Yeah, I know, “Because they’re sick and are on drugs.” But my mom is back in the hospital, looks like for the last time, and when I spoke with her she was WAY out of it. I could understand what she was saying, sorta, but it made no sense. I asked my SIL, a psychologist and who was in the room with her, how long she’s been like that. “Since she came in on Monday.”*
“So this is her new normal?”
“For now. People tend to mentally backslide when they are in the hospital.”
I have noticed that, too. Beyond the obvious, why would it be? ETA: Or, beyond the obvious effects of illness and drugs, DO they backslide?
Background: dropmom is 91. She fell in her home (she lived alone) a couple years back with a broken hip and wasn’t found for a day. There was also a urinary tract infection, of course, because she has always alternated between having one and being between having one. (We always had cranberry juice in the house. Not sure if that actually helps.) According to what my brothers and SILs said (Bless them! They are all out in Seattle while I’m in Chicago.), her doctor claimed her incoherence then was caused by the infection. After a few weeks she got better, mostly, and has spent her talks with me being recreationally outraged by my brothers, the other ladies in the place we have her in, and Donald Trump. Perfectly normal; recreational outrage is a family hobby.
Monday she got pneumonia and was put in the hospital. Of course, nobody told me until 10PM Thursday. Another family hobby. Older brother has been battling bladder cancer for two years. I learned about it at around 10:30PM. One of these days I’ll tell them how close Wife came to dying last year, but the topic hasn’t come up and she hasn’t told me everything yet.
Mom’s retaining water so they’re working out whether it’s congestive heart failure or just that her kidneys (kidney? she always had problems with them and nobody tells me anything and I think SIL used the singular before shooing me off the phone) are/is making a gallant effort but they really loaded her up with fluids and antibiotics the other day.
In the elderly, a UTI does indeed cause delirium. When a person becomes altered fast, it’s something doctors are supposed to look for before assuming that they’re developing dementia.
Another cause of delirium that is more common as you get older is ICU psychosis. If this is the case now, she’ll probably get better within a few days of leaving the hospital.
I can second that from my experiences with my in-laws as well. For some reason, as he got older, my father-in-law would also get daffy from almost any IV antibiotic for any reason. The first time was after a bout of pneumonia - the second time we warned the nurses ahead of time. By the third time they had it in his chart.
Could it have something to do with lack of quality rest? When I was in the hospital after my daughter was born a nurse was in to do something or other every couple hours, day or night. It was awful.
Oooh! I had something like ICU psychosis, except it was kinda faked because I was going through alcohol withdrawal and wanted a few more days of enforced drying out. Not that I was being treated for it or anything else by that point, but I feel suicidal often enough that the claim comes easy.
Apparently the word for the day is “decompensation,” as in, “Mom always decompensates at hospitals. It was blamed on the infections (UTI and pneumonia) at the beginning and inefficiencies of her heart if that turns out to be the diagnosis.” But the Lasix is doing its job and she’s doing much better than a few hours ago, and the lesson to be learned is that my brother, otherwise a perfectly respectable lawyer, should not have married a psychologist for the sake of his vocabulary.
For some reason psychologists don’t enjoy delusions like Mom and I do. They see an elderly person who’s not thinking right. I see an old lady whose head is in some happy place we can’t share. She’s very happy right now. I hope nobody turns on MSNBC, much less Fox News. :eek:
One time my father was in the ICU and they were panicking about something about his heart. Older brother kept asking if anybody had looked at his chart until someone finally did. They calmed down when they understood it was his normal state.
Every single time my husband is in the hospital - the same hospital, 9 or 10 times in the last three years - I tell them, “You’re going to make him NPO, his heart rate is going to go up, you’ll give him Carvedilol IV, and it will work for 24 hours and not a minute more. Then you’ll keep him here an extra two days on telemetry for the tachycardia on a useless Carvidolol drip before your Cardiology Attending suggests you humor us and give him his oral Metoprolol. That will bring his heart rate down within an hour and he’ll be discharged six hours later. Can we just skip the Carvedilol, please?”
Now I know how to say “(s)he goes nuts any time (s)he’s sick” in actual psychological terms. Gotta love the Dope. I know people to whom it happens any time they suffer from an acute condition, whether they are being hospitalized or only needing to see the doctor in non-routine circumstances.
This isn’t just a joke.
The issue , of course, isn’t lack of coffee–The real issue is lack of your regular, daily routine.*
Being thrown in the hospital is disorienting. It can screw up your mind, even for a young and healthy person. For the elderly, the brain just gets overwhelmed.
To see this for yourself, try this little exercise *(If you can get away with it without getting arrested!): lay down on an empty bed, and have your spouse push you through the hallways from whatever room you are in, to the X-ray department at the opposite end of the building and 2 stories above you. Stay lying on your back, just watching the lighting fixtures in the ceiling whizz by you for 10 minutes, till you are dizzy and have no idea where you are or what’s happening to you.
Now imagine doing this under while suffering painful medical problems and taking lots of drugs.
When you visit someone in the hospital, you are not visiting the same person you knew a week earlier at home. Their entire world has collapsed to the size of one bed. It is a profoundly disorientating experience.
*hint: do not try this unless your spouse is 65 yrs old, an employee of the hospital, and has only one week left to work before retirement. Or unless you want to get arrested. Or both.
My dad suffered ICU psychosis big time during his last long hospital stay. A bit of reading on the subject seemed to point to lack of quality sleep and a disrupted day/night schedule as the chief culprit. He was (mostly) back to normal after a couple of weeks at home.
Lack of nutrition in hospital doesn’t help, either. For some reason quality food is never included as an integral part of all treatment. A lot of (particularly elderly) people are malnourished upon admittance, so they’re way behind the eight ball by the time they’re discharged.
The constant nerve-jangling noises are enough to add ten years. Being confined to an unfamiliar and uncomfortable bed from which you hear the snores and farts of people whose names you don’t even know makes a stay in hospital stressful AND revolting.
I believe metoprolol is a beta blocker. You. do. not. stop. a. beta blocker. suddenly. Ever. I don’t know what carvedilol is, but when I accidentaly forgot my beta blocker, my pounding heart told me that evening and I took my pill.
In my mom’s case, the doctors and nurses kept messing up her medication. Every time I’d leave for a couple hours, I’d come back to find that some miscommunication had resulted in them making a mistake, and that’s just the ones they would admit to.
Your mom was lucky. When my mother had ICU psychosis she almost needed to be restrained. She did not have happy delusions- her delusions were more of the type where the staff were stalking her. She ended up being treated with Haldol (an anti-psychotic). Even weeks later , she though some of her plausible delusions were real memories.
That’s why I’m glad SIL is there: sorta medical so she has a clue of what’s going on, practical, and suspicious. Little Brother is a drama queen who has been trying to soften the blow to me of Mom’s inevitable passing for years. He seems to have a problem with “acceptance,” that Death stalks us all, especially Mom, me, and my wife. Death’s a familiar presence but I’m a lousy chess player so I don’t accept his invitation to play.
