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My mother originally went to the hospital for shortness of breathe. She came out with 17 different medications. The she went to rehab for two weeks. We picked her up on a Friday and that Saturday she was talking with a slur so we took her to the hospital again and was told it was another urinary tract infection. My brother feels that the hospital over medicated her. Now is is always weak and slow to speak. Has this ever happen to any of your parents?

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When this happened to us the cause was severe overmedication.

In our situation, every other doctor on rounds had added another Rx or increased a dose. This, along with an accumulation of what was too much medication already over the course of several years was too much for Mom’s body to process. Some of the meds had terrible interactions. Mom’s symptoms and new problems aligned with the warnings and (some of the most severe) side effects, yet none of the medical professionals noticed. The doctors in the hospital refused to acknowledge a change or any problem, attributing Mom’s sudden disorientation and downturn to her age. (It’s surprising the hospital’s pharmacy warning bells and whistles didn’t catch the problem). When Mom was released (newly in a wheelchair), even the drug store pharmacy alerts were not triggered. Further, Mom’s dosages were appropriate only for someone twice her size. (Don’t be fooled by claims of advanced technology and computerized charts-now all the doctoring time is spent inputting data with only a couple minutes left for patient examination, listening to concerns and actual care).

After discharge, Mom’s primary care provider refused to reduce the overwhelming list of medications when approached by concerned family. The new pill box was large and administering was difficult, meds 6x throughout the day, some with food, some without, some at rising, others at bedtime). Mom was diagnosed with dementia. My dad was leading the charge in finding a resolution. He was telling her doctor that he believed mom was over medicated. (When we later obtained the medical records we saw the primary care provider had included in the records nothing about our suspicions of overmedication, but rather, “Husband has dementia” (not true) and “Daughter is in denial about patient’s general health condition.”

We decided to change providers and Mom was weaned slowly under close medical supervision. We went to a cardiologist because her prescribed drugs were predominantly heart medications. Weaning too quickly can cause additional problems and damage - do not attempt this without the help of a medical professional).

Mom returned to normal- a miracle! Actually even better than normal, she said she hadn’t felt so good in years. She got out of the wheelchair and resumed exercise, cooking, gardening, other hobbies… many activities that had grown difficult or impossible in preceding years.

I have shared my story widely and have learned that this problem is widespread. (A visiting nurse at the time was able to help 2 of her other patients (at that time!!!) after witnessing mom’s positive transformation).

Look up all the meds, the dosages (frequency and relevant to her weight), drug warnings, interactions and chart them out. This information is readily found online and will give you a roadmap to identify any potential problems.

Wishing you the best.
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betskand Apr 2023
This is a really useful story! Thanks for posting it. I am going to get hubby's urine tested right away and also check his meds against each other (although our PCP is genuinely very careful about this and when he was released from the hospital immediately starting making careful changes and reductions.)
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I think hospitals are wonderful for treating an acute crisis but I would not trust them to choose the wisest course for long term problems because their knowledge of the person is superficial. If her regular doc isn't helpful then I would try to find a gerontologist that can review those medications and also work toward eliminating the recurring UTIs (D - Manose is often recommended)
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Good Morning,

These UTI's can mimic other things. You need to clear the UTI with medication, lots of water and a shot of Cranberry juice in the morning--per your doctor's recommendations.

Also, once the UTI clears, this is your mother's "baseline". Basically, what you are left with. My mother during the Pandemic was in a similar situation. The medications now are streamlined but they are keeping her up and running. Mother has Lewy Body Dementia and wears hearings aids which causes another issue when the hospital staff wakes you up at 2AM and ask you who is the President of the United States?

Follow-up also with home services--physical therapy, occupational therapy, good walking shoes, not sitting for too long.

Also, white cotton underwear. An UpWalker Lite far surpasses the gray aluminum one's that are passed out upon discharge.

It takes a while for the elderly to regain their strength (or what's left) upon a hospital stay. The short-term rehabs you really can't sleep. They have their own doctor and pharmacy who prescribes or oftentimes overprescribes.

Some of the medications--heart, blood pressure, anything that sends serotonin to the brain are required so they won't be lethargic are important. The more I read, the more I realize the brain inhibitors are crucial and also the importance of the "executive functioning skills" to be maintained as best as they can.

At one time my mother didn't even know how to brush her teeth. Your brother is going to need a "team" of people. Ask the primary care doctor to send a nurse out the house for an assessment. Write orders for p/t, o/t and home blood draw.

I agree with Burnt Caregiver the medications can also have side effects. It's hard to find out in the early stages what is doing what. I could not get over the medication list my mother came home with. They are now streamlined and I have gone through every area of her life to give her quality of life--medications, physical appearance, home cooked meals, flowers on the table, studied the health insurance and know what is available out there for help, fresh air, exercise, socialization, Church people visit on a Sunday.

Know what each pill does and why. Read the side effects, follow up with doctors and get a Geriatrician if you can find one. Check out ALL your mother's doctor's on your State Board website. Some of the Psychiatrists for the elderly, well put is this way, people pick their profession for a reason. This is important, don't assume anything.

A hospital bed with 1/2 railing can be covered by insurance. It's adjustable and they will be safe. Clear the pathways in the house and change the light bulbs and buy more lamps if needed.

Half of the elderly population is on a blood thinner--Warfarin (Coumadin) was a nightmare since the INR was all over the place due to the UTI antibiotics. Anything can set that off (too many greens), etc. I switched my mother to Eliquis. There are no blood draws but it is more expensive but well worth it.

Good walking shoes, throw out all step-in slippers with no backs and long nightgowns are trouble too. Also any type of blanket that can trip over at nighttime needs to go. Usually after a hospital stay the elderly's shoe size changes.

I buy the SAS Tripad Comfort Soft Step Mary Jane with adjustable strap in case of Edema which usually happens during a rehab and/or prolonged hospital stay. A trip to the Podiatrist every 10 weeks for toe-nail clipping is usually covered.

This is important--the booster seat for the toilet do NOT use because you can't wipe yourself as good and can lead to further UTI's. I recommend the railings around the seat so they can push off getting up. A shower chair and nozzle will suffice. Make sure you control the water temperature not your mother.

As you can see, I have been in trenches. I'm seasoned at this. At first, when I was a newbie to this I prayed to the Lord everyday to help me. Now I can help others. You will learn on the job...Amen.
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I would take her to her doctor and evaluate the need for all the meds.. and of course, the UTI.
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Actually any infection can cause someone to be confused and extended hospitalizations can add another level of confusion.
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YES UTI can causes disorientation & confusion.

So could 17 meds, eek!

I'd want a review of those meds, stat. Also a good medical checkup to rule out other causes (? stroke).
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This is common for dementia patients. My mom came back in a deeper dementia and after 4 months it has not resolved. She had pneumonia. We feel the hospital visits have damaged her quality of life….No more ER visits for her..her geriatric MD agrees. Ps. Look up elderly and hospital delirium..my mom takes 250mg Keflex daily to stop the UTIS….she had 12 in 16 months. Works to suppress Utis.
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Beatty Apr 2023
Pneumonia can cause delerium in the elderly just as UTI does. Add strange & stressfull hospital environment. Add Covid probably at some stage too.
Adding it all together, just too much 😥
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My mom went into the hospital last October with UTI. She then went to Rehab, then back to Hospital, then back to rehab, then we took her to Boston area hospital because her WBC and her confusion kept escalating. We were very concerned about the delusion she was experiencing. They did as many tests as they could to try and track down an infection to see what was causing it and finally couldn't find anything. Ultimately, we took her home with the advise that familiar surroundings, routine, and people would help. They also planned a "Senior Consult" doctor team that looks at elderly persons meds and whole history to try to figure out and consult with PCP to determine what she should really be on. She has so many doctors prescribing so many things, she had multiple pain relievers and other sedating drugs that likely contributed to her confusion. It took 2 months of hospital and rehab time and then a good 3 weeks at home before she gradually became herself again. Now she is as alert as ever. Definitely have PCP go over meds with you.
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17 different medications? That's ridiculous. What does your mother's primary doctor say about this?
Why was your mother put in rehab? She may very well have had another UTI. That happens all the time when an elder goes into the hospital or rehab or any care facility.
Her strange slurred and slow speech could also be cause by different medications or different dosages of ones she has taken for a long time. Or a stroke.
The hospital did a urine culture and it came up positive for infection. Okay. That may not be the only reason for the slurred and slow speech.
Is your mother diabetic? Did they tinker with the regular doses of diabetes medications she takes. Or change them? This will certainly cause the slurred and slow speech too.
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Agree that UTI is likely causing her issues.

But so are the meds. Our insurance offers consultation about prescriptions. Perhaps mom's does as well. Of course get the PCP visit as soon as possible and have that doctor review the meds.

And you can also check meds yourself by going to one of the sites like drugs.com or webmd.com and using their Interactions Checker. You might find that some drugs need to be taken several hours apart from other drugs. And some drugs shouldn't be taken together at all.
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Grandma1954 Apr 2023
All pharmacies are required to give information and answer questions about medications. They always ask if this is a new prescription, they always ask if there are any questions. I bet 99.9% of the time people just say no, or ignore the question.
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