Orienting and confusion.

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MercurysKid Asked January 8, 2024

Orienting and confusion.

Hi again,

Is it possible that a person with dementia's cognition can decline in an accelerated fashion when they are not "at home." Reason being I had to take my Dad to the ER because he was having such a difficult day and shortness of breath etc. turns out I now know he is aspirating hid food and liquids and that set up an aspiration pneumonia. OK. So he was admitted and ever since then he has seemed increasingly confused and disoriented to the point that today they placed a sitter with him because he keeps trying to leave etc. I understand that this is dementia and is this decline possible context driven? Like if he was at home he'd be more oriented? Just trying to understand what to be extra alarmed about and what is perhaps typical when a person with dementia has to say go to the hospital etc. Sorry if this is a super naïve question and thank you all for your wisdom and reflections. <3

Alzheimer's & Dementia Cognitive Decline Emergency Care

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score 1 · Answer 1

Yes, delirium + possible Sundowning would produce those symptoms in him.

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score 2 · Answer 2

It is EXCEPTIONALLY common for patients undergoing hospitalization to become exceptionally disoriented. It is, with dementia, in fact more COMMON than UNcommon. It isn't at all a naive question. Ask the nurses at the hospital and they will verify this for you. Be certain they have as good a careplan from you as you can give them re what is the norm for your Dad. Realize also that illnesses involved with hospitalization exacerbate everything.

Things may look up upon return to a normal environment. They generally do.

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Thank you so much. I am doing a little research on hospital delirium and going tomorrow to advocate for him while there. I feel like the medical team has been really dismissive of my concerns and one Dr. acknowledged the disorientation but was like "Well yes, he's 90."

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score 2 · Answer 3

It's totally normal for any elder to have hospital delirium while hospitalized with an illness, even elders w/o dementia. My father was Sundowning to the point my daughter had to sleep there in the hospital with him on the couch every night just so he didn't flip out entirely, and he had no dementia. My mother who did have dementia and went to the hospital with aspiration pneumonia herself was seeing mice crawling on the floor with her delirium, it was awful. They're always more oriented at home in a familiar environment and more out of it when in an unfamiliar environment. Both my folks DID improve when they got out of rehab after their hospital stays.

While in the hospital, make sure dad has a swallow study performed to see where he stands regarding eating. Dementia can cause swallowing deficits which makes it necessary to have foods pureed and liquids thickened after a hospital stay. Its vital to get this information for dad.

Best of luck to you.

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Thank you so much that really helps!

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Orienting and confusion.

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