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Meanwhile, help her keep her tasks and routines clear-cut, deliberate and with plenty of rest breaks in between. Remind her that she is still in the convalescent phase and must cut herself plenty of slack.
Examples of how to help: a display clock showing time with clear day/night markings, day and date. A timetable for each day, and a calendar for the week. If she's struggling with the phone then consider getting one where the speed dial numbers have the person's photo next to them - but go carefully before you replace any devices or appliances that she's very familiar with, and make sure the new one really is easier *for her* to use.
Does she have support with continence care, personal care, and medications? - besides you, I mean?
Above all, lay on the reassurance with a trowel. She's been through an ordeal, God willing this will get better, and don't panic :)
[Did the procedure sort out the bowel obstruction? No residual underlying causes to worry about?]
When I came out, I had trouble getting ideas from my brain to my tongue. I literally couldn’t find the correct words. This particular issue lasted 2 months. It was most upsetting. Apparently, my brain was too stressed to work correctly.
I could type just fine. But, verbally, I was way off. It was so very frustrating.
I can very much understand what an operation and hospital/rehab stays might do to cause delirium in someone who is 94.
I am sorry that this is happening to your mother.
This is, unfortunately, very very common.
Rather than dementia, this is called *delerium*.
People over 65 are more at risk. Top triggers are
1. infections (UTI, chest infection/pneumonia, Covid)
2. Anaesthetics
3. ICU stay
4. Hospital stay
5. Medication withdrawal
6. Dehydration, electrolyte imbalance, low sodium
All these cause stress on the body & brain.
It can last days, weeks, fluctuate for weeks, or even be the new level of functioning.
Be patient. Be hopeful. But also be practical & arrange more care for Mother, more hands to help you so you don't burn out.
Ask for a copy of MAR (Medicine Administration Record) from the hospital and the rehab. This should show every medicine that was prescribed and how it was administered. Review them with her regular doctor to get advice on readjustments. She may not be able to return to the exact regiment she was on prior to the hospital, but she very possibly does not need to be on the medicines they changed her to. This may take a few weeks to make the adjustments but hopefully she can become more like she was.
As others have said, the anesthesia may take some time to completely leave her system. Her doctor should be able to give you insight to this too. Our geriatrician recommends only local or regional anesthesia and sedation (you don't remember anything) whenever possible and if not, then decide how urgent is the procedure because as we age we do not respond and recover the same way as we did when we were younger.
I'm also going to guess that they've put her on a daily dose of Mira Lax which seems to be the go-to for elderly constipation and is horrible for people with dementia.
My 95 yo mother was put on Mira Lax after extreme constipation following a hip surgery in early 2020 and I was giving it to her daily. Very quickly, her dementia got worse with delusions and sundowning for hours every night. After some research, I took her off of the Mira Lax and began to give her Milk of Magnesia. The difference has been amazing. No more sundowning, no more hallucinations or delusions. It took a few months for her to recover from the Polyethylene Glycol that was in her brain, but it's so much better now.
Give her several months and be patient. She may pull out of this.
Take care.
Get a copy of her medical records and review them. (Any medical mistakes will be white washed). Look specifically for medication changes.
Check her medications upon admission and discharge. Did they add anything? Remove anything? Change dosages?
!!Do not make any changes yourself without the advice and supervision of a doctor!! Some medication changes must be slow and “weaned.”
Chart out side effects, drug interactions.
My mom was discharged once as a completely different person also. The culprit was medication changes.
My mom was prescribed medications that should not have been prescribed together in dosages that were not appropriate for her size. The changes happened during a hospitalization. Her doctors were reluctant to admit this, standing behind their expertise, and refused to remove her medications or lower her dosages. I was sure something must have happened during that hospital stay.
I switched doctors. Mom came back, 100% after the slow weaning process that was closely supervised by a cardiologist.
The medical records from the doctors who would not make the changes when I asked read “daughter is in denial.”
Follow your instincts.
Emotionally she is still struggling and came home just like your mom wearing incontinence briefs, using a walker and needing constant care, feeling helpless and sometimes, hopeless. I have tried everything but we just can't get back where she was.
My mom also fixates on things, has OCD behaviors and is getting to the point that she can't do anything for herself. I hope that your mom recovers. If I could do things over I certainly would never allowed her to stay in the TCU for so long.
She was hospitalized twice in the past 8 weeks, suffered delirium both times and came home with more decline. At least this time I was keenly aware of delirium from hospitalizations and did everything possible to advocate for her for a quick release, home, I will never put her in a TCU again or allow anyone I care about to go to one. I was pleasantly surprised that most of the doctors we had these last two times were keenly aware of what hospitalizations can do to an elderly person and were in agreement about getting her home. We have also decided that if something happens we will not be going back to the hospital and have started hospice.
I empathize with you and pray that your mom comes around. It may take time. In the meantime concentrate on keeping her safe and happy. You are doing all you can for her and some things are out of our control. She is lucky to have you. I am hoping with posts like yours we can educate others on this very important subject.
Sadly, delirium seems to fast forward the decline that was inching forward prior to the hospital stay.
She has lived a nice long life and this can be a wake up call to get all essential paperwork and bucket lists taken care of.
Get lots of help. Let us know how she is doing.