Back in the hospital

[Anonymous]

I wrote awhile back about my mom suffering hospital delirium after general anesthesia for knee surgery back in November. She went from the hospital to a SNF to home. Her short term memory was completely shot for about a month after she got home but seems to have been back on track since then. I see her at least twice a week and try to talk to her every day. She suffers from primary progressive aphasia but is still able to generally take care of herself. She’s in independent living and takes her meds, showers, does her own laundry, gets herself to and from meals in the dining room.

Friday I was planning on taking her shopping for summer clothes but before I was able to get over there she called me utterly freaking out so i went over there. She was almost completely incoherent. From the two hour conversation with her she basically communicated that she’d done something awful and thought they’d kick her out but she was such a mess she wasn’t able to actually formulate a sentence coherent enough for me to understand what she’d done. And the place she’s living at never called me so whatever it was must not have been a big deal, if she’d even done anything at all. Which is highly likely because she’s also apparently been hallucinating. I was able to get out of her that she hadn’t been sleeping so I figured she just needed some rest. I put her to bed and went home. Talked to her very briefly yesterday and she seemed okayish. But last night she called me all freaked out again and wanted me to come over first thing today which I did.

She was back to babbling and nothing she said made much sense at all so I started getting more and more concerned. I checked her oxygen levels and she was normal. I decided to take her to urgent care to check for a UTI but changed plans when she told me that she was having issues seeing out of her right eye. So to the ER we went. So far they’ve done CT scans, an EKG, urine sample, COVID test and blood tests. All the results are normal so far. She’s being admitted for a brain mri and neurologist review. And as soon as she’s discharged we’ll head straight to the ophthalmologist. She’s very unhappy about being admitted, doesn’t like or understand all the things hooked up to her and is mad at me because I didn’t go over in detail for a 75th time every possible scenario of anything that could happen. I’m planning on staying with her until they get her settled in her room then coming back first thing in the morning. But I’m already absolutely exhausted.

I don’t know how people do this for an extended period of time. And I feel awful praying they find something on the MRI so we could at least have a medical explanation for everything. I’m terrified this is just the progression of her aphasia and this is the new normal. And I don’t know where to start in terms of getting her into a place that can help her navigate life. I don’t even know if I need assisted living, skilled nursing or memory care. This is so overwhelming.

[Anonymous]

That sounds really hard. I’m sorry. Try taking it one day, or even hour, at a time. Try not to think of anything beyond that.

Hopefully the doctors will be able to figure out what is going on with your mom fairly quickly.

[Anonymous]

As parents age, unfortunately, the simplest of tasks take great effort for them and their caregivers. Explaining things multiple times isn’t unusual, recovery from medical procedures seems to take longer than it used to. This unfortunately isn’t going to get easier. Rule out any medical issues and if something needs taken care of do it now, putting it off won’t help. At the same time you have to do it in stages and not address everything at once. That can be too overwhelming on their body and mind.

I’d probably start with a sleep apnea test too, that can cause the symptoms you speak about. I take care of an elderly parent that refused that study until they ended up in ICU- now requiring full time O2 and CPAP nightly but cognitively it’s night and day. It’s never easy, just be thankful for the good days.

[Anonymous]

And even if her O2 levels are good her CO2 levels could still be too high, so I wouldn’t use that as a sole indicator in this instance. You need something called an ABG to test for CO2 levels.

[Anonymous]

Could her aphasia be a variant if Frontotemporal Dementia? If so, she could be experiencing paranoia.

[Anonymous]

Is she on any mood meds to help with anger, etc? If not, I’d ask about it. My mother lashing out and blaming me for worse until she was medicated. It sound like memory care is the way to go, but Hospital social worker can give a better idea. How much money can you throw at this? If she can afford, you can hire an aging care professional to help with placement. Just avoid any professionals who push aging in place and claim their agency contracts with everything you need.

[Anonymous]

UTI’s and some vitamin deficiencies in the elderly can present in confusion.

[Anonymous]

My mother's been going through something similar but without dementia or hallucinations. She's had several hospitalizations and all the tests, but there's no definitive answer. This will probably continue.

One thing that has been clear is that she doesn't get enough liquid and becomes dehydrated. You might want to watch this and ask about electrolyte imbalance.

I wish I had an answer for you, OP.

[Anonymous]

You need memory care.

[Anonymous]

It is so hard. This is similar to what I went through with my dad. His delusions were so intense. One time he thought he set his apartment on fire and was going to get kicked out.

He was having significant issues with sleeping, which did not help things. So, definitely find something to help with that. During one hospital stay, his doctors said he hadn't sleep in 4 days. He was finally put on an anti-psychotic - Seroquel. It helped stabilize things enough for him to go back to his assisted living facility. He was quickly moved to the memory care floor.

Turns out he had stage 4 pancreatic cancer. I am not sure how much one played into the other. We spent so much time chasing issues with the dementia, we didn't find out about the cancer until a week before he passed.