Your Dad is old and a bit doddery, but always good in mind. After a fall, they took him to hospital where they wanted to keep him in for observation. This quiet old man started hallucinating, hitting out and clearly didn’t know where he was.
“Oh, no!” you think, “Dad caught Alzheimer’s in the hospital.”
It is very common for elders to develop a temporary hospital dementia, more properly called a delirium.
Don’t panic and don’t listen to anyone who tells you its Alzheimer’s. Alzheimer’s cannot possibly be diagnosed by looking at someone else’s behaviors. Alzheimer’s needs a full and complicated workup, including MRI, CT scan, blood tests, oxygen tests and more.
No-one knows why elders develop this temporary but alarming condition, but let’s guess.
Five Causes of Hospital Dementia:
1. Too much light, noise and little sleep;
2. Too much new medication;
3. Too little human contact;
4. Too much loss of calming routine;
5. Poor communication from hospital personnel.
Caregivers of people, who already have dementia, already know how devastating a hospital stay can be. The terrible surprise of temporary hospital delirium usually frightens family members.
No-one develops Alzheimer’s overnight or even in one week. This delirium is a temporary condition and the person usually returns to normal functioning. Somewhere from two weeks to as much as two months.
The bad news is that, although this happens often to elders, hospital staff often seems woefully ill-prepared to deal with it. They may use violent methods of restraint or overuse anti-psychotic drugs. Staff is unable to recognize and help an elder who is being overcome by a displacement trauma.
Elders do not do well in hospital. That’s why you should go as little as possible though, of course, it’s not always avoidable.
However, think about this. Over 65 percent of admissions of elders to hospital is due to, NOT their medical conditions, but to the medications they are taking.
That gives you something else to factor into your care of an elder. When I was running my care home, our biggest battle was over medications.
We negotiated with each person’s doctor. We drew up a list of side effects, correlated with that resident’s daily problems. Often, the duplication of medication was the result of different doctors prescribing different medications without consulting each other.
This approach to elder health keeps many balanced upon a knife-edge of overwhelm. Then they go to hospital. And they plunge into the abyss.
I don’t think I’m a doctor — I’d be earning lots more money if I were. But as a caregiver, I am often the gatekeeper whose job is to keep my person as safe as I can.
I read up on side effects. I negotiate on medications. I question the wisdom of applying, say, thyroid standards for 50-year-olds to someone of 93. I always ask, would it be safe to watch this for a while? And often, it is.
We have one standard only. If it ain’t broke, don’t go to the hospital. If it ain’t broke, don’t start a new medication — because you’ll probably fall down and then you will break.
If you do go to the hospital, I go too because I have to be your safe environment in all the noise, confusion, bustle and lack of normal routine which is, I feel sure, the big reason for temporary hospital dementia.