I took my mom for an assessment on her walking on Monday at the ER, per her Dr.'s orders. She was admitted that night for PT assessment on Tuesday. She was cognitive, very aware and ate well. Wednesday I got a call saying my mom was in ICU. As she was getting her breakfast the nurse said her head dropped and she was incoherent. They did an MRI because they thought she had a stroke. That was negative. They have done CT Scans and an EEG. They're still looking over the EEG, and tomorrow they might do a lumbar puncture. Her numbers are perfect. Her doctors are "baffled." The ICU doctor is trying to persuade me to sign a DNR. I will not do this until I get an answer why this suddenly happened. She did know who me and my brother, sister in law and husband were. She was able to say our names, but everything else was gibberish. But she would continually make noises and turn her head back and forth. I am so confused and broken hearted. Has anyone else experienced such a thing. I am POA.
Another thing, about 90% of elders who go into the hospital get delirium. Delirium causes a person to become frighten and confused. When you think about it, it's not peaceful at a hospital... all the new noises, the new smells, the bright lights, the food doesn't taste the same, staff poking and prodding at all times at night. Now, 20% of younger patients experience the same thing if they had major surgery.
Ask her hospital doctor if he ordered a UA.
She must have been experiencing some extreme symptoms for the doctor to send her to the ER, and for her to be admitted.
What else was going on?
I agree with Chad. It would be good to have a medical power of attorney and full power of attorney just in case something happened. But your Mom will need to be able to sign it in all likelihood. My honey and I both have a medical POA and full POA over each other "just in case". We both also signed a DNR as we did not the other to have to make the decision. (We went through this with my honey's Mom.) I keep them in folders marked legal papers with our names so that if anything happens they are right at hand.
First, last month I was advised by EMTs to have my 97-year-old Dad taken to ER for imaging. He had banged his head very hard in a fall. He had been falling increasingly, and we had perhaps over-used the “courtesy lifts” that 911 can provide. From ER he was admitted to the hospital for four more days, then to rehab for 20 days. Rehab PT had him “walking” 75 feet a day. Once he was discharged to home, he seems to have had multiple strokes and now can barely speak (aphasia, dysarthria, apraxia). I imagine it’s possible his severe aortic stenosis (first diagnosed because of the ER imaging) may have caused strokes or plaque disruption? For years, and at ER and at the hospital, Dad happily signed DNRs. But once admitted to Rehab he wanted “all extraordinary measures” to keep himself alive. His dementia had increased markedly in the hospital. At rehab, he was most definitely declared incompetent and I was put in the position of DNRing him. Why did I do that when my heart was breaking, I felt so guilty about overriding his wishes, and I loved my dear father?
Ten years prior, my 100-year-old mother-in-law fell, after numerous falls, and was admitted to ER, where she expressed her DNR wishes and wore a huge DNR bracelet. Though having survived a number of strokes and still able to be rational, she had signed so many DNRs and clearly worded directives, which I made sure hospital staff shifts were always aware of, as well as her family’s legal role in supporting that decision. She was such a bubbly, giving personality that she had endeared herself to nursing staff in just the few days she was there. She had another heart attack during this short hospitalization. An RN went into a panic and intubated her. Roommate witnesses said the tubing was the most horrible thing they ever witnessed. It caused such trauma, the entire ward (including visitors) was shaken. Once deceased, when I viewed her body, it was quite obvious there was a lot of internal tissue trauma caused by the intubation, which also extended her life struggle.
I don’t think ER or hospital staff have the time or emotional capacity to always make exquisite decisions filled with perfection. Many are weary and exhausted. Many have seen too much, and are burnt out too. They fall back on protocol training and knee-jerk reactions in a pinch. I can’t fault what happened during either of my two experiences. I just saw a bunch of people (myself included), who did the best they could do under very stressful circumstances. We are forever saddened and traumatized. But that is why I will sign DNRs on behalf of extremely frail, aged, and irreversibly diseased love ones. And why palliative/hospice care provides highly skilled monitoring and brilliant comfort measures.
I apologize for my graphic description, but I couldn’t sleep if I didn’t share it with another going through this heart-rending experience. I am truly sorry you are in this time with your mother. I hope you find some clarity in these caring responses.
They love giving the elderly antiphycotics through the night to "calm them down"...these drugs can definietly cause the symptoms. Also if she has been tested for a uti get them to do it again....sometimes the first test comes back inconclusive which alot of the time they dont test again on the elderly...pls insist on this and insist on knowing what medication they are giving her.
The POLST has several different levels of care that are spelled out in the document so you can elect what course of action to take.
A personal comment tough...CPR does not work all the time. If it does when done properly the patient will have broken ribs possibly a broken sternum. Would your Mom be able to recover from that? Or would she be able to deal with the pain from the injuries sustained in attempting CPR?
I think CPR works great on a younger, healthy person but not sure about an older, frail person with many other health issues.
I know none of these comments help your decision now but it is a good conversation to have with your siblings now. It is a great conversation to have about yourself. It is a great conversation to have with your Mom when this episode comes to an end.
As several have pointed out it is possible that it is a UTI. Unbelievable what crazy symptoms a UTI can cause.
Another side note it is odd that she would be admitted to a hospital for a PT assessment. And also odd that after the assessment she would remain in the hospital another night.
Oh, and please let us know how she is!
Sounds to me very plausible that she had a fall or hit her head somehow and has a brain injury. If this isn't a stroke I'm not sure why they wouldn't investigate that immediately next but it sure sounds like she's behaving that way. She was in for walking or motor evaluation meaning they had her up and doing various things and there is some problem with it that made her doctor order this in the first place, maybe she hit her head on the steps or some other PT tool they use for assessment and either the elevator didn't see it happen or didn't report it not thinking there was an injury.
I am curious about why she would be admitted to a hospital at all never mind a couple of days for walking evaluation though, are there other medical issues that make this necessary and could be contributing? I don't think that would be possible in CT, is it an acute rehab facility that's in the hospital and did she have a condition or trauma that created the need? I'm just curious but trauma sure sounds like good possibility here and it could be trauma from days or even weeks before. Make sure they are asking and you are providing all info about anything like that even if it seems insignificant and you are just remembering something because your thinking about it.
I pray all works out positively for your mom.
Patrick
If this came on suddenly...
If she was not "tagged" as a "Fall Risk" and she got up herself it is possible that she had a fall in the hospital and it is a head injury.
Was she able to get out of the bed on her own?