I took my mom for an assessment on her walking on Monday at the ER, per her Dr.'s orders. She was admitted that night for PT assessment on Tuesday. She was cognitive, very aware and ate well. Wednesday I got a call saying my mom was in ICU. As she was getting her breakfast the nurse said her head dropped and she was incoherent. They did an MRI because they thought she had a stroke. That was negative. They have done CT Scans and an EEG. They're still looking over the EEG, and tomorrow they might do a lumbar puncture. Her numbers are perfect. Her doctors are "baffled." The ICU doctor is trying to persuade me to sign a DNR. I will not do this until I get an answer why this suddenly happened. She did know who me and my brother, sister in law and husband were. She was able to say our names, but everything else was gibberish. But she would continually make noises and turn her head back and forth. I am so confused and broken hearted. Has anyone else experienced such a thing. I am POA.
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Another thing, about 90% of elders who go into the hospital get delirium. Delirium causes a person to become frighten and confused. When you think about it, it's not peaceful at a hospital... all the new noises, the new smells, the bright lights, the food doesn't taste the same, staff poking and prodding at all times at night. Now, 20% of younger patients experience the same thing if they had major surgery.
She must have been experiencing some extreme symptoms for the doctor to send her to the ER, and for her to be admitted.
What else was going on?
Ask her hospital doctor if he ordered a UA.
First, last month I was advised by EMTs to have my 97-year-old Dad taken to ER for imaging. He had banged his head very hard in a fall. He had been falling increasingly, and we had perhaps over-used the “courtesy lifts” that 911 can provide. From ER he was admitted to the hospital for four more days, then to rehab for 20 days. Rehab PT had him “walking” 75 feet a day. Once he was discharged to home, he seems to have had multiple strokes and now can barely speak (aphasia, dysarthria, apraxia). I imagine it’s possible his severe aortic stenosis (first diagnosed because of the ER imaging) may have caused strokes or plaque disruption? For years, and at ER and at the hospital, Dad happily signed DNRs. But once admitted to Rehab he wanted “all extraordinary measures” to keep himself alive. His dementia had increased markedly in the hospital. At rehab, he was most definitely declared incompetent and I was put in the position of DNRing him. Why did I do that when my heart was breaking, I felt so guilty about overriding his wishes, and I loved my dear father?
Ten years prior, my 100-year-old mother-in-law fell, after numerous falls, and was admitted to ER, where she expressed her DNR wishes and wore a huge DNR bracelet. Though having survived a number of strokes and still able to be rational, she had signed so many DNRs and clearly worded directives, which I made sure hospital staff shifts were always aware of, as well as her family’s legal role in supporting that decision. She was such a bubbly, giving personality that she had endeared herself to nursing staff in just the few days she was there. She had another heart attack during this short hospitalization. An RN went into a panic and intubated her. Roommate witnesses said the tubing was the most horrible thing they ever witnessed. It caused such trauma, the entire ward (including visitors) was shaken. Once deceased, when I viewed her body, it was quite obvious there was a lot of internal tissue trauma caused by the intubation, which also extended her life struggle.
I don’t think ER or hospital staff have the time or emotional capacity to always make exquisite decisions filled with perfection. Many are weary and exhausted. Many have seen too much, and are burnt out too. They fall back on protocol training and knee-jerk reactions in a pinch. I can’t fault what happened during either of my two experiences. I just saw a bunch of people (myself included), who did the best they could do under very stressful circumstances. We are forever saddened and traumatized. But that is why I will sign DNRs on behalf of extremely frail, aged, and irreversibly diseased love ones. And why palliative/hospice care provides highly skilled monitoring and brilliant comfort measures.
I apologize for my graphic description, but I couldn’t sleep if I didn’t share it with another going through this heart-rending experience. I am truly sorry you are in this time with your mother. I hope you find some clarity in these caring responses.
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