Alzheimer's patient with broken hip/health failing
Posted: Fri Mar 19, 2010 1:25 pm
Hi All,
My mom had hip replacement surgery after a fall. She is also in an advanced stage of Alzheimer's. While in the hospital and in the nursing home for rehab, she was drugged to within an inch of her life. I stayed in the hospital around the clock with her because she is such a fall risk and she is impossible to contain, moving constantly, wanting to escape from the bed, becoming agitated and aggressive, impossible to restrain without constant intervention. So she was kept heavily sedated, and was also under the influence of morphine for the pain. She was in one of two states while in the hospital: 1) In a stupefying sleep so deep we could not rouse her, could not shake her awake, and, at times, so drugged, she ate (very little) and talked with her eyes completely closed, slurring her words, making no sense, or 2) In perpetual motion, insisting to get out of there and go home, calling my name repeatedly, crying, anxious, agitated, angry.
She is hallucinating, mistaking one object for another, seeing things where nothing exists. While under the influence of sedatives and painkillers, she kept reaching out to touch things in the air, and saying things that made no sense, babbling. She still tries to put sentences together that make no sense, then looks stricken when she realizes that she has not been understood.
She believes that she is doing something wrong and causing problems, that people don't like her, that bad things are happening in her assisted living facility, that she's not safe, or that something has happened to me.
She keeps saying that she is alone, even though there are people around her constantly. I tell her that the caregivers are her friends, she insists they are not.
She goes from room to room, opening all the doors, wants to go home, wants me. She requires constant company, is afraid to be alone for a moment. Sometimes, in her assisted living facility, she'll fall asleep on the couch in the common area where she is near the caregivers, but will not stay in her bed. (When she lived with me and I tried to put her to bed, she used to keep coming out, telling me she didn't want to be alone, or that there was someone in the house, or that she was afraid that I was going out at night, leaving her alone in the house, which made her angry. She wanted to know where I went and why she couldn't come with me, insisting that I was lying when I told her I didn't go anywhere. So she wouldn't stay in bed; she kept coming out to find me.)
Her face is pale, her blood pressure goes from hypertensive to hypotensive. At one point before she broke her hip, she suddenly sat staring, would not respond to verbal stimuli, and her pupils were unevenly dilated. We believe she may have suffered a mini-stroke due to the drugs. Now her pupils are constantly dilated. This, after months on an antipsychotic, which I insisted be discontinued.
She had a vasovagal while in the nursing home. While being put on the toilet, she was in pain from her hip, and suddenly she stiffened and went completely still and unresponsive with her eyes wide open and staring, her foot trembling. Shortly thereafter, she came around.
She is so sleepy, but does not sleep at night. If she does fall asleep, she wakes shortly thereafter or wakes very early and does not go back to sleep.
She is refusing to eat and has lost a lot of weight. I ask her if she is hungry, and she replies with an enthusiastic yes, but then won't eat.
She is frustrated about being stuck in a wheelchair and rocks constantly, trying to propel herself. Everything given to her she says she doesn't like. Sometimes, she spits out whatever has been put in her mouth. She is requiring hand-feeding, where before she fed herself.
Her leg on the surgical side is swollen and edematous.
She sometimes becomes combative and uncooperative, refusing assistance, becoming verbally and physically abusive. While angry in the hospital when we were caring for her, she grabbed our clothing and hair, and punched, telling us we were mean for hurting her.
Her skin is hot, but she has no fever. Normally, her hands are very cold to the touch. While in the hospital, for one day only, she sweated profusely during sleep, but with no fever, and her upper body became cold and clammy.
She is extremely anxious, wrings her hands. When she was able to walk, she paced and wandered about continuously, rarely sitting down, wanting out of her assisted living facility, asking constantly about me.
She is interested in nothing, will not watch television, occasionally participates in activities. The speech therapist said that her major obstacle is that she will not apply herself to anything for any length of time. I told the therapist that she is that way with everything: Before one thing can be completed, like a meal, she is asking what's next, saying let's go or what are we doing now, ready to rise and get going. She is always ready to move on to something else. This, I believe, comes from the lifestyle she had with my dad when he was alive, relocating constantly, never staying at home, but always out and about.
She cannot focus her eyes on anything, make out what she is looking at, even if placed directly in front of her face.
At times, she is smiling and friendly, sweet, generous and grateful.
She seems to have a thirst, though I am not with her all the time.
She is still continent.
I have a physical therapist scheduled to visit her, and I exercise her each time I am there. I am also trying to hire companions to watch her, alternating with my bringing her home with me on occasion. I am not equipped at home, however, to safeguard her properly. At the assisting living facility, there is a hospital bed lowered to the ground, a fall mat, bed alarms, raised commode, and an overnight staff member, so I will bring her back there to sleep.
I'm hoping to get her to eat while home with me. Right now, she'll take a bite of something and then want nothing more.
I need a remedy(ies) to help pull her through this. She is clearly suffering not only from the surgery and dementia, but the effects of all the drugs. Plus, she is not getting proper sleep: She sleeps on and off throughout the day, and then is up all night. Her circadian rhythm is reversed. And she is not getting proper nutrition. Please, can anyone offer a suggestion?
Thank you,
A very worried daughter,
Toni
My mom had hip replacement surgery after a fall. She is also in an advanced stage of Alzheimer's. While in the hospital and in the nursing home for rehab, she was drugged to within an inch of her life. I stayed in the hospital around the clock with her because she is such a fall risk and she is impossible to contain, moving constantly, wanting to escape from the bed, becoming agitated and aggressive, impossible to restrain without constant intervention. So she was kept heavily sedated, and was also under the influence of morphine for the pain. She was in one of two states while in the hospital: 1) In a stupefying sleep so deep we could not rouse her, could not shake her awake, and, at times, so drugged, she ate (very little) and talked with her eyes completely closed, slurring her words, making no sense, or 2) In perpetual motion, insisting to get out of there and go home, calling my name repeatedly, crying, anxious, agitated, angry.
She is hallucinating, mistaking one object for another, seeing things where nothing exists. While under the influence of sedatives and painkillers, she kept reaching out to touch things in the air, and saying things that made no sense, babbling. She still tries to put sentences together that make no sense, then looks stricken when she realizes that she has not been understood.
She believes that she is doing something wrong and causing problems, that people don't like her, that bad things are happening in her assisted living facility, that she's not safe, or that something has happened to me.
She keeps saying that she is alone, even though there are people around her constantly. I tell her that the caregivers are her friends, she insists they are not.
She goes from room to room, opening all the doors, wants to go home, wants me. She requires constant company, is afraid to be alone for a moment. Sometimes, in her assisted living facility, she'll fall asleep on the couch in the common area where she is near the caregivers, but will not stay in her bed. (When she lived with me and I tried to put her to bed, she used to keep coming out, telling me she didn't want to be alone, or that there was someone in the house, or that she was afraid that I was going out at night, leaving her alone in the house, which made her angry. She wanted to know where I went and why she couldn't come with me, insisting that I was lying when I told her I didn't go anywhere. So she wouldn't stay in bed; she kept coming out to find me.)
Her face is pale, her blood pressure goes from hypertensive to hypotensive. At one point before she broke her hip, she suddenly sat staring, would not respond to verbal stimuli, and her pupils were unevenly dilated. We believe she may have suffered a mini-stroke due to the drugs. Now her pupils are constantly dilated. This, after months on an antipsychotic, which I insisted be discontinued.
She had a vasovagal while in the nursing home. While being put on the toilet, she was in pain from her hip, and suddenly she stiffened and went completely still and unresponsive with her eyes wide open and staring, her foot trembling. Shortly thereafter, she came around.
She is so sleepy, but does not sleep at night. If she does fall asleep, she wakes shortly thereafter or wakes very early and does not go back to sleep.
She is refusing to eat and has lost a lot of weight. I ask her if she is hungry, and she replies with an enthusiastic yes, but then won't eat.
She is frustrated about being stuck in a wheelchair and rocks constantly, trying to propel herself. Everything given to her she says she doesn't like. Sometimes, she spits out whatever has been put in her mouth. She is requiring hand-feeding, where before she fed herself.
Her leg on the surgical side is swollen and edematous.
She sometimes becomes combative and uncooperative, refusing assistance, becoming verbally and physically abusive. While angry in the hospital when we were caring for her, she grabbed our clothing and hair, and punched, telling us we were mean for hurting her.
Her skin is hot, but she has no fever. Normally, her hands are very cold to the touch. While in the hospital, for one day only, she sweated profusely during sleep, but with no fever, and her upper body became cold and clammy.
She is extremely anxious, wrings her hands. When she was able to walk, she paced and wandered about continuously, rarely sitting down, wanting out of her assisted living facility, asking constantly about me.
She is interested in nothing, will not watch television, occasionally participates in activities. The speech therapist said that her major obstacle is that she will not apply herself to anything for any length of time. I told the therapist that she is that way with everything: Before one thing can be completed, like a meal, she is asking what's next, saying let's go or what are we doing now, ready to rise and get going. She is always ready to move on to something else. This, I believe, comes from the lifestyle she had with my dad when he was alive, relocating constantly, never staying at home, but always out and about.
She cannot focus her eyes on anything, make out what she is looking at, even if placed directly in front of her face.
At times, she is smiling and friendly, sweet, generous and grateful.
She seems to have a thirst, though I am not with her all the time.
She is still continent.
I have a physical therapist scheduled to visit her, and I exercise her each time I am there. I am also trying to hire companions to watch her, alternating with my bringing her home with me on occasion. I am not equipped at home, however, to safeguard her properly. At the assisting living facility, there is a hospital bed lowered to the ground, a fall mat, bed alarms, raised commode, and an overnight staff member, so I will bring her back there to sleep.
I'm hoping to get her to eat while home with me. Right now, she'll take a bite of something and then want nothing more.
I need a remedy(ies) to help pull her through this. She is clearly suffering not only from the surgery and dementia, but the effects of all the drugs. Plus, she is not getting proper sleep: She sleeps on and off throughout the day, and then is up all night. Her circadian rhythm is reversed. And she is not getting proper nutrition. Please, can anyone offer a suggestion?
Thank you,
A very worried daughter,
Toni