memory worse in hospital

[cymbid]

Mum was admitted 5 days ago with a broken hip after lying on the sitting room floor all night . She has had her op and the infection she had on admittance seems under control.
Her initial dilerium has gone but her memory loss is much worse.
She will tell us she has been in bed all day , when we have just watched the nurses hoist her from her chair where she spent the day.
She is asking me to hide uneaten bits of meals incase the nurse sees.
She also told me to take the biscuits and sweets visitors brought as someone would steal them

She is in a private room and has wonderful care from the nurses and seems quite placid . but her brain is obviously off on a tangent.

 

[Collywobbles]

A medical episode like this can certainly accelerate dementia, as can a general anaesthetic, unfamiliar surroundings and a major fright. Your Mum has experienced all of these, so sadly, what you’re seeing might not be entirely unexpected.

However it would be good to rule out a UTI which can also increase symptoms, so it might be worth asking for her to be tested, just in case.

 

[Chizz]

Hi @cymbid
My sympathies to you and your mum.
This happened to us - my OH was taken in to hospital after a fall. A hospital stay makes everything for a PWD worse.
Firstly, when you're not there, their confusion about everything is exposed for the hospital staff to see. The staff often are v busy and, thus, do not have time to spend extra minutes with your mum, especially if she cannot understand and/or follow instructions. Not all nurses and doctors have training in dealing with dementia patients. Thus, they don't have time to check whether your mum drinks enough, and she could become dehydrated. They aften don't have time to help patients go to the toilet, and thus expect the patients to either use a bedpan, or an incontinence pad. If the patient can't speak clearly, the staff don't have time to wait and try and understand what the patient is saying. Some patients just cry because of pain or un-ease because they can't express themselves.
What is most important is that you chase and chase and chase to make sure your mum get a physiotherapist to help her everyday to get and start weight bearing and walking again, with frame, or crutches. I cannot express this strongly enough.
My wife, in the ward, perceived the blue/green plastic floor tiles to look like water. So she didn't want to get out of bed as she thought it would be dangerous to step into water. The nurses said they didn't have enough time to help her to go to the toilet and put her in an incontinence pad. My wife didn't recognise this as a toilet and wouldn't open her bowels. After more than 3 days of this, my OH became v seriously impacted and was in great pain, which she couldn't fully express in words (as her speech was at that time pretty poor because of the dementia). By the time the doctor in charge was told, he was horrified and had to do something immediately. It took the hospital more than a week and half to get a physio to my OH. He said there were 3 physios, but one was ill and off work, and one was on holiday, and he was trying to cover 5 wards! He was a "stranger" so far as my OH was concerned and thus, she didn't feel inclined to do what he said. Then he couldn't get my OH to follow instructions and he couldn't get her to stand up. Result = after about 2 weeks or more of lying in bed, my OH suffered muscle wastage, shrinkage of the ligaments and tendons from non-use, and she forgot how to walk. In fact, that was at the beginning of July 2022, as she hasn't ever walked since!
Please don't let this happen to your mum. Be pushy!
Our world has been turned upside down. My OH spends her time in bed (in what was our dining room) or via a hoist in a chair in the lounge. She has since then, not been out of the house, not been to the memory singers, the dementia cafe, the craft workshop, etc, etc - all things she loved.
Best wishes.

 

[SherwoodSue]

What a worry. You say the initial delirium is gone but it can take up to six months for any recovery to develop

After each such event in my experience you never get the person back 100 percent.

Try to make sure your mum keeps hydrated ask for fluid balance chart for example. Offer drinks when you are there. My dad always denied pain but needed painkillers , ask questions about whether mum is opening her bowels These are things which will continue to affect cognition
Is there a plan to discharge mum back to where she lived before this? You may see some more slight improvement once returned to a familiar environment

Thinking of you

 

[leny connery]

Hi @cymbid
My sympathies to you and your mum.
This happened to us - my OH was taken in to hospital after a fall. A hospital stay makes everything for a PWD worse.
Firstly, when you're not there, their confusion about everything is exposed for the hospital staff to see. The staff often are v busy and, thus, do not have time to spend extra minutes with your mum, especially if she cannot understand and/or follow instructions. Not all nurses and doctors have training in dealing with dementia patients. Thus, they don't have time to check whether your mum drinks enough, and she could become dehydrated. They aften don't have time to help patients go to the toilet, and thus expect the patients to either use a bedpan, or an incontinence pad. If the patient can't speak clearly, the staff don't have time to wait and try and understand what the patient is saying. Some patients just cry because of pain or un-ease because they can't express themselves.
What is most important is that you chase and chase and chase to make sure your mum get a physiotherapist to help her everyday to get and start weight bearing and walking again, with frame, or crutches. I cannot express this strongly enough.
My wife, in the ward, perceived the blue/green plastic floor tiles to look like water. So she didn't want to get out of bed as she thought it would be dangerous to step into water. The nurses said they didn't have enough time to help her to go to the toilet and put her in an incontinence pad. My wife didn't recognise this as a toilet and wouldn't open her bowels. After more than 3 days of this, my OH became v seriously impacted and was in great pain, which she couldn't fully express in words (as her speech was at that time pretty poor because of the dementia). By the time the doctor in charge was told, he was horrified and had to do something immediately. It took the hospital more than a week and half to get a physio to my OH. He said there were 3 physios, but one was ill and off work, and one was on holiday, and he was trying to cover 5 wards! He was a "stranger" so far as my OH was concerned and thus, she didn't feel inclined to do what he said. Then he couldn't get my OH to follow instructions and he couldn't get her to stand up. Result = after about 2 weeks or more of lying in bed, my OH suffered muscle wastage, shrinkage of the ligaments and tendons from non-use, and she forgot how to walk. In fact, that was at the beginning of July 2022, as she hasn't ever walked since!
Please don't let this happen to your mum. Be pushy!
Our world has been turned upside down. My OH spends her time in bed (in what was our dining room) or via a hoist in a chair in the lounge. She has since then, not been out of the house, not been to the memory singers, the dementia cafe, the craft workshop, etc, etc - all things she loved.
Best wishes.

you describe everything I will say myself about hospitalisation. Unavoidable, but it does decondition a PWD. When mine was hospitalised for severe chest infection I stayed with him as much as I could, 4 hrs in the morning and another 4 hours in the evening. Not being 'an angel' . The family said it was 'my need' to be there a bit like a co dependent in drug addiction. No, I went because I really did not want him to plummet into a much worse mental and physical condition. An act of self preservation on my part. It was only for 12 days, and he was in an isolation ward, so I was allowed to be there. Would not have been possible if he was in the ward. which he did for 2 days before I insisted he was discharged

 

[canary]

My mum fell and broke her hip requiring an operation. The shock of the fall, the pain from the fracture, the general anaesthetic and the unfamiliarity of the hospital massively progressed the dementia.

Your mum may well improve once she is in familiar surroundings, but might not get back to the level she was at before

 

[cymbid]

she is almost 92 , and lives alone, will not entertain the thought of carers. I cannot see her returning home now. I think a care home is on the horizen. I live 2 hour drive away and am currently driving a lot to visit everyday and camping odd evenings with my son (who is still an hour away from the hospital) . This is unsustainable in the long term. and a strain on everybody ....

 

[canary]

Going from a hospital to a care home is not unusual, but you will probably need to talk to the hospital SW and may have to dig your heels in

 

[cymbid]

Tonight my brother reports she asked 6 times where she was (didnt know she was in hospital) Also asking about going to the butchers and telling him the dominos were broken. There are no dominos