Can he come home?

My DH was in the hospital two weeks ago for 4 days. He had hospital delirium, which could be what your husband is experiencing. I even slept in the hospital bed with him to keep him calmer, Even though he thought we were in a really crummy motel room. He was also quite paranoid. He didn’t get violent, but he did not know where he was or what was going on. It scared me. I got him home and he pretty quickly reverted back to the point he was at prior to going into the hospital.

@Jazzma

Given that both an infection or hospital experience can trigger extreme behaviors-- I would trust your own gut on this with a proviso that you have a solid Plan B. It's a great sign that he calmed down once he was moved from the chaos of the ER and into a regular room and that aggression isn't his normal baseline.

I would check out MCFs and SNFs just in case you need one later.

HB

Out on a limb here but might this be the time to transition to the most probably inevitable outcome? This comes from a person who almost daily thinks that now is the time to transition him, but can't get there. While you follow your heart, listen to your mind. All the best in this most difficult time. Kathy

My thoughts are not in line with others here. You have been presented with an opportunity that others can’t seem to get at all costs. The opportunity to get him placed with the help of hospital social workers. The opportunity to get his medications tweaked at the same time. Many people can’t get this help when they need it. Can’t get anyone to listen to the fact that that just can’t be the caregiver any longer

You feel he is fine but your family and friends do not. Are you sure that they didn’t see signs that you didn’t before he got pneumonia? Sometimes primary caregivers miss signs because they are so busy being primary caregivers. I’d ask them for their concerns.

Having kept my husband at home until the end, I can say that I agree with Quilting Brings Calm. You should seize the opportunity for placement while it presents itself, and before you are so exhausted that your own health is in jeopardy. Stage 7 is so radically different that all the previous ones. It almost did me in. Just being honest here.

Sorry if I missed this, but do you have a diagnosis? Your post sounds like you are aware that he has dementia, is declining and just want to know if he will return to baseline after this experience. In our experience, yes, DH returned to baseline in a couple of days after getting meds (an antipsychotic and anti-depressant) and an antibiotic for UTI.

We have fortunately not had any violence at all, but there was aggression (words, anger, demands that I leave). It took major effort on my part to disappear any weapons or anything that could be weaponized. Also, to learn all I could about AD, and to follow recommendations (especially from this forum) to the letter about validation and de-escalation etc. Like your DH, mine overall is sweet, fairly easy to redirect and to care for.

I don't feel it is inevitable that a PWD must be placed in MC at some point. It depends. But QBC is not wrong either. Many caregivers go through the dramatic and dangerous roller coaster of out of control behaviors from LOs without Drs or family believing them about the need for a diagnosis and prescription support, etc.

If things escalate again, violence is one of those deal-breakers that can go really wrong for him or you - whether at home or in a facility, so getting a handle on the best med regime for him is key before taking him home. '

*Edited as I see your follow up post that you are both home. Hopefully in a few days he will be back to his baseline. I recommend crushing any meds that you can and stir them into his juice, applesauce, or pudding. That will be key to keeping him stable. And, I do hope any GI upset or hospital delirium subsides very soon. You must be exhausted. As you are observing, he may get back to baseline, but will still decline. And yes, behaviors, incontinence, pee and poop on furniture, endless laundry, and increasing effort on your part is the best we can look forward to. It just comes with the territory. Good idea to make sure your POAs etc. are in order, and to tour some MC's just in case. Even virtually perhaps to narrow down options for your Plan B.

It can take a few days to revert back to baseline. Our hospital did not put him on new medications such as seroquel because they felt it could create more problems. That’s why I stayed with him in the hospital. He reverted back to baseline within a day,

Jazzma - this sounds so much like UTI behavior, but did you say they checked him for this and it was negative?

I'm so sorry this disease even exists, and that another family is going through the roller coaster and twilight zone that we caregivers know so well. Very glad he is not violent. I wonder if this is a medication reaction? Can you call the Dr. to get on-call guidance?

Also, for future reference, I found liquid Melatonin to be a life saver in moments that we needed to slow his escalation and for him, his Dr. approved 10 mg and higher once the 3mg dose did nothing. After slipping it into his water or juice DH would chill, then nap for an hour or so at least. Then he'd wake up a new man. Calmer and not remembering the wackiness.

@Jazzma - It took a couple of days for DH to get back to baseline and the hospital delirium was pretty serious, before that. I hope you can get an after hours call-back at least, to give you some support and guidance so you both can get some rest.

Question. You said in the hospital they were experimenting with the drugs? Was he on any of those drugs prior to hospitalization?

I am recalling that Prednisone sends my DH absolutely off the rails. So much so that it is now in his records as DO NOT ADMINISTER. Just an example of things that might be administered in an ER or hospital that can trigger the kind of behavior you are seeing.

I agree with jfkoc that you may need to do some quick research on your own to troubleshoot what is in his system, while you also call the Dr. urgently.

I AM NOT MEDICAL

I would consider reducing the dosage by cutting in half. Your pharmacist can give you info on this.

I would have a hospice agency come to you and evaluate him. It is mainly to get in-home support as you need it without this kind of delay, if he qualifies. In this condition, with a recent ER visit he almost surely will. Then they can also follow him to MC if you decide to place him.

But hospice care is comfort care. They prioritize pain control and can coordinate everything you need so you don't have to try to do this all with 1 hand tied behind your back. Most times they will be there to evaluate him within 24 hours and their resident Dr. will make an admit or no admit decision to start services immediately if needed.