Definitely common. And awful. In my mom's case the post-surgery delirium gradually improved when she was out of the hospital, but she had dementia anyway so...

This is OP again for another update. Yesterday was fine until it wasn’t. She was okay all day until I went to leave and called the nurse for one more bathroom call- my mom didn’t understand to wait for the nurse and was trying to get up. She couldn’t comprehend her situation and things just got worse from there.

I finally did have to leave (thank god for visiting hours) but received a ranting phone call from her at 2:30am with a bunch of gibberish mostly related to how horribly she was being treated. I tried to explain to her why she was there and what she needed to do but it did not good. She finally got off the phone but at 8am the hospital called and asked me to come because she was so confused and agitated.

I got there 30 minutes later and she was sitting in a chair in front of the nurses station fully dressed. Apparently she’d been up all night on a rant and kept trying to leave. She was becoming combatative with the nurses. Her surgeon’s PA was there and was basically telling me this was out of her expertise (she’s just an ortho PA). I was able to get my mom to calm down after a few hours and now she’s finally sleeping.

I know I need to get her out of here because it’s clear this environment is not good for her but it’s Sunday and apparent nothing happens on weekends. I still don’t know if this is medication and hospital related or our new normal. I don’t think the rehab place we were going to send her will be able to handle her, and I worry that hiring someone 24/7 at her place still won’t keep her safe.

Does anyone know of a memory care/ skilled nursing place I could send her while she rehabs the knee? Her leg is bruised from top to bottom at this point because she’s been overdoing it and wandering around by herself. My issue is twofold- first priority is healing the knee, second is dealing with her mental state.

This is the worse thing I’ve ever been through. Thanks for any and all suggestions and frankly a shoulder to cry on.

Anonymous wrote:This is OP. Thanks so much for all of this information, I really wish I’d known before the surgery. It’s insane because we had to her medical clearance from about 1000 different people but not her neurologist. And no one even mentioned to me what the risks were. They were going to do a spinal initially but ended up going with general anesthesia.

My mom is 81 and it was a total knee replacement. Her daily walks are basically all she looks forward to and the knee was shot so it was a lose-lose decision.

When I got to the hospital today she was almost back to normal and we chatted for several hours. Then mid-day she started losing those words again and very shortly after had PT and OT but also got pain meds. So it’s really hard and honestly too soon to tell whether it’s medication related or the new normal.

But man what a terrible, terrifying wake up call. Thanks for sharing your stories, I’ll update this thread as we get further and further from the surgery.

Thanks for your update OP — which I find very encouraging. If she was “almost back to normal” while still being in the hospital, by my standards, that’s wonderful, and very positive. IMO, I think it’s way to early to even think about “the new normal”. Your Mom has been through a lot, and is still going through a lot. Medications will change, where she stays once she’s discharged from the hospital may change, and your Mom’s ability to cope with these changes will change. Instead, in your place, I would be paying very close attention to the factors that seem to support your Mom in positive ways.

FWIW : I had absolutely miraculously stellar experiences with the National Rehabilitation Hospital with my Mom. If this can be a discharge option for your Mom, it might make a huge difference in the quality of her life going forward.

It sounds like she's already getting better.

My mom had hip surgery in her mid-80s and no delirium. About six years later, at 91, she had heart surgery and was under anesthesia for weeks.

She came out of it okay (a bit confused and she was seeing what we thought was floaters)- and within a day or two, she had delirium and didn't even recognize me.

We took her home and she slowly got better. That was a year ago and I think there is a decrease in her working memory but she is probably way within normal.

The one thing she's still confused about was her actual hospital stay. She does not recall me or my siblings being there and yet one of us was with her every day in the hospital, from morning until leaving time.

Can you get her home? Is she on any meds that may be contributing? I especially wonder about sleeping meds or sedatives - they can cause major problems in older people.

This is OP. Thanks so much for all of this information, I really wish I’d known before the surgery. It’s insane because we had to her medical clearance from about 1000 different people but not her neurologist. And no one even mentioned to me what the risks were. They were going to do a spinal initially but ended up going with general anesthesia.

My mom is 81 and it was a total knee replacement. Her daily walks are basically all she looks forward to and the knee was shot so it was a lose-lose decision.

When I got to the hospital today she was almost back to normal and we chatted for several hours. Then mid-day she started losing those words again and very shortly after had PT and OT but also got pain meds. So it’s really hard and honestly too soon to tell whether it’s medication related or the new normal.

But man what a terrible, terrifying wake up call. Thanks for sharing your stories, I’ll update this thread as we get further and further from the surgery.

She needs a change in scenery and to get out of there asap. This happened to my father and he was so much better first when he got out of the hospital and into rehab and then even better at home. She needs to see sunlight during the day and to get outside if possible. You wouldn’t believe how much better my dad did once he got out of that hospital room

This often happens even without anesthesia etc to the elderly. It has to do with that the hospital routine is for the staff, not the patient.

This means, the patient is constantly woken up, for blood tests or doctors' rounds, to check blood pressure, etc. And lights are on (messing up melatonin) and everything is beeping all the time, and then add to that visitors coming in, or waking the patient up for meals...

After a few days the patient gets delirious. It happens with younger people too, but it's classic in the elderly. When my mom's doctor first explained it to me, he was so unconcerned it took me aback. I had no idea this is such a "thing."

NP. This forum can be so informative. Thank you to pp’s for sharing your stories.

This happened to my father. He never really recovered. He passed away 3 months later.

Anonymous wrote:It’s delirium not dementia. It’s different and should fade away. Should improve when back in own living space. My mom hallucinated and acted out and was so confused thinking she was on a cruise ship.
Another thing you should check for is a UTI possibly if she had a catheter she has developed one. UTIs in the elderly population cause very disturbed and delusional behavior.

It can be both, my dad had it after a hip replacement. My dad's delirium subsided after a couple of weeks but unfortunately he has now been diagnosed with dementia. He was fine before the surgery. Sometimes cognitive decline can be temporary and sometimes it is accelerated after surgery.

Anonymous wrote:

Anonymous wrote:It’s delirium not dementia. It’s different and should fade away. Should improve when back in own living space. My mom hallucinated and acted out and was so confused thinking she was on a cruise ship.
Another thing you should check for is a UTI possibly if she had a catheter she has developed one. UTIs in the elderly population cause very disturbed and delusional behavior.

If you haven't seen this in action, you would never believe what a UTI causes in the elderly.

+1

As others have said, this is very common. Being in the ICU itself has risks, as does general anesthesia. With my Mom, being in a private room, having someone familiar with her at all times, and eventually returning to a familiar place were all very helpful. It is a terrifying change — but eventually my Mom improved. Her humor returned, her personality returned, her connections with people she knew and loved returned.

I’m angry, though, that these issues were not explicitly discussed when her surgeon discussed an option for a second surgery with a woman over 90. I am certain that if my Mom had been aware of these risks —and if I had — she would have seriously considered them and probably would not have consented to the surgery. She had an aneurysm. I’m pretty sure that she would have chosen “let nature take its course “ vs all that she endured following that second surgery.

tldr: Don’t despair OP. Things can definitely improve significantly. Wishing you comfort and reassurance.

I had an elderly relative who was so knocked out by surgery/drugs that she had hallucinations -- saw tons of things that just weren't there, like animals, people, etc.

With time, she recovered 100% back to where she was super mentally sharp, as in doing the NY Times crossword puzzle sharp.

Anonymous wrote:It’s delirium not dementia. It’s different and should fade away. Should improve when back in own living space. My mom hallucinated and acted out and was so confused thinking she was on a cruise ship.
Another thing you should check for is a UTI possibly if she had a catheter she has developed one. UTIs in the elderly population cause very disturbed and delusional behavior.

If you haven't seen this in action, you would never believe what a UTI causes in the elderly.