Hello everybody,
I haven’t posted here for quite a while because, frankly, I haven’t had much to post about. Mom has been in pretty good health and has been doing well. But last Thursday she fell and broke her hip. At the hospital they gave her some strong pain medication, which, combined with the anesthesia, gave her a serious case of “hospital delirium.” For 2 days she was having delusions and hallucinations. It was a frightening thing to see. Fortunately, the delirium is fading. Yesterday she was pretty cogent and seemed fairly focused on reality. But there is one delusion she is still clinging to. It involved her daughter-in-law and granddaughter yelling at her and trying to shame her—and then forcing her to take a bath. She thinks this all happened in the last few days, and says that she is “finished” with them.
I’m worried that this delusion will not fade and there will be a riff in the family over—literally—nothing. Do you think it would be a good idea at some point to talk to her about what happened to her and try to explain that this delusion is not really true—that it was a bad dream caused by the medication?
Thanks for your opinions.
She's pretty clear-headed now, but a new "story" pops up from time to time. I'm hoping once she's back home, in a familiar environment, they'll disappear.
Thanks again.
Another thing I would do is find out what those meds were AND dosages. Add them to Mom's list of allergies under NEURO EFFECTS: hallucinations and possibly permanent delusions.
My Mom is allergic/reacts to "EVERYTHING" per HER list. Some are serious and some are questionable. (It's pages long.) Ultimately, the drs became afraid to give her meds and things got dicey. I finally organized her list in alpha order, duplicating the generics and brands. I added a column for drug type too. In the Effects column, the first word for each row is a consistent abbreviation of the system or function affected (sometimes multiple) - like NEURO, GASTRO, CARDIO, MUSCULAR, (for physical), etc., then I added detail - like nausea, hallucinations, fatigue, heart palpitations, extreme anxiety, temp paralysis, hives (where on body), etc.
And I have columns for dosage, method given (oral, intravenous, injection, however), and frequency (QD, BID, TID, QID, PRN). Mom is obsessive, to her credit, she had DATES of her reactions. That became very useful added to the detail. Example, no dr would give her any scan with contrast because she listed iodine as a hyper sensitive reaction. Well, Mom had 1950 on that. When querying her about it, I discovered that in the 1950s, one DRANK the iodine. Today's drs shutter at that and said no wonder it made her sick. So, with the proper prep to curb any reaction, I had them do what they do today (intravenous and slow) with the contrast, and, voila, no reaction!
The drs and nurses love my list. It's in their speak, and they are quickly able to ascertain options.
Just by organizing Mom's allergy/reaction list, for myself, I was able to see patterns and trends that effected her health. Drs, the pharmacist and I have worked together with this info and found out it was the dosage (too much to quickly) or the method that causes the reactions. We've had a bit of success now treating infections, pain, and getting good labs.
It's just good info to start keeping.
Hope your Mom recovers quickly and regains her capacity. Please insist on therapy 5x week for at least the first 2 to 4 weeks. It's key to her regaining maximum function. If you have to appeal the insurance to get it, use that language (to regain maximum function) along with "the lack of frequent 5x week PT and OT will be detrimental to her overall health and quality of life"
Leave it alone.
It is important that all family members (and friends) understand that dementia (if you mom has dementia) changes the brain chemistry - it isn't 'the old' her talking. If they understand this, they will accept that she doesn't understand what she is saying.
Wait and see how she does with the medication.
I personally wouldn't bring up anything that could create a 'I'm right and you're wrong" scenario. It only causes emotional upsets and doesn't resolve anything.
Still, everyone needs to find their own way to manage these communications and the brain changes. There isn't any one right answer.
Try 're-directing' or 'refocusing' your mom when she gets into these delusional thinking. Telling her it isn't true will frustrate her / make her mad / upset and defensive. There is no point to correct her. At least, this is how I would handle it - and how I interact with my clients, depending on the severity of dementia or / and considering other health conditions and medication.
If you were hallucinating - and believing it is REAL, which is what a hallucination is (I think), would you want someone to tell you that what you 'know' to be true isn't? Why would you believe them? It reminds me of forgetting - me and others. It is hard or impossible to tell someone they don't remember if they don't remember.
* Try holding her hand, reflective listening ("I hear you are saying . . . ") She will want to be heard, not necessarily believed. Then, change the subject ASAP.
We'll with you - we know how it is.
Gena / Touch Matters
Hope the delirium resolves itself.
Best to try 're-directing / re-focusing attention' then changing the subject.
However, I've witnessed my client answering MD questions about drinking - my client was not telling the truth - and the MD didn't question her (nor ask me anything about the alcohol consumption). It amazes me how medical staff talk to my client / their patient as if they do not have dementia. The mis-information is shocking. And, I sit there wondering how and why they do this, and do not ask me, the 'caregiver.'
Would it help if DIL and grand-daughter ignored delusion but sent loving notes to help the brain get past the delusion?
When my mom took her last fall, that led to her last days, she was found having been on her kitchen floor overnight, near hypothermia. She was hallucinating that 'workmen' were in her house, possibly the EMTs that found her; the idea stuck with her for a long time but she eventually reframed it as a 'bad dream', not real. I didn't argue with her, but let her come to her better understanding.
BUT that may not work either and if not, just move on with other parts of the day and not dwell on it and hopefully she will let it go. If not, that's not your responsibility or fault that she continues to feel as she does. Just move on.
Another time, when Mom was in MC, she was frantic because she said one of the other residents kept coming in her room. I could believe this but then she said this resident would go through Mom's stuff and ended up putting her things in Mom's closet. I looked but didn't see anything so I guessed this was another delusion. Well - when Mom had to move to another facility and I cleaned her things out - guess what? I found a bag of this woman's things - stuffed in the back of the closet! From then on, I would look into the things she said and address them if it was needed. Sometimes, they were true (or at least partly true) and I didn't want to chance dismissing something that was upsetting to her.
Hospital delirium can last days, weeks, months or even be permanent so I think your 2 days is a very short period to expect total recovery even if this is going to happen. Try being patient for a while and assuming she will improve. If she does then she will lose this delusion anyway (or you will be able to talk about it sensibly with her), id she doesn't then I doubt you are going to be able to discuss it logically and making an decision on how the daughter - in - law and granddaughter and going to handle seeing her or not going forward is better had with them. Best wishes for hopefully a not too long recovery.
I was (relatively) young and healthy when I had back surgery at age 46, and I swear, my brain didn't work properly for a solid month after that anesthesia. (And it made me lose a ton of hair to boot!)
An older person will take much longer to bounce back, so just wait it out, warn the DIL and granddaughter what's going on, and play it by ear.
But if she mentions it and gets upset I would address it sooner.
I would tell her that it was the medication that made her see, hear things.
Please tell daughter-in-law and granddaughter about the delusion and that they should not be upset and if it means keeping the peace and making things better, easier they may need to “apologize” to make mom feel better. This is one time when pick your battles may be important to soothe mom
Not knowing this, when my sister stayed with him while I went on a quilting retreat, she invited my cousin come over. For 2 weeks after I got back, he went around looking for all the other things she stole. I'm dreading this Thanksgiving.
Just chiming in to say my mom went through the same thing. It was horrible yet fascinating at the things she came up with and had absolutely no memory of later.
She did remember that she had a bad reaction but not the specifics. My mom did not have dementia.
My aunt, who has dementia, in early days, would latch onto a false memory and want to share it with everyone. I decided to ignore her comments when she did this with one story in particular and discouraged her from sharing it with others. My idea was that the retelling was reinforcing it in her memory. She finally quit telling it on a daily basis but it was so real to her that every once in awhile she will start to bring it up and stop if I’m in the room.
Why she can remember a false memory but not something from her real life is such a conundrum. I know this isn’t hospital delirium but just wanted to mention she might be reinforcing her experience by retelling it.
After my moms stroke she was not really alert for 2 months.
Mix stroke recovery and healing with new medications - UTIs and the trauma she endured - she had so many weird things she would say.
It took her time to go through them and place them or make resolve with them. She now works with neuropsychologist for talk therapy. He is explaining a lot to her so she can learn more about her injury and what the brain can do and it is also helping me.
You can request one while in the hospital come Eval and maybe can help guide you going forward. When mom did have severe delirium once - a neuropsychiatrist did follow her case and stop and check in throughout her stay - so maybe request to speak with them. Best wishes