the hospital and have started hospice.

I empathize with you and pray that your mom comes around. It may take time. In the meantime concentrate on keeping her safe and happy. You are doing all you can for her and some things are out of our control. She is lucky to have you. I am hoping with posts like yours we can educate others on this very important subject.
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It is hospital delirium and is very upsetting to the person going through it because they know something is wrong with them but not sure what and so dont know what to do to a get better. Its also very upseting to their loved ones because there is nothing we can do. We can however try to console them and love them and tell them thats its just temporary and tell her....she's getting better every day and it will go away soon. And lots of long hugs go a long way to let them feel that you are always there for them no matter what. I would also look into her meds and see what new ones they put her on and see if they are necessary and research them. I have found that the hospital delirium does go away usually but you never know how long it will take. Just give her all the love she deserves and a big hug from me please.........Gloria
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dontknow20: Many elders unfortunately acquire hospital delirium, especially with the use of anesthesia. Your mother had a total of 20 days where she was in the hospital bed and/or the rehabilitation facility. That, in conjunction with medications changed, could have had an effect.
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I had gallbladder surgery last December, and it messed me up for a good month. Not delirium, per se, but I didn't feel normal in the head for a solid four weeks. I'm only 61 and in good health otherwise, but I had back surgery when I was 47, and it affected me that way, too.

At some point you decide whether hospital trips are worth the side effects of delirium. My mom conked her head and split it open, and by the time I got to the hospital an hour after she got there, she was out of her mind crazy. She was yowling and crying and throwing such hysterics that they decided to release her after having already admitted her. She had one more lengthy hospital stay 18 months later with similar effects, and after that I said we were done with hospitals and we'd treat her as best as possible at her nursing home. I put her on hospice, she had better care than she'd had in a Covid-choked hospital, and she died peacefully in her own bed seven months later -- a year ago today.
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My dad, Rest his soul now, got a dementia style reaction when they changed out his meds one for another. The Dr said it couldn't happen, but when I flushed the new ones and told the Dr to find another med, my dad came back! I'm not saying this is your case, but it's worth checking in to.
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Some people are more sensitive to anesthetics than others. I have a history of taking an unusually long time in recovery because of this, so when I had hernia surgery a few months ago (at age 75), I talked with the anesthesiologist about it before surgery. After surgery I woke up on the cart and was talking with the nurse as they wheeled me back to the recovery room, vs. my normal routine of being zonked out for a couple of hours. About an hour later the anesthesiologist dropped by to see how I was doing. He told me that he had monitored my brain waves very closely, and was able to keep me under for surgery with half the usual dose of anesthetics. Instead of hanging around the surgery center for several hours feeling loopy and unable to stay awake, I was being driven home within an hour of surgery.

If you know you are sensitive to anesthetics, it pays to talk to the anesthesiologist about this before surgery.
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MargaretMcKen Jul 2022
Very interesting post, which I will try to keep in mind for the future.

I had retina re-attachment surgery as an emergency outpatient at a major hospital. I didn’t realise at the time that it’s quite a major operation that takes well over an hour of surgery. It involves elevating the eyeball and lasering very close to the optic nerve, which goes straight into the brain. I don’t know what anesthetic I had, but it certainly wasn’t a general and I was fully conscious throughout. My guess now is that (as well as eliminating an overnight hospital admission), they avoided a general to minimise messing with the brain. I’ve always seen the anesthetist visits before and after as being a routine greeting thing that I had no input into. Your post suggests that it’s well worth discussions with the anesthetist. Thank you!
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Same thing happened to my mom who was living by herself, doing everything without any help at 84 years old until she went to the hospital for a very bad UTI they claimed that she stop walking so she was sent to rehab for 16 days, she came back not walking, can't stand up without 2 people and is wetting herself....very strange 🤔
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Many elders get delirium when they are in the hospital and especially when undergoing anesthesia. My 90 y.o. dad just went thru this as well. Unfortunately, the older they are and with underlying conditions, sometimes the delirium can be the start of a cognitive decline or sometimes the delirium is temporary. It can take a while to get better, even once they are home - when my dad was a tad younger, he got it after gallbladder surgery and subsequent rehab stay. Once he was home, about a week or so later, it was gone. This time, unfortunately, because he also has PD, he transitioned from rehab to fulltime skilled nursing home, and the cognitive issues have gotten worse. We have an apt with a new neuro tomorrow to assess. But I would speak to her doctor and ask about the delirium and what to expect in your mom's particular case - it can get better or it may not at 94. I know how hard it is to see this type of decline especially in someone previously so independent, that was my dad too.
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My mother developed hallucinations. The meds they are given are usually too much. My mom came back to herself when back home and meds adjusted
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Something similar happened to my hale and otherwise healthy father when he was 83 and nearly died from sepsis. He was hospitalized for a month, had to have a kidney removed since the sepsis destroyed it, and then rehabbed for a few weeks followed by weekly dialysis. More than one nurse assured us that his lack of coherency, forgetfulness, hallucinations, and inability to do the smallest things (like shave with an electric razor) often occurred in extreme cases like dad's. They called it 'hospital-induced delirium' and told us that patients can recover once they are back in their normal routines and the remains of all the chemical therapies have left their bodies.

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.
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Is your Mom in pain? Work on eliminating the pain first. Once the pain is significantly reduced, then work on the physical and mental. If your Mom is on meds, check for side effects.

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.
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PeggySue2020 Jul 2022
When I had my breast cancer reconstruction, I ended up rehosped because I got pleurisy.

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.
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"The hospital changed her medicines and she had to be put to sleep for a procedure."

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.
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I believe it definitely worsens any existing dementia or senility. My mother was slipping a little bit, but nothing of major concern for her age last November, but she went into the hospital in April with congestive heart failure and started exhibiting all of the symptoms of dementia. I had to make all medical decisions because she was deemed unable to do so, she lost track of time and place, started hallucinating and had to wear depends as well. She improved some once she got out but was still sundowning, confusing day and night and becoming more irrational. She went back into the hospital a month later and went even further downhill to the point they had to have a babysitter in her room. She was calling me and my husband all hours of the day and night claiming she was being held hostage, or was kidnapped as part of a medical experiment. She even grabbed a metal IV pole and ran into the hallway brandishing it at people. I ended up having to place her in the memory care unit of a nursing home, and two weeks later she was back in the hospital completely delusional, aggressive, incontinent and refusing to eat. She passed away in hospice last week. This all took place over a 4 month period. Each time she entered a hospital her mental state dramatically deteriorated.
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Please delve into this with her medical team. It may be medications but, one thing for sure something something trigger this change… Hoping you get the answers you need💕
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Yes … I believe every time you have anesthesia you can lose a little mentally … my 90 yr old father had hip surgery and was just like your mother… study up on dementia … it is rough … like becoming a toddler … and angry spells sometimes…very sad. She may not have Alzheimer’s ( my mother had)… probably a different dementia… maybe TMI… small stroke.
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irwind45150 Jul 2022
Your comments align 100% with what occurred with my Mom after hip replacement back in 2019. She was 85 at the time. She was in quarantine situations in the hospital and then rehab during the beginning of Covid (no visitors allowed timeframe). The family would visit through the windows and talk to her on the telephone, but it wasn't the same (no physical contact - and we are huggers). CT Scans, EEG's and a host of other screenings with a group of specialists including a Geriatric/Elder Care physician have produced NO reasons. To DONTKNOW 20: Patience, Perseverance, and Faith in yourself and your supreme being will be needed to get you through this day by day.
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A little over a year ago my mom had to go for a consult for surgery. She's 88. The Doctor told her due to her age, medical condition, etc that the surgery alone could kill her (due to bleeding) and that the anesthesia could do this to her. He refused to do the surgery but suggested a second opinion. The last time my mom had surgery was over 20 years ago. It takes healthy adults some time to recover from surgery. Giver your mom some time and consult with her PCP if she continues with this.
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That is a familiar story the same thing happened to my wife she went into an assisted care facility after a fall and broken wrist. After 30days she returned home. she was never the same a month later she was diagnosed with dementia. It was the worst place ever which may have worsened to case
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My mom was 80 years old when she needed a skin graft for melanoma. It was a large graft from the bottom of her eye to the top of her lip. The plastic surgeon told me about the risks of dementia from anesthesia. He told me any surgery will carry that risk. My mom was never the same after the surgery. It’s possible she had the beginning of dementia but it was unnoticeable before the surgery. She went downhill in the past few years and is now in memory care. I had no choice, she needed the cancer removed but I feel so guilty about the surgery I gave consent for. I hope your situation is different and your mom continues to improve. Hugs
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The anesthesia used during surgery can definitely cause a condition called delirium, which many lay-people might interpret to be dementia. The difference is that delirium usually wears off, while dementia gets progressively worse. It can be very bad—to the point where the patient is not only confused about where she is or how to do things, but also has hallucinations. This often occurs after prolonged surgeries such as heart procedures.
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?
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" The hospital changed her medicines and she had to be put to sleep for a procedure."

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.
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At 94, a hospital stay can completely disrupt an elder's life. Anesthesia can trigger changes in the brain that may or may not dissipate with time. A 20-day hospital plus rehab stay may have also induced delirium as can changes in routine and medications.

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.
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Yes, definitely long stays in hospitals or rehabs plus anesthesia can have a brain fog side effect. It took my dad about 6 weeks for his head to clear up and he was 85. Your mom is much older. The change in medications may be contributing also. You may want to speak with her primary about the changes.
It takes them a long time to rebound. Ask about setting up home PT to get her up and moving better. Good stimulation.
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Perhaps being put under exposed something else going on like the beginnings of dementia. When my dad had the same surgery (we did not know at that time that he was in the beginning stages of dementia) it took him several weeks to overcome the effects of the sedation. Might want to have a chat with her doctor about this.
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Demand an MRI to see whether she could have had a stroke (sometimes strokes can be mitigated if treated immediately).

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.
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Anesthesia stays in your system up to a year.
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?”)
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It could be what is called post op delirium that will clear up with time OR your mother could have already had some cognitive issues going on and the anesthesia from the surgery brought it to the forefront...or worsened it... for lack of a better word.

Give her several months and be patient. She may pull out of this.

Take care.
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