Help needed… grandfather thinks he fell in love with a nurse and had a big outburst, dementia?

brandonranck

I'll try to keep this as short as possible. My grandfather recently had a toe amputated about two weeks ago as it became infected (diabetic). He had to then come home on IV antibiotics, that I was to administer (i'm his grandson and POA). One day when I went to visit, a few days after the surgery, he had a nurse in his room and joyfully told me "this is emma", the happiest i've seen him in his life. He has never introduced me to anyone like that or acted like that, so I thought he was just having a great day and being taken care of very well. After she left the room he kept saying things like "she really likes me" and smirking, and I would just affirm that shes a good nurse.
She then left, and another nurse came in. He had told me that if he needed a home nurse, he wanted her, and i informed him that it wasn't possible. He then wanted me to get her address so that he could visit her, which i informed him was not appropriate. She returned that night after i left. The next morning when I returned, he stated to me that "well, Emma and I had it out last night. I called her a name, and I really didn't mean to make her mad", and then proceeded to state "I really loved her".
The next day I came into visit, it was a quick visit because I'd be picking him up to go home the next day, and we'd be transitioning to home health. He had asked me to help him pick out a christmas card for her when he got home.
That night, he also got his PICC line placed, and was his joyful self like he had been for most of the hospital stay (even though he's normally very frustrated and agitated in that setting), I was surprised how well he was handling it besides the nurse situation.
When I had returned to pick him up, on the way to his house, we had been chatting when he randomly informed me that he was moving, and when questioned, said him and this nurse were getting a house and he needed me to withdraw him a few thousand dollars from his account so that he could help pay for the house. I informed him that unfortunately that wasn't going to happen, and that she was his nurse and that's all. He raised his voice and asked if I wanted to bet, I left it at that. There was only ever one other nurse during this stay that he seemed to act differently about as well, she had stated that if she won a million dollars, they'd get a beach house and bring their families. He then informed the next nurse that he was going on a trip, and getting a new family.
This brings me to the uproar. I got him home that night, and my father stayed the night with him. That night, he told me that he needed to buy Emma a sweater, and find a way to get it to her. I informed him that it wasn't a good idea and that they couldn't accept gifts like that. He then asked (as he did when he was admitted as well), for me to write his phone number down. After I did that, he wanted me to write down the number to the hospital because the "nurses told him that he is supposed to call every few days and let them know how hes doing". I knew he wanted to try to contact this nurse and wouldn't give it to him. My dad informed me in the morning that he was very agitated throughout the night and moved stuff back where he had it before (he lives in a very cluttered house, and i cleaned and reorganized so that he could come home and have home health). He told my father he was going to "have a talk with me".
The next morning, myself and the HH nurse went inside, we didn't even get past the consent form. She asked if he had a POA, I said yes and informed her that it was me, and he lost his mind. He began yelling at me saying that he doesn't need help, i'm not even his grandson because i don't have the same last name, he's never loved me, etc.... he wanted me out of his house. I had an emotional meltdown and left. The HH then called an ambulance, as he no longer had a caregiver, and took him to the ER where he was later placed in a nursing home.

The ER called and asked me to take him to the nursing home, and then called me back and told me that he didn't want me around because "I'm keeping him from the love of his life". My uncle took him, and he would not talk to him, and told him he was never eating again (he had asked what he had for dinner).

This has completely torn my family apart, and i'm emotionally damaged. I'm hoping that he didn't mean anything but it's very hard to hear and I'm having a hard time coping.

Could this be alz/dementia? Is it side effects from anesthesia? He's being evaluated, but it's going to take time to get answers. I dont' know where to go from here. Even after this inpatient rehab nursing home, I don't think he will be able to return home, because i'm the only person that could physically care for him, and at this point, I really don't think that I can do it, for both his and my sake. I'm really hoping that he will come back around, and our relationship will heal, but i'm very upset, and terrfied.

Any information, suggestions, input would be greatly appreciated. So sorry for the long post.

Phoenix1966

Others will be along shortly with additional advice. To me, yes, it does sound like he has some form of dementia. The inappropriate(and I’m using that loosely, simply because he “fell in love” overnight) behavior regarding the nurse seems to be a red flag. If he was already suffering from dementia(it sounds like he lives alone) and unless you were spending overnights for many days in a row, he probably “showtimed”(being able to pull it together for short visits is common with folks suffering from dementia, but it takes a great toll on them mentally and physically, so they usually cannot do it for more than a few hours at a time at most) for you and you were none the wiser to his growing deficits. If that was the case, the anesthesia could very well have caused him to lose some ground and his symptoms would be more easily noticed.

My grandmother was OCD about cleaning, but as she fell down the dementia rabbit hole, she began to hoard items and the clutter just grew out of control in her home. She was also very cruel verbally to her only daughter(my mother) and to her only grandchild(me). And in my case, she never had an “a-ha” moment where she apologized and recognized that we were caring for her. I hope your situation will be different.

You mention he is going to be evaluated. Will that be while he is in the nursing home? I would push for that if I were you. And you mention you are his POA. Is that for both legal and medical concerns? Is the POA “springing”(meaning it needs 1-2 doctors to sign off on his mental status before activation) or is it active now? If it is immediately executable, I would start looking for memory care facilities now, since there can be waiting lists for them. It would be the easiest on you to be able to transfer him from the nursing home to a permanent facility if you believe you cannot provide the potentially full-time care he will need if he does have dementia.

I would recommend seeing a CELA(certified elder law attorney) if your grandfather has not yet applied for Medicaid if you think he may need it and review your POA if necessary. If your POA is springing, I would also push to have that evaluation done on your grandfather now, so you can get the doctors’ signatures you may need.

This is a lot and it is scary and it is sad for both you and your grandfather. I’m certain folks will reply shortly with links to short and longer free reading for you that may help you recognize symptoms he may have been displaying, but you were unaware of what they meant at the time.

Please post often to vent and ask questions. Read this forum when you have the time because it is so full of information and folks who found themselves exactly where you are.

You are not alone.

brandonranck

Thank you so much. The POA is already activated (he signed it and it was notarized 3 months ago, perfect timing). It is for medical and legal, and I plan on contacting a CELA next week as well.

I’m pushing for the evaluation at the nursing home on Monday (he was just admitted Friday night).

Quilting brings calm

Phoenix gave you great advice. Others will also concerning the things you need to get done. My advice is for your own health. Don’t fight placement in a facility for him. His diabetes needs to be better managed. He needs Geriatric psych to get his mood stabilized. With delusions like that, he needs 24/7 supervision. Allow him to be placed, advocate for him since you have his POA and spend more time as his grandson rather than his caregiver.

Read a lot of discussions here so you start getting a good sense of what’s going on with him. If you can find the groups tab, there’s a post there listing resources for our newcomers.

brandonranck

https://alzconnected.org/discussion/comment/230634#Comment_230634

thank you! I do not plan to fight it one bit, I want him in there long term to get the help he deserves. I’m looking forward to reading up on some resources here to help with that transition back to grandson rather than caregiver.

Iris L.

I worked in health care. It is not uncommon for a patient to "fall in love with" or have a crush on health care personnel. The nurse should be aware of this complication and put a stop to it in a diplomatic, professional way. Continue to repeat that this is inappropriate. Or continue to divert.

Iris

Emily 123

That must have been very hard for you. The change can be so shocking…

He may have hospital induced delerium, dementia, effects from the general anesthesia, a UTI—any combination of things or all of them. The hospital should have checked him for a UTI (urinary tract infection), but there are other things that can cause the confusion that need to be ruled out.

Don't take to heart what was said, because he's not himself.

One of the best ways to deal with dementia- or delerium-driven statements from your person is to agree with them. You were doing a good job but were trying to reason with him when his 'plans' grew, but it's impossible to argue with a person who isn't able to think clearly. His reality right now is very different. You've seen the meltdown that can happen when reality intrudes. Your goal here should be to keep him calm and happy. If that means fibbing and telling him you'll go buy Emma a sweater, well, tell him you did. Doesn't mean you have to. If he says he's running away with her and needs money-sure, agree with that, but keep putting him off with excuses. Don't discuss anything in front of him that might make him think you were making decisions for him—that, and telling him 'no', seem to really get him going.

Your grandad, for whatever reason, has an incapacity, which means that your POA is active. I'm concerned for you with dad & uncle doing the communicating, as it cuts out your voice at the table, yet it seems like you might be saddled with care that might be for a lot more than just post-op recovery. It might be best to have your dad and uncle pursue obtaining guardianship over him if he's not competent to re-assign POA. A certified elder law attorney (CELA) would know, and they could also help with looking at your grandfather's arrangements and financials to help your family determine a good course of action.

If he doesn't bounce back to his old self then it doesn't sound like he'd be safe at home alone, and dementia caregiving (if this is dementia) requires a lot of vigilance and support. I don't think that it should be up to you to provide it if that's the case. A lot of times the in-home caregiver needs assistance (and breaks from being on call 24/7), and it becomes quite expensive. Generally facility placement is less expensive. The discharge planner at his current facility would be the person to work with your family to find placement. I hope this is just a bump in the road and he's able to be back to normal soon…

brandonranck

https://alzconnected.org/discussion/comment/230640#Comment_230640

thank you so much! That was very helpful. I did not communicate my uncle and father’s involvement that well, but I am very much so in the picture and the first line of communication from the facility and professionals. It’s just him personally, will not speak to me right now, so I’m giving him some space (he was only admitted Friday night)

SDianeL

so sorry. Yes it sounds like cognitive issues perhaps made worse by the hospital stay. Learn to fib to him. Tell him the nurse is married or moved out of state. Call the nurse and tell her what happened so she can play along with your fib. Tell him you’re so sorry. He will probably forget it all happened if he has dementia so just wait. You did the right thing. He is not himself. Try not to take it personally. Meanwhile read the book “The 36 Hour Day” which will help if he is diagnosed with dementia. Please keep us posted.

Emily 123

https://alzconnected.org/discussion/comment/230641#Comment_230641

A big challenge for me (with Mom) was to fight the temptation to explain decisions—I think I wanted for her to 'sign off' on the major decisions I had to make because that would remove the anxiety about making them for her. Overcoming prior family (adult-child) dynamics can also be tricky because the person with dementia often isn't aware of what's happening to their abilities, as the disease alters the way their brain can processes information (anosognosia). Tempering information to a level they can handle is a big adjustment, since they may still look and talk like they always have. It sounds like you, dad and your uncle are going to be a good team at handling these challenging times.

Care for a person with cognitive issues is like a swan moving across the water. You want the person affected to see the calm, graceful swan, but behind the scenes it'll feel like you're the swan's little feet, paddling away furiously to keep things balanced and moving forward.

I found the attached to be a great resource, as well as these threads.

understanding-the-dementia-experience.pdf

https://alzconnected.org/discussion/65171/books-about-alzheimers-disease#latest

https://alzconnected.org/discussion/65993/excellent-handout-packet-dementia-stages-cgs-actively-dying-tam-cummings#latest

H1235

https://alzconnected.org/discussion/comment/230655#Comment_230655

I really liked the “understanding the dementia experience”. Thank you very much for sharing. This should be added to the new members group!

brandonranck

UPDATE:

Thanks everyone so much for the support in navigating this time. My aunt and uncle were to the home this morning to drop some things off, and he seemed to be having a good day. He joked with them like his normal self, and asked where I was and why I haven’t been visiting. My aunt said she didn’t think he was talking to me and he said “what do you mean why wouldn’t I talk to him?”. When they left, he called my dad and said the same thing.

I decided to take advantage of that current mindset and went to visit for the first time in the NH. He was very pleasant, still fixating on the few same things and asking me when he could leave/whispering to get him out, etc

I just informed him that it was no longer up to me and that he was in the right place. He dropped it and moved on. He did bring up Emma but I was sure to play along with it, agreeing to buy her the sweater and mail it with his name and phone number in the box. (Obviously I won’t be doing that).

He even apologized, said he didn’t mean what he said and that he loved me.

His roommate seemed to be helping him cope with being there, which was great. The nurses have him in line for some mental evaluations to see if it is dementia, hospital delirium, anesthesia effects, or a mixture.

He seemed to be in and out of being with it.

Overall, it was a great day and Im glad I got some closure on his statements (even though I know he didn’t mean anything) it was nice to see a good day, as I’m sure there are many worse days ahead.