Hospital delirium

Yes, this is my dad’s journey in a nutshell. He went to the hospital for a UTI, then to rehab and straight to MC. He never went home again, partially due to the decline he experienced after being given an anti-psychotic due to delirium and after 10 days in the hospital, his mobility was never the same. Also a UTI can cause delirium on its own, it presents much differently in a PWD and sometimes severe confusion is the only symptom. But then if they are medicated in the hospital, cognition becomes even worse.

Once your dad is out of the hospital, he can improve cognitively but probably not to where he was before. Think of it like a stair step: he took a big step down, then he’ll come back up to a mid-step level and that will be his new baseline. It can take as long as a month or two to see where he will land.

Something to know going forward is that he will probably experience delirium every time he’s in the hospital. It’s really not safe to leave a PWD in the hospital alone. I had to employ private caregivers if I could not be there or if the hospital would not provide a safety sitter. Sometimes they will, or sometimes they can use electronic monitoring. Sometimes they can use safety mittens on their hands to avoid having to use sedation. I have had to use all of the above at different times.

I learned after dad’s first hospitalization to make it clear he was to be given no anti-psychotics or sedatives and to employ the other methods I listed above. I even resorted to listing them as allergies. My dad has LBD so these medications can do severe damage. Sadly medication is the first thing they reach for and of course it is sometimes unavoidable, although I did in fact avoid it going forward but I had to be insistent and diligent every time. Explain that he has Alzheimer's and the delirium. There are things you can do to lessen it (leaving room in natural light during the day, keeping harsh florescent lights off that are directly above him, playing calm music, keeping nighttime disruptions/checking to minimum, bringing familiar things from home like pictures or a blanket).

See if he is eligible for rehab at the hospital he is in. They can wean him off meds and get him stabilized so that he can be accepted. I suggest this begin immediately and request that PT/OT come in and start working with him because mobility will go as quickly as the cognition.

My dad was living at home, still going up stairs, driving, cooking, etc. the day he left his home and never went back. That’s how fast it happened.

I could go on and on but this is probably enough. I’m so sorry, it’s devastating and shocking but now you’ll know how to move forward and I wish you the best.

My mother went through it in the hospital. I went through several hours trying to calm her down only to accompany the social worker out of the room when security had to come to resolve the situation—it broke my heart. I do believe nurses are stretched very thin. To that end though, it wouldn't be hard for loved ones caring for anyone 65+ to be handed a pamphlet upon admission about hospital delirium. There are very specific steps that could be taken that may makes things easier, e.g., staying over night with patient, ensuring eyeglasses are available, bringing in familiar items, regularly orienting to time and place, etc.