My mom has been in a skilled nursing facility (SNF) for about 1.5 weeks since falling and fracturing her hip. She's experiencing delirium and I don't know what to do about it. I mentioned it to some of the nurses and they are going to do a test to check for a UTI, but I don't feel like they are taking me seriously. While she does sometimes get confused, this is different. When I went to visit her yesterday she didn't know where she was. She also told me she wakes up and night and she's "hanging from the ceiling". This also happened about 1.5 years ago when she was in another SNF and it got very bad. She called me crying because she thought she was at home and the physical therapist was coming to "take her away". It's breaking my heart thinking that it may get that bad again. Have any of you witnessed this with your loved ones? Who can I speak to at the SNF that will understand this is serious. The nurses are different everyday and don't recognize that this isn't normal for her. Thanks!
Even young people who have had major surgery, some will get delirium.
My Mom was waking up in room she wasn't familiar with, with sounds she didn't know, and people who were unfamiliar. She didn't know she was in the hospital. Eventually she was moved to rehab and stayed in a nursing home while there. Sights, sounds, and smells weren't familiar, so that once again triggered delirium. Meds were given.
I even remember myself being in the hospital with a UTI, and found myself on the cusp of delirium.
If it's not a UTI see if a geripsych or advanced practice nurse who specializes in behavioral issues can visit and prescribed something for her agitation.
Have a look at what meds she's taking FIRST and foremost; once you (and/or the doctor) rules out the drugs being the cause of her delirium, then you can go from there. Delirium is quite common for elders in new surroundings ie: hospitals, SNFs for rehab, etc., but when things get very bad, meds have to be considered. But make sure the meds aren't causing the delirium in the first place! My mother was always very sensitive to ALL meds, so it was a Catch-22 with her!
As far as UTIs go, she had 2 of them in her 95 years of life, if I recall. The vast majority of her issues/behaviors were always due to other factors, mostly medication related.
Good luck!
Sometimes they overmedicate the person.
You should speak to the nurse. If you are paying for medication assistance, I would stop and see if you can administer the meds, and take them with you or lock them up without them to have access.
I found many AL facilities have staff that aren't competent in this area. One my mom was at didn't administer them for two days. The other tried to give her meds that weren't hers. So start there. If she's on pain meds, take her back to the doc and try something else or try topical creams. Most likely that's the problem.
You should read this:
https://aging.uams.edu/wp-content/uploads/sites/101/2021/03/IOA-FLY-Opioid-pain-meds-confusion-and-delirium-Flyer.pdf
It's more common than you think, and from where I sit, I think half the dementia people report comes from pain meds.
You might get her a TENS or other pain helping system. I got my mom NeuroMD and it's great. It's solved her back problems and she's no longer taking any pain medications after having seven back fractures. I'd also get your mom on some good calcium. My mom takes Garden of Life calcium supplements and it really helps. good luck!
My mother would look around the room and ask where the furniture came from because she would never have picked that out for her house. She referenced people sitting in a corner who were not there. She would tell me she baked cookies for everyone during the night. Another time she called my dad thinking she was in a train station waiting to be picked up. Sometimes she would lay in bed with her eyes closed and gesture with her arms like she was driving a car. I was alarmed to see all this, and shocked that the staff did not even acknowledge this behavior was abnormal.
When she got released and stopped taking the pain meds, her behavior did return to baseline, but it took several weeks.
You were wise to call attention to your mother’s abnormal confusion and delusions. Even with the prevalence of post-operative delirium and the high potential for some degree of long term or permanent cognitive and functional decline in some patients, very few hospitals or SNF have a protocol in place for assessing patient risk factors, prevention and treatment of delirium.
For that reason, it is vital for family to make the medical team aware if the patient’s behavior is not normal and request immediate medical intervention. It’s not uncommon for medical professionals, unfamiliar with the patient’s normal cognitive state, to attribute the symptoms of delirium to old-age dementia.
You can read about the prevention, diagnosis and treatment of post-operative delirium at the url below. (I’m sorry, I was unable to hyperlink it.)
https://www.the-hospitalist.org/hospitalist/article/123437/get-clear-delirium
However, in 2020-2021, she had several falls, hospital & rehab. She would tell me things that made no sense - everybody smoking pot & wild parties downstairs in the staff lounge (she was unable to leave her room at this time, so I don't know when she supposedly saw these parties).
I quit taking her calls after 6:00pm last time because her bizarre delusions caused me anxiety. I let my husband deal with it and he always seemed to calm her down.
Thankfully, it stopped when she came home.