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My dad fell in December and had a lumbar compression fracture and 2 subdural hematomas. As a result, he had to have 2 surgeries within 2 weeks of each other and a long period of hospitalization. Two days after surgery, my dad was recovering and was functioning well cognitively. He went to an intensive inpatient rehab for therapy but developed a UTI and cholecystitis and his VS and mental status deteriorated quickly. He was experiencing episodes of low BP there when he changed positions, was agitated, and was confused. The rehab doctors diagnosed him with dementia but I said isn't it really delirium since it came on quickly? I was told by the nurses that they didn't have time to worry about his BP and other medical issues as they were there to do the rehab. He continued to be treated as a dementia patient. He was admitted to the regular hospital through the ED after 1 1/2 weeks because he reportedly had a seizure which ended up being low BP and urosepsis. Two days later, my dad has his gallbladder removed. This time he didn't bounce back and his altered mental status has continued. Some days he is more with it than others but that can change from day to night. Yesterday, he was a little hyper but was aware of where he was, and why he was there and was generally with it. Today, he was anxious, confused, and had hallucinations. I don't think he has been properly diagnosed and treated so I am reaching out to find out if others have gone through this and what they did. Thanks!

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Someone recently told me that this happened to their father. Apparently it's quite common. However it appears it is not diagnosed properly for some time, if ever.
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My husband 85 spent three days in the ER for covid and nausea and diarrhea aned low blood pressure. when he returned home he slept a great deal, did not want to eat. He is being treated by a psychiatrist for depression. She said that he had delirium, hypoactive delirium. So I looked it up and the symptoms corresponded to his. There is no specific treatment other than to have regularity with sleeping,eating and meds. He is gr adually improving.
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ConcernedinNC1: My mother experienced this, but only after having been given morphine.
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Yes I believe a few weeks ago someone also posted about hospital surgery and then mental confusion. It
seems anesthetic effects the elderly. For sure follow up about that and demand info from anesthesiologist. What was used/Side effects/ length of effects
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Google "Geriatric Psychiatrist near Raleigh, NC"...............looks like you have some good choices.
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Look up delirium on a reputable site, like Mayo Clinic. It has two forms hypoactive (which my husband 85 yrs had) and hyperactive. His psychiatrist diagnosed this after a three days stay in the ED. The only treatment is supportive care. His is improving with a change in antidepressants. I don't believe this diagnosis is given too often by the hospital staff but I understand it is prevalent. His symptoms were sleeping all the time and not eating as much. Good Luck
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yes, my husband who has Parkinson's had delirium-hallucinations after being given prednisone in high doses to bring his blood pressure down after being taken to the hospital after a fall in the shower. Secondly, Urinary tract infections in the elderly can trigger delirum/hallucinations. My mother had delirium (perhaps caused by a common drug...??"Uxxx given to people with urinary tract infections. My husband lost strength in his lower legs due to a urinary tract infection. People have trouble recovering from anesthesia this way too. The hospital setting can be very disturbing too. Also, I heard that sometimes broken bones can release substance into the blood stream/brain that cause temporary problems. Your dad's body has been under assault, hydration is of the utmost importance, even through IV. Those nurses responses were unacceptable. Low BP leads to fatigue, fatigue leads to inactivity. Inactivity in a hospital setting can lead to pneumonia and perhaps the crashing of various organs. Perhaps it was premature to put him in rehab. Unfortunately, good health is like dominoes, sometimes there is a cascading of health problems, but water, water might stem the progression. It will also help flush the antibiotics, toxins and aesthesia chemicals out of his body and especially his kidney and liver. I'm just a concerned person, not a professional.
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Yes my wife. I think the Anesthesia has long term effects.
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Yes this happened to my dad after he had emergency abdominal surgery in his mid 80’s. We were expecting him to be able to go home after, but he had to come stay with me for a month before we felt he was at all capable of being on his own again. We didn’t realize at the time that he was in the beginning stages of dementia so that played a part. He was able to function on his own for about 5 more years but then had to live with me again until his death. When he had the emergency surgery the doctor told us that it takes the elderly a lot more time to recover from the effects of anesthesia etc.
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Very common. It's also common for these elderly patients to get a urinary infection while in hospital or nursing home/rehab. It can also be pain meds they are using for him.

Ask if they have checked him for UTI - ask for test if they have not.

Ask for list of meds he's getting and review it yourself if you understand medical jargon or take to his pharmacist to review for you. Tramadol, gabapentin are two that come to mind that can alter mental status. Norco is a common pain med and some folks don't do well on it.

Don't let them just tell you mental status is normal for people his age after surgery. Rule out other contributing factors yourself.
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Yes this happened to both my mother and my older friend several times. There is a good chance it will settle but in my experience it can take longer than two or three days.

It is very difficult for both of you. Hope things improve.
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Hopeforhelp22 Mar 2023
I agree with Elainera - that type of behavior happened to my father when he fell, fractured his ribs...went into the hospital and also had a UTI then sepsis - previous to that, he was very sharp, and then a host of other reactions cognitively initially in the hospital - such as hallucinations, delusion and confusion. The doctors said at the time that a good percentage of the time that it's temporary and he should settle back...and fortunately, in around a week, he rebounded back cognitively. I hope this also is the result for your dad and this is just temporary with his change cognitively and he'll return to his previous state. Wishing you all the very best - and lots of continued strength.
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My brother -in -law (95 yrs old and lived w/us) experienced almost all of what you mentioned. After being hospitalized in Oct 2022 with a UTI which quickly developed into sepsis, he began experiencing what we thought were "dreams" where he thought he was in another place and began calling us to tell us the places he had been that day actually believing he had been there. This, we understand was effects from the UTI. He had several other physical problems while there for the next 2 Mos. When he returned home, I began researching his "new" mental experiences which I quickly diagnosed as delirium....not dementia since he had no previous symptoms . Although I realize delirium can be an offspring of dementia. As time progressed....it became much worse...going downhill with increased delirium daily. Nights were the worst !! This behavior continually worsened and became difficult to control even with prescribed medications.

My heart breaks for you both having to go through this. Delirium is horrible ands is such a painful experience not only for the patient but for the caregivers.

I hope you find the help you need...don't know if he would be qualified for palative or hospice care, but both are wonderful !

Good luck my dear 🌹
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Yes, my father was admitted last December with a UTI which became a blood infection and after 6 days in the hospital the delirium set in. It was awful because it was not my Dad at all. For his age (87), his mind has always been great, but he became completely disoriented and even had very bad bouts of anger. It was very aggravating when the neurologist came in to see him. We explained to her this was not like him at all and had come on suddenly. She asked when we moved him into assisted living. When I told her it has been almost 2 years, she insisted that is when his dementia began. We kept explaining to her, he went to AL due to neuropathy and being a huge fall risk, not at all due to his mind or memory, but she continued to insist that his dementia had to have began then and that the hositalization had nothing to do with it.
They also placed him on an anti-psychotic medication, then sent him off to rehab after 2 weeks. The medication made him completely out of it. I kept fighting with them to have the medication removed after he moved to rehab and started improving. They would remove it a day or 2 and then he would be back on it. The nurse on shift would remove, but I couldnt get them to remove it from his chart. It affected his ability to successfully do rehab there. They basically got him up for an hour a day and left him medicated in bed the rest of the time. During that time, he became incontinent from being in bed with a brief on all day.
He moved to another rehab after 3 weeks where we successfully had him removed from the medication and he improved mentally almost immediately and almost 100% back to himself in that aspect, but unfortunately after the 5 weeks of hospital and the first rehab stay, he still has not been able to progress very well physically which has resulted in him not being able to return to AL and is now remaining in long term care.
I know his decline is due to his age and other health conditions, but I truly feel the speed of his decline is very likely due to how they treated the "hospital induced delirium".
A couple of suggestions I would make if you have an elderly loved one hospitalized is, have family/friends visit as much as possible so they have some familiar surroundings and also keep the hospital blinds open to help them differentiate between day and night. The first room my Dad was in had very small windows near the ceilings and the blinds were closed the entire time and I think it really added to the start of his confusion and sleep patterns.
All in all, I do believe those with the 'hospital induced delirium" have a very good chance of returning to their normal mental state with the proper treatment and support from family, it may just take a little time. Wishing you the best with you parent!
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I agree with Bandy7 in that your post makes me angry at what you are going through. It seems elderly patients are often written off as everything is due to old age and dementia... even when they were fine before the issue that brought them to the ER. You are wise to keep looking for answers, but at the same time keep an open mind that the issues may be related to the hematomas. Either way, a thorough evaluation could help provide a clearer diagnosis of various issues that may be happening. If you have not done so already you may want to request a copy of his MAR (Medicine Administration Record) to review any changes that may have been made without you being aware which may relate to his current condition.
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jkl0916 Mar 2023
I agree as well, it is so aggravating because in my experience they insisted my Dad had been developing Dementia for some time and the hospitalization had nothing to do with it, when he was fine mentally before the hospital stay. They medicated him and decided to release him to rehab and I felt like it was because he was a nuisance for them. They released him on Christmas Day and no rehabs were wanting to take him due to the delirium and the Social Worker told me I would need to consider choosing a 1-2 star facility since none of the others would take him. I insisted that I would not, especially due to his mental state. They finally found a nice rehab that was a bit of a distance, but I later found out the Dr doubled the anti-psychotic medication upon release to rehab so they basically kept him medicated and bedridden most of the time. After a couple of weeks we got him moved to a skilled nursing facility and got him off the meds and he recovered 95% mentally almost immediately. It angers me as well because I hate to imagine what would have happened to someone who did not have family to advocate for them in that situation! They likely would have been medicated and shipped off to very poor skilled nursing facility for their remaining days.
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Hi, I'm sorry to hear about your dad. I'm going through a similar situation in that my dad has had repeated (11) hospitalisations since last August. He's had falls, hypothermia, anaemia, UTIs and severe dehydration, some of which are due to living alone at home/self neglect (he refuses carers). He had a heart op in January and developed another UTI and URI in hospital. After 2 weeks respite in a nursing home and a week back at home he is back in hospital with UTI, LRI, low blood pressure and breathing problems. He has stage 3 heart failure and chronic kidney disease. He has been mildly cognitively impaired for a year or more (it very much comes and goes but has gradually worsened) but doctors have declared him to have capacity. He has delirium during every hospital stay, and currently his delirium is worse. He has vivid hallucinations and is paranoid the nurses are conspiring to ignore/kill him (and sometimes that my sister and I are in on it). The doctors and nurses have explained it's very often a combination of an unfamiliar environment, change to routine and infection that cause significant cognitive decline, and it can be temporary. With my dad they have put a DOLS (deprivation of liberty) order on him for a week to stop him trying to self discharge, which he is liable to do. They are hopefully clearing his infections with antibiotics, and then the 'older persons mental health' team will re-assess his cognition once he's clear of infection. (I am in UK by the way so things may well work differently here)
Another issue is sleep disruption/deprivation when the patient is sharing a ward with those with severe dementia who shout out and wander regularly. It's bound to affect their cognition.
I would say from what you describe it seems the doctors were a little hasty to diagnose your dad with Dementia. What he's been and is going through is bound to cause a cognitive decline. He may well have early stages of Dementia but a mental health team should wait and assess him once he's physically more stable. I just keep calling and pestering the doctors and nurses on my dad's ward, mental health team and Dad's GP. Ask for second opinions! I'm also keeping a diary of everything, including who I spoke with and when, what they said, how Dad is and what his cognition is like when I see him. Also just trying to talk to my dad every day, visit him often and reassure him that he's not being neglected, ignored or forgotten. We're trying to get him out of hospital and back to the nursing home (he liked it there) where he's much more likely to shake the delirium and make significant improvements.
Keep fighting to be heard. Let us know how it goes and I wish you and your dad all the best.
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jkl0916 Mar 2023
TiredK12 I am so sorry for what you have been dealing with this past year, but so glad your father has you to visit often and reassure him! I think that is so important. I also believe the UTI's can strongly add to it. After my Dad was hospitalized with his first bad UTI, I have been able to recognize now when one is occurring quickly just based on the change of his mental state. When the hospital delirium set in, my Dad also had severe paranoia and hallucinations and thought the staff was conspiring against him, it was awful to watch him go through that. Once my Dad was released and settled into long term care, his mental state began to improve almost immediately, hoping the same for your father!
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My mom went through something similar. She fell and broke her hip. She was in the hospital for a week. She went to rehab for a month and a half. She came home for 3 days and back in the hospital with Covid for a week. Then back to rehab for another month and a half. She’s never been the same mentally. She became confused. Forgetting what was said in a conversation within minutes of it being said. Her confusion has just gotten worse since. I’m sure part of it can be attributed to Covid but she’s just not the same mother she was before she fell.

If you want a definitive diagnosis, maybe you should have him worked up. Best of luck.
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Bandy7, I just wanted to thank you for your very informative posts on this thread.
We went thru the exact same things with my Mom and I hope your posts help others going thru this to be vigilant when their loved one is in the hospital.
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My Dad has been hospitalized several times for various issues and this is extremely common — but that doesn't mean it's not disturbing. It can take weeks for it to go away, and sometimes it does show an underlying issue. It's so common I was shocked at how little it seems to be understood, especially in the ER. Because he got very agitated, they put him on all sorts of meds that "calmed" him but basically made him almost catatonic.

From personal experience, he improved dramatically when he was back in a more comfortable and known environment (in our case, his AL)
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I have not experienced this but stick around for answers from other posters.

I hope your dad recovers fully from this experience. Sounds like he’s been through quite a lot.

Wishing you and your father all the best.
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