She was in rehab for 2 weeks after surgery and at her home for 1 month during home health PT. We took her to our home for 1 week, then took her back to her house. She is not recognizing her home as her own, she says something is not right. She can function fine in her home and is oriented but insists she is still at our house. She has not been diagnosed with dementia or any cognitive decline, she did have some trouble with time of day after naps prior to surgery. What can be happening?
It is also well known that UTIs can cause dementia-like symptoms as well (I was a skeptic when I joined this forum, but after witnessing severe sun-downing with her first UTI in MC, and bed-wetting episodes in subsequent UTIs, I am a believer! Best to test and rule it out.)
Your profile indicates she has dementia/AD, which if true will also impact how well she recovers from the anesthesia and/or UTIs. Moving can also cause disorientation in those with dementia, even early stages, as short term memory is generally what goes first (depends on the type of dementia.) There are many factors at play here, so you need to rule out each one, starting with the simplest.
Since a UTI test is simple and quick, this might be one place to start, even before she can be seen by a doctor. Home test can be taken, but she should still have a regular UTI test, maybe even a urine culture, as UTIs can be sneaky (plus a culture can help fine tune the correct antibiotic to use.)
Meanwhile, have a checkup scheduled no matter what the UTI results are and ensure she has someone to supervise her (you aren't local - someone needs to be close at hand, to help her AND be able to make observations!) It doesn't sound like she should be alone at this point. Depending on the cause of the disorientation, it may improve enough to allow her to live alone again, at least for a while, but be proactive anyway - dementia can sneak up on us when we are not there to see it in action. It can even blindside those who live with the person, but is more common to miss the signs when only random visits/checks are done, as in the early stages they can appear to be okay, just a little slower maybe, but it can be deceiving.
When I became aware of mom's early dementia signs, one of the things we did was install some cameras (she lived alone, and was about 1.5 hrs away from me.) While some signs were clear, not being there all the time resulted in missing some other issues, like realizing she was not cooking anymore. She was relying on microwave dinners and boxed crap, letting meat remain in the freezer and fresh veggies to shrivel up in the fridge! It also revealed OCD behavior just before bed, checking several places over and over again, for up to 1.5 hours! We wouldn't know this without the cameras (I think this was her "version" of sun-downing.) Then seeing her wear the same clothes over and over again, up to 6 days in a row, even though some were stained with food - this was NOT my mother, she had SO many clothes, with a different outfit for every day and every occasion! There were other issues that couldn't be observed by camera, and only being there would reveal - some of it only became apparent after we moved her to MC and started to clear out and clean/repair the place.
Do not forget to bring the medications she is taking..
Did she have a stroke in that time frame? Seizure? or are there more signs of dementia from this operation?
Get another analysis on her behavior... Get a 'NEW BASE LINE" for her memory/brain function. You need to get her evaluated. Sometimes it takes awhile for the body/brain to become clear again...
Get her evaluated... And ask questions.. why? how long was she under? Was there any signs of seizures or strokes while she was under? WEhat can be expected at this time? And how much longer until full functions and memory are back to "normal"? hence... the new base line...
https://www.everydayhealth.com/alzheimers-disease/anesthesia-linked-to-increased-dementia-risk-in-seniors-6759.aspx
Maybe watch and wait. It may well be a true mental decline and important to watch for things such as leaving pots on stove to burn to identify if she needs additional help in the house or someone to be with her in the home.
Check out this article
https://www.agingcare.com/articles/how-general-anesthesia-affects-elders-mind-160100.htm
Here's one google definition but please get proper medical advice.
'Delirium is a term meaning “sudden confusion.” It refers to a sudden change in mental function. ... Post-operative delirium is delirium that happens after an older adult has an operation (surgery) and is the most commonpost-operative complication in older adults'.
After hip surgery in elderly patients it is VERY common. Your Grandmother will need supervision until it passes. Can last weeks & be off & on.
Sometimes if there was some mild cognitive decline, this may become the 'new normal'. Keep her supervised, either at your home or someone moves in to hers (if possible). She will be a huge falls risk among other dangers.
I'm glad she has recovered physically but you will have to watch & wait I'm afraid. Good luck.
It's very common in our elderly LOs to suffer mental decline with something as simple as a urinary tract infection.
If you haven't already, you need to talk to her Doctor.
Does she have someone in her home caring for her?
Sometimes they don't mentally recover from these things.
Hang in there!!
God bless!!
Breaking a hip is very serious in the elderly. The anesthesia can cause Dementia type symptoms. If you have Dementia, it can cause further decline. Being in the hospital and then rehab can cause some confusion. There's a name for it, just can't remember it.
It can tak the anesthesia a while to wear off. She could also have a UTI that causes confusion.You need to bring up this change to her PCP.
Your husband's reality now is that gramma can't be alone. We were trying to care for my MIL in her home until we discovered she wasn't remembering to eat. Food was rotting in her fridge. She couldn't remember how to use the microwave. We'd call her every day and ask what she ate and she'd give us a detailed account, only to go to her house the next day and find no dirty dishes, no food containers in the trash. She had to go to AL to keep her protected and socially engaged.
Right now you and your husband only have seen the tip of her cognitive iceberg. You and he should make a trip up there to have a discussion with her. Start there and see where it goes. It needs to be gentle and compassionate. She may resist any change or help but this doesn't mean she is ok. You cannot be expected to keep making a 5-hr drive because she won't leave her house (you know, the one she no longer recognizes). Do not take her into your home to care for her (please read some of the thousands of posts on this forum under Caregiver Burnout). I wish you and your family great success in helping her in a compassionate, realistic way!