You know this because you’ve probably lived this: Hospitals can be a harsh environment for your caree. A lucid caree can become confused and disoriented hospital patient. A caree with Alzheimer’s can become combative and aggressive during a hospitalization.
This week, The New York Times toook an interesting look at the prevalence of hallucinations among hospitalized elderly patients. Pam Belluck, the article’s author, writes:
“The cause of delirium is unclear, but there are many apparent triggers: infections, surgery, pneumonia, and procedures like catheter insertions, all of which can spur anxiety in frail, vulnerable patients. Some medications, difficult for older people to metabolize, seem associated with delirium.”
Belluck followed up this article with a second, “Six Questions to Protect Elderly Patients.” Her six questions are really helpful as are the comments following the article, including this one:
“My late father, an anesthesiologist, said the quickest way to bring on dementia in an older patient was to give them demerol. He said it was a good drug, reduced pain, cleared quickly, etc. BUT it did often induce dementia in older people. He refused it when he was in the hospital even though he’d ordered it for thousands of patients. When my 88-yo grandmother was given demerol after a car accident, she insisted she was in a bad hotel rather than a hospital room and spent hours picking ‘bugs’ off her sheets and trying futilely to put on her pants which were actually a blanket. Once we persuaded the staff to ditch the demerol in favor of tylenol, she cleared and was fine in a couple of days. I just routinely tell people I’m allergic to it so they won’t give it to me. I’ve never had it, but don’t want to risk anything.”
I’m not sure how true or valid this advice is, but I will certainly take it under advisement.
How about you? How have you managed your caree’s hospital confusion? What tips can you share?
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You are a disruptor. The delivery of health care starts with you, continues because of you, and ends with you. Let's disrupt together to make the world better for family caregivers. 
NJ
When my Mother was hospitalized for a intensive session of chemo it affected her mind. At one point the social worker insisted that I select which nursing home I would be sending her.
I knew she was severely malnourished before the chemo (due to cancer). I felt she hadn’t gotten a chance to regroup nutritionally. The hospital gave her a liquid through a feeding tube that was supposed to be “complete nutrition”. But I prayed and researched and discovered that it is a maintenance type nutrition- not enough for someone already severely malnourished.
Through reading and remembering a similar dementia/ confused reaction in an alcoholic relative- who was then treated with B1 shots, I asked Mom’s doctor to give them to her, stalling for at least time through the weekend. By Monday her mind was obviously improved! Without the B1 I am totally convinced she would have been committed to a home with disastrous results.
In people with anorexia the first thing they become deficient in is B1. So please be aware that anyone with dementia/ confusion that has had a severely deficient diet could possibly benefit from B1 and other nutritional therapy and even prevent the need for full-time care.
NJ
Other thoughts I have about hospital confusion: If you take a nap and wake up sometimes it seems like another day. Imagine that multiplied over and over for the caree, complicated with side effects of drugs, monotony of not being ambulatory, etc.
I made it a point to tell my Mother what day and time it was whenever I visited with her, when she woke up to help her tune in to reality.
I tried to have visitors spaced a part (rather than all at once and then no one at all some days).
When she was able, she read the newspaper (helped her differentiate the days) or worked on ringaword puzzles to keep her mind busy.
Worst thing is to be there hours at a time just watching tv or staring blankly without visitors. Ask for volunteers to visit if necessary!
Roaringmouse
When my husband is in the hospital, I visit him every single day to keep tabs both on him and the staff. There have been many times where his reaction would be hallucinations and think he was seeing or experiencing something other then he should be. One of two things would occur either I would catch it or he would tell me about it. When it occurred the first thing I would do is go to his allergic reaction list to compare it with other meds he had before. Depending on the quality of the medical arena…we would identify the problem immediately, or he would refuse the meds or if they still refused…then he would hide them and throw them out later. (The last note is one I would never endorse personally but that was at a very scary institution that required me calling a government watchdog on. A story for another day…).
Fortunately my spouse’s doctors have closed themselves to be a very tight group due to his multiple unusual conditions and prior history. So now we just give them a head’s up and the problem is always addressed immediately..