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I kept arguing with the doctors that she didn't have dementia, showed them videos on my phone of her being totally coherent and present the week prior to, but they were unconvinced. It wasn't until she went to rehab that I heard 'post-operative delirium'. Which was strongly evident upon her entry to rehab.
During the first 3 weeks of rehab following the surgery, my mother thought she was back home in her home country, that war had broken out (yes, she did go through WW2), and kept having hallucinatory nightmares that were prompted by what was on the tv that was on in her room (one example that stood out was that she had fallen asleep with the news on and upon waking, she was insistent that I, her daughter, had been killed in a car accident. And following this nightmare, she accused me of not being her daughter, that I was an imposter - even though I tried everything to prove I wasn't - brought up past childhood events, vacations, places, spoke to her in our native language, reminded her of things that we had done/experienced in the past 10-20 years - nothing, absolutely nothing convinced her that I was her daughter - I was an imposter who was made to look like, and sound like her daughter (and the accurate memories were 'implanted'). And she told EVERYONE at the rehab that I was an imposter - the admin, the nurses...everyone.
The post operative delirium finally started lessening about 3 weeks after surgery. It wasn't a overnight thing, but instead, small tiny gradual steps that took another 2 weeks to abate. However, word of caution, I was told by the nurses that at her age, post operative delirium can remain permanently.
It was a scary time for me, and of course, she didn't remember anything.
On the other hand, I'm not sure that tranquilizers are always a good answer since medication may well be partly responsible for the post-op "mania".
I experienced this post-op condition a few years ago after being admitted to a "rehab facility" following a knee replacement. I knew I was not thinking logically, became angry, I could say almost paranoid, at the rehab facility (actually a nursing home with "rehab" as a side line.) I didn't understand what was wrong with me. It isn't my usual temperament. But, to my great relief, my thinking began to clear as soon as I returned home.
However, I would still advise caution re: the nursing home/rehab facilities.. I asked to see the "incident" or "accident" reports I accumulated over a three week period. It appeared to me that much information was falsified. I didn't feel well enough to complain (and had no advocate at the time). However the facility closed down shortly after I left. I believe that now, there are more actual REHAB hospitals available for a short post-op stay.
It's been a few weeks. How is your Mom doing now? I would love an update from you.
Be sure to practice self care for yourself!
After reading yours and other's posts, oh WOW! Earlier in June, my Mom, dementia, arthritis, scoliosis, went to the hospital for oral surgery under general anesthesia. She was tied to the bed at night (12 hours) because 1) they said she was combative and 2) she was a fall risk.
The reason why she was combative was because she was trying to follow her routine which includes waiting in the hallway to get a bath. Obviously that wasn't going to happen at the hospital, however, this was after hours so I couldn't be there to calm her down (hospital rules, not mine). The other reason for the restraints was because she is a fall risk and they didn't want to take the chance that she would get out of bed on her own and fall down. I verbally gave them the okay for the soft restraints.
Little did I know that most of our facilities will not allow a person back into them if they have been restrained for the last 24 hours. What a mess...the hospital restrains her at night to keep her from falling (or walking), and that action prevents her from getting out of the hospital the following day (and therefore the hospital collects more money for the stay.) The way it was phrased to the MC facility "we are not releasing xxx today" The way it was phrased to me "the facility said they will not accept your Mom back at the facility today". <Little did they know that my Mom and I are well known to all the nurses and caregivers at the facility>
On top of that, the hospital doctor gave her an anti-depressant to calm her down. They said that it had been previously prescribed for her so it must be safe. What they didn't know is that she never took the anti-depressant since that doctor was the one that got my Mom upset. (Ironically, we saw the doctor to find out if she had dementia or not). The office visit where the doctor prescribed the medicine was over 2 years ago. The drug NEVER showed up in the drug list that the MC facility gave to the hospital and of course no followup visit to the doctor. I was even told by her PCP that the drug they prescribed was quite dangerous as it could stop her breathing due to age.
Anyway, she went directly back to the MC facility. She was really confused that first night, and slept a lot the following day. However, after 2 days of routine and being out of the hospital, my Mom returned back to normal dementia self.
...and she doesn't remember anything about the hospital stay or that she was even in a hospital.
This is the 3rd time she has been in the hospital since turning 93. Each time, they (2 different hospitals) have done something(s) that has been detrimental to her health, however, benefitted them. As I was yet again verbally sparring with the hospital doctor, I knew this time, I wasn't going to give in until there was a suitable reason.
So yes, if you are able, go to the hospital and stay with the person as much time as you are allowed. Make sure that you advocate for the person and understand everything they are doing and their diagnosis. It is easier to do it these days as many medical facilities have stored a sanitized version of the doctors notes electronically....then get that person out of the hospital.
In general, I don't think our hospitals are equipped to deal with seniors with dementia behaviors.
Since Covid especially, hospitals are under staffed and medical personnel are overworked.
I learned tying them to the bed is illegal some places but they did it to my spouse too. If they tied your mom at the hospital then I bet they gave drugs to control her behavior too! We found out after from his PCP those drugs are bad for post surgical delirium and they almost killed my spouse with them! Heavy pain meds due to surgery aren't good for it either so all those things together are making her act crazy. It will take time. I never thought it would end but it did. The hospital tried to say some peopel get dementia from surgery but we found out that isn't true and it was only delirium. My husband was back normal after about 4 months. Long, scary months.
Home is the best place where your mom can recover - I'm convinced. Another thing to make sure is if she didn't get a urinary track infection at the hospital cause they make delirium really bad too. Be patient.
Her increased delirium could be from ANYTHING in this whole chain of circumstances.
You have done the right thing, now that she is well enough to be home. Most/many deliriums pass after some time in one's own environment. I hope that is the case for your Mom.
Do update us and I surely wish you both the very vest of luck.
My mom experiences it every time she is in the hospital or rehab - she makes bizarre statements and the staff tell me how 'confused' she is, especially at night.
Once she's home, she's back to herself - not perfect, but much better and she is much more comfortable.
If she wasn't confused before her surgery and is now, it is more than likely caused by the anesthesia. Often times it goes away within a few weeks but sometimes it does not.
Her doctor should have made her and you aware of that before she ever had her surgery, as they are more than aware of the negative effects anesthesia has on the elderly.
My late husband who already had vascular dementia, after having minor surgery to have his supra pubic catheter put in, suffered a significant change in his mental status after the surgery for the worse, and it scared me to say the least.
However in his case, after a few weeks he returned to where he was prior to the surgery.
I'm sorry that your mom is experiencing this and I hope and pray that she will return to her "normal" status.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2546478/
Has she seen her regular doctor since the surgery?
I would call her/him and seek advice about next steps-- ER, wait and see or get her admitted to rehab.
Was rehab presented as an option after surgery?