Father developing delirium in rehab center

[David1961]

My father, who is in his 90s, is in a rahab center to learn to walk again after a fall a couple of weeks ago. Physically, he is doing well – the physical therapy and occupational therapy are helping. But he has what the doctors call delirium. Sometimes he is very aware and other times, he does not seem to know where he is and mumbles. I’ve heard that delirium is common when elderly people are admitted to a hospital or a nursing home. Nobody at the rehab center is doing anything to try to treat this. Maybe it is really not delirium, I don't know. He is very aware and can carry on normal conversations sometimes. My question is has others experienced this and is there any way to treat this? Do some people eventually come out of it? Is there any doctors specialty (like neurology) who might be able to help? Thanks.

 

[Rich_by_the_Bay]

It's not unlikely that this is due to his medications (esp pain pills, sedatives, etc.). Be very insistent about reviewing each one with his doctor and eliminating all but the core medicationss.

A distant second: sleep deprivation.

If neither apply, a quest for physical caused should be done including a CT of his head to exclude bleeding, etc.

Good luck and best wishes to your dad.

 

[W2R]

Is he in pain and/or on medication since the fall? That could be responsible. But also, some elderly do better in familiar surroundings.

There are doctors that specialize in geriatrics (problems of the elderly). I don't know if that would be the right specialty to treat him, though.

When is he getting out of rehab? I would think that a good step to take would be to see if the problem goes away once he is back in familiar surroundings and off any new medications.

Does he normally live at home? If so, he may need a live-in helper to keep an eye on him for a while, and to determine if he is still experiencing mental issues. It is possible that he may need to be placed in a nursing home for his own protection, but I would think that decision is further on down the road.

Edited to add: What Rich said!

 

[David1961]

It's not unlikely that this is due to his medications (esp pain pills, sedatives, etc.). Be very insistent about reviewing each one with his doctor and eliminating all but the core medicationss.

A distant second: sleep deprivation.

If neither apply, a quest for physical caused should be done including a CT of his head to exclude bleeding, etc.

Good luck and best wishes to your dad.

Rich:

Thanks for your reply. As a matter of fact, my sister and I are asking for a complete list of his medications today. I know he has some sort of patch on his back for pain (starts with an "L").
And also, he is not sleeping well so sleep deprivation could be a facxtor, too. And they did a CT scan at the hospital that said was normal, but we are trying to get him into a neurologist.

 

[David1961]

Is he in pain and/or on medication since the fall? That could be responsible. But also, some elderly do better in familiar surroundings.

There are doctors that specialize in geriatrics (problems of the elderly). I don't know if that would be the right specialty to treat him, though.

When is he getting out of rehab? I would think that a good step to take would be to see if the problem goes away once he is back in familiar surroundings and off any new medications.

Does he normally live at home? If so, he may need a live-in helper to keep an eye on him for a while, and to determine if he is still experiencing mental issues. It is possible that he may need to be placed in a nursing home for his own protection, but I would think that decision is further on down the road.

Edited to add: What Rich said!

I guess he'll get out of rehab when the therapists and doctors think he is ready. From what I understand, they will do what they can to get him back home and as long as he continues to make progress, it is good. But I wonder if he'll get out of rehab if he has this mental confusion.

 

[W2R]

As a matter of fact, my sister and I are asking for a complete list of his medications today. I know he has some sort of patch on his back for pain (starts with an "L").

Good luck and I hope that the medications are behind this. I really think they might be.

 

[Moemg]

My 93 year old Mom was admitted to rehab last year after total knee replacement and her doctor told us to expect some delirium . She did have a few confusing episodes but then returned to normal and like your Dad she was on strong pain medication . Once they changed her back to her extra strength Tylenol she was fine .

 

[Nords]

In the book "Elder Rage", the author's father had obstructed flow in his carotid arteries. The lack of bloodflow to the brain contributed to dementia (and behavioral problems) that would clear up in a few minutes.

Today they'd probably find it on a fMRI or a CAT scan, but back then it required exotic ultrasound techniques to verify.

 

[Dawg52]

My dad was all screwed up one time he was in one. He thought he saw spiders crawling all over the wall. Sometimes he thought I was someone else. And it was all from med's, not my kind of med's. But they eventually got him straighten out.

Hope your dad has good luck!

 

[Ed_The_Gypsy]

My father had periods of confusion that my BIL finally figured out were due to dehydration. It took some clever detective work to figure this out. Dad was infirm and the mechanics of going to pee frustrated him, so he just didn't drink anything. Discovering this improved his life substantially.

We also learned that the more the family visits, the better care the patient gets. And don't trust the facility to be all-seeing and all-knowing. More than once, we found serious problems that they would never have noticed. Nobody cares like family cares.

 

[Achiever51]

Ed the Gypsy beat me to it, but my 90 year old Dad was just released after being hospitalized for dehydration. Very similar situation to what Ed described...Dad wasn't drinking much (any?) water because he didn't want to pee...this combined with a mistake in a Rx that had him taking double the amount of diuretic he should have. We knew he was in trouble when he called my brother and said his digital clock was telling him the month and date rather than the hour and minutes.

When we got him to the hospital, his renal function was severely compromised and the docs were concerned that he might need dialysis if his stats didn't improve quickly. Happy to say that after five days in the hospital, he's back to normal and back home. No more delirium...and he's watching his fluid and food intake carefully!

 

[Buckeye]

I'll second the comment about constantly having a family member at the rehab center to watch over your dad. A healthcare facility (hospital, nursing home or rehab center) is not the place to leave someone alone who cannot advocate for himself. We just went through this with my MIL who traversed all 3 types of facilities prior to passing away.

 

[Ed_The_Gypsy]

A healthcare facility (hospital, nursing home or rehab center) is not the place to leave someone alone who cannot advocate for himself.

ABSOLUTELY! More than that, family may notice things that even the patient may not be aware of.

God help me when I get there.