Is this progression??

Daughter of a Marine

Hoping for some guidance since at this point, I do not know what/who to believe. My 73 yr old DH diagnosed with mild dementia approx 8 yrs ago; still driving, forgetful but pretty stable. He had extensive spinal surgery on 5/17, fused from L1 to S1, under anesthesia for 5 hrs and placed on narcotic pain meds. Since then he has had altered mental status, hallucinating, agitated, restless, cannot sleep, does not know where he is, sometimes doesn't recall he's had the surgery.  etc. Family taking turns watching him all night and we are zombies. He's been readmitted for eval of mental status and given Seroquel. I'm wondering if anyone has experience with that med and if so, do you recommend?  My research shows it can cause the same issues we're trying to resolve.  That said, I just checked with my daughter who is staying with him tonight and he's asleep - first sleep in 5 days!  Any insight, recommendations, etc., are very welcomed.  Thank you in advance.

ButterflyWings

Hi DaughterOfaMarine,

I'm really sorry you and your LO are going through such a tough time. I have heard and experienced that hospitalization and the meds, plus especially major surgery and anesthesia can cause progression yes. Separate point, but please be careful if he is still driving. It is a possibility he could harm someone else with judgement and reaction time issues, or a whole host of other things beyond just maybe forgetting his way and getting lost. That's a huge risk, so please reconsider.

His current behavior also may be helped by a sleep aid like over the counter natural Melatonin in addition to his other meds, if your DH's doctor understands he's not sleeping (and keeping you awake). Not good for recovery.

Seroquel is like gold at my house. We were on the fast track to totally unmanageable behaviors before DH's neuropsych prescribed it. Many others here chimed in to a thread about this recently, in the caregiver's forum. I hope you can get some rest also, and it sounds like family is helping at the moment. That's great! Here is what some others posted recently:  Seroquel Success Stories?

Iris L.

Many older adults will experience delirium after a stay in the hospital, especially ICU.  This may wear off in a few days or several weeks.  Or this could be progression stemming from the anesthesia.  There are several threads on use of anesthesia with PWDs.  

Iris L.

Just Ro

Aricept and Seroquel were lifesavers.  I was checking out Memory Care for my DH because his behaviors were really becoming unmanageable.  Wandering, not sleeping, delusions, hallucinations, didn’t know me his wife of 50 years, didn’t know his house was his house, etc. etc. etc. Started him on Aricept first (middle of March) and then Seroquel 2 weeks after that and the improvement has been remarkable. All of the above behaviors have stopped.  He gets a little confused in the evening, but so much more manageable.  Hope it lasts for awhile.  Good luck with your LO.  I did take keys away in December and will not allow him to drive no matter how much better he is doing.

M1

Hi Daughter, I concur with what everyone else has said about Seroquel. You've got the perfect situation to stop his driving now as he won't be able to after the surgery anyway. Just don't restart. Hope his delirium clears.  

Joe C.

As others have stated we have had great success with seroquil to deal with delusions and agitation. DW was prescribed it 14 months ago and I don’t know how I would have kept her home without it.

Ed1937

Spinal surgery was what triggered my wife's problems too. She developed AFIB during surgery, and was put on new meds. She came home from the hospital, and was doing pretty good. But 5 days later, it was like someone threw a switch. She didn't know how to turn the lights on and off, her speech was mostly nothing but word salad, and I had no idea what she was saying. She also had other problems that might suggest late middle stages to late stages of dementia. The surgeon thought it might be due to the new meds. We stopped them, and a few days later she was regaining a lot of what she lost. She never returned to baseline, but was much better. About 4 months later, she was DX'd with vascular dementia. It has been downhill since. Meds might have nothing to do with his losses, but you can check for side effects and interactions at drugs.com. I hope he returns to baseline soon.

French

Dr don’t explain it but delirium is quite common after surgery and often due to the médecine they give for pain.

3 years ago, my father had a major heart operation. The first 2 days when my mother went to see him, everything was fine. But after 5 days, she found him tied to a chair and the room upside down. He asked her to come closer and blew on her, telling her that she had straw all over her.

He asked her to go get the car at the silo (in Paris!!!) so that they could leave together. She ran away thinking he had gone crazy and called me crying as soon as she was in the train.

 I immediately went to Paris and I heard a lot of fantasy stories. Goats climbing the walls of the building across the street, a dragon waiting for them and shooting them. Animal tails hanging from the ceiling, quail singing, his dog walking the halls, the caregivers eating his meat.... I stayed with him to help him coming back in reality. 

It took a week before I could get him to understand that these were hallucinations. It was so real to him!

Now we laugh about it a lot