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I. How We Work in Washington. Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services. APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
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V. Complaints. Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights. APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.I agree that: A.I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information"). B.APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink. C.APFM may send all communications to me electronically via e-mail or by access to an APFM web site. D.If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records. E.This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year. F.You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
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Yes, hospitalizations cause extreme disorientation with anyone, especially the elderly and especially if they have had a surgery where they were administered anesthesia. Even more so if they have dementia, even early stages. Stepdad had a hip replacement six years ago and after about four months he was back to presurgery brain condition. He had not been diagnosed with dementia and remained sharp until he passed last October.
My mom on the other hand had been diagnosed with Alzheimer's type dementia and uterine cancer. She had the hysterectomy and while there was preexisting memory issues, the surgery accelerated her condition. That was about ten years ago and she is still alive, a shell of herself, barely verbal, in a wheelchair, sleeps most of the time and on hospice now.
The effect is different for everyone. It also depends on their an medical history. Having elective surgeries should be considered very carefully as anesthesia effects on the brain are well documented.
Merrys13, do you mean she went into the hospital with no sign of ALZ and came out with ALZ? Or that she had ALZ before the hospitalization and came out with a changed personality? A little clarification would help.
Same thing happened to my mother a few months ago. She is 82 and had signs of minor confusion, especially related to financial affairs, but was living alone (Dad went to Alzheimer's facility about a year prior). Mom needed surgery, and came out of it with severe delirium, to the point that she got up in the middle of the night, ran down the hallway in the hospital, fell and fractured her hip. The delirium subsided, eventually, and she now has no memory of anything that happened in the hospital at all.
My research on the internet shows that post-surgical delirium is definitely a possibility in elderly patients. The condition is often, I have read, reversible. In my mom's case, her new cognitive "baseline" is lower than before and I have put her in assisted living (mild memory care) after the 5-week nursing home rehab for the fractured hip.
Hospitals can overwhelm elderly very easily. All the noises and constant lights, changing people and environment, it can calls dementia like symptoms including hallucinations. I'd give it about a week for him/her to calm down, and get his/her brains back in focus. If that doesn't help, I'd call his/her PCP.
All of the above situations are possible, and I add infections in the elderly can cause mental degeneration and behavioral changes, especially in elderly women with UTI's.
I agree with the others here in saying that there were probably signs of ALZ or dementia that no one noticed before, or just waved away as "aging"...slight memory loss, tendency to repeat things now and then, etc.
Hospitalization Dementia is a very real thing. My mother had it. Whereas she was only a little forgetful beforehand, during hospitalization, she developed a tendency towards sundowning (erratic behavior only at night, with no memory of it the next day). She would attempt to escape her bed, even with the rails up, she pulled out her IV and waved the tubes at me while giggling, yanked out her catheter and caused bleeding down there. She was *never* like this before the hospitalization. Once out of the hospital, she returned to normal nighttime behavior (for her) within 24 hours - but the advanced level of dementia (increased memory loss, repeating, loss of everyday functions like how to use the bathroom or where to put things) stayed, and only got worse with each hospitalization.
Its important to know the difference between dementia and delirium. If the elder already has some (even modest) cognitive decline, the ability to diagnose the delirium can be more complicated. Hospitals are disruptive to an elder's routine, disorienting, and terribly frightening if they are unaware of why they are there. Keep a few familiar comfort items nearby; family photos, glasses & hearing aids, things like that.
I personally have experienced ICU Psychosis. Hallucinations, delusions, extreme sadness. It cleared up 2 days after I was moved out of ICU to a regular room. So I surely do not discount the possibility that the hospital experience caused some psychosis. That should go away in time.
About ALZ -- I heard a lecture at a dementia conference about when ALZ starts. Researchers have much better ways of measuring changes in the brain now and the results are surprising. The pathology appears in the brain long before it causes changes in behavior and cognition. A person with ALZ in the brain can appear totally normal until suddenly symptoms appear (they usually appear very gradually, but it is sudden in that now you don't see it and now you do).
The pathology starts in the brain DECADES before symptoms are present.
This means that hospitalization does not "cause" ALZ. But perhaps something about that particular kind of stress triggers the start of the symptoms showing. (That is just my guessing.)
When my mother fell and broke her hip. She discovered the "joys" of getting attention at the hospital and went on a spree of surgeries. Every time she had anesthesia her Alzheimer's got worse noticeably. This lead to more falls and accidents due to bad choices... A self compounding spiral with a rapid decline. Several pain medications can also cause dramatic personality changes. H
I'm wondering ... if the patients receive meds with heavy metals in them, such as multi-flu shots with mercury, or anything preserved with aluminum (not to mention formaldehyde or other toxins) ... these are substances that can damage the brain. It would not surprise me if some patients suffer unnecessarily due to medical treatment.
Usually if an older person's mental state becomes much worse during hospitalization, that is delirium. Any illness or strain on the body/mind can bring it on.
The more vulnerable an older person's brain is, the less it takes to tip into delirium. So although delirium and dementia are not the same thing, people with dementia are especially likely to develop delirium during hospitalization.
Although some people get better within a few days, for many older adults it can take weeks, or even months, for their cognitive abilities to recover. I once had a 91 year old patient get slowly better over a whole year.
Unfortunately some people never get back to their previous mental baseline, but with enough time and support to rest and recuperate, many older people do recover.
The Hospital Elder Life Program website has a lot of good information about delirium...it was founded by geriatrician Sharon Inouye, who pioneered the research into this very common and important condition.
Definitely can cause issues! My friend's grandmother had no idea who anyone was, even her husband until she got home and was back in a familiar setting. Being in the hospital/having surgery can really drain you, especially when you're elderly. Be patient with them. Another thought, if they have had some decline in kidney function, it's much more difficult for the body to get rid of anesthesia; so that can prolong the effects as well.
Has there been an actual diagnoses of Alzheimer's? I agree that in the elderly, a hospitalization or any change in routine,especially with illness involved, can cause confusion and disorientation. But not Alzheimer's. Alzheimer's isn't contagious nor "sudden onset". There is usually an underlying cause for sudden onset strange behavior, but rarely is it Alzheimer's. If there are concerns about this person managing on their own, a frank discussion with their doctor is in order. Ask if the nursing staff noticed this bahvior and what what done about. Also, It might not be a bad idea to have the person checked for a urinary tract infection, as these can cause truly bizarre behavior in the elderly.
It is a long story of medical issues that I won't go into but my mother had an incident on December 24th and went into the hospital. A series of events following, including medication reactions, A UTI, and two other medical events resulted in my mother vaccillating between full dementia where she didn't know me, to psychosis and general anxiety and depression. It was very, very difficult to experience for all of us. The hospital provided the opening we needed to have her agree to an assisted living facility. Throughout all of this I read, (and joined this group), to learn more. The hospital stay alone can result in a decline, in my mom's case some dementia was already present, just not to the extent we saw post hospital. UTI's are the scourge of the elderly! All of this started with an improperly treated UTI. Four months later and my mom has leveled out. She has memory issues but not as profound as in January, mostly she repeats herself a lot. She is on 5mgs a day of Celexa which has been tremendously helpful. She is not, nor will she likely ever be where she was before all this began, but she is back into her treasured activities and is settling into her new home nicely. Today she is coming to terms with the turn her life has taken and I can only imagine how tough that is as she left her home in the morning one day never to return. Prior to this we were getting ready to "have the talk" about an assisted facility due to her frailty, but she wasn't as debilitated as she was post hospital. One last thing, I absolutely agree the Alzheimer's doesn't just appear. Dementia was probably present but mild and likely being masked. Now that my mom has leveled out I see her appear perfectly fine in front of others, stick around long enough though, and it starts to show.
Any kind of trauma can cause severe deterioration in someone with Alzheimer's or Dementia. Even if it previously was mild. Moving them from place to place will also accelerate these two diseases. When I say moving them, I mean from home to hospital, hospital to rehab, rehab back home or to a nursing home, etc. My mother was about a 4 on a scale of 1 to 10. As soon as she broke her hip she immediately went to 10+ and has never returned to her previous state. That was 8 months ago.
If your loved one is experiencing abrupt behavioral changes after being in the hospital is very possible that they have delirium, a condition that is often diagnosed as dementia but in reality is very different. Delirium comes on abruptly and suddenly and exhibits unusual behaviors, confusion including changes in perception, attention, mood and activity level as well as hallucinations and USB most commonly occurs during or after a hospital confinement. This can go on for months if not properly diagnosed but once done is reversible. Dementia is a slow process the comes on over time not abruptly. You can find more information by doing a Google search for delirium versus dementia the Alzheimer's Association has an informative article on it .
I agree with most everything the others have said. Surgery anestheia plus they administer delauden for pain & comfort. My Mom sort of went somewhere, it took almost a year to recover from 2 hernia surgeries & 2 broken femurs same leg & with all the drugs in her system & the ones they continued to give in the NH. Moved her as soon as I could to Asissted Living for 9 - 10 months then home. The hospital stays were a nightmare as was the NHome, even AL became somewhat of a nightmare. Since the NH stay, she has had 24/7 skilled people & continues to have SN people as well as conpanions. My saying has been Trust No One...it is real. If you feel something in your gut is wrong it probably is! Oh, be sure you have POA for everything-you will need it.
My mom entered the hospital with bronchitis. She was admitted on a Monday and by Thursday, was completely out of it! They wanted to send her to rehab, but I fought it and she went home. It took me 3 months to get her back from where her mind had gone. She didn't even know how much time had passed. She was never the same again.
The elderly often have weakened immune systems before they enter the hospital. If they are then given more drugs then necessary, that creates even more stress on their immune systems. I believe it can also aggravate, and even trigger, neurological disease, to include dementia.
My father went into the hospital for routine prostate surgery. He wasn't healing as well as expected. A number of tests were done. An oncologist told us Dad had lung cancer that was not treatable, and he had 3 to 5 days to live. OMG!! He died three days later.
He went in for a simple procedure and he died of something totally unrelated. Obviously being in the hospital did not cause his lung cancer.
He would probably died at home if he hadn't scheduled the procedure, but we may have never known the true cause of death.
Point being that not everything that becomes apparent while you are hospitalized has anything to do with being in the hospital. We distrust it in fiction, but in real life coincidents do happen.
My mother's best friend husband was in his 60's and went in to have his gallbladder removed. When he woke up he had changed completely. He went from calm and gentle to angry and nasty. He was never able to return home and spent the last few years of his life in Veteran's facility in FL.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
My mom on the other hand had been diagnosed with Alzheimer's type dementia and uterine cancer. She had the hysterectomy and while there was preexisting memory issues, the surgery accelerated her condition. That was about ten years ago and she is still alive, a shell of herself, barely verbal, in a wheelchair, sleeps most of the time and on hospice now.
The effect is different for everyone. It also depends on their an medical history. Having elective surgeries should be considered very carefully as anesthesia effects on the brain are well documented.
My research on the internet shows that post-surgical delirium is definitely a possibility in elderly patients. The condition is often, I have read, reversible. In my mom's case, her new cognitive "baseline" is lower than before and I have put her in assisted living (mild memory care) after the 5-week nursing home rehab for the fractured hip.
Hospitalization Dementia is a very real thing. My mother had it. Whereas she was only a little forgetful beforehand, during hospitalization, she developed a tendency towards sundowning (erratic behavior only at night, with no memory of it the next day). She would attempt to escape her bed, even with the rails up, she pulled out her IV and waved the tubes at me while giggling, yanked out her catheter and caused bleeding down there. She was *never* like this before the hospitalization. Once out of the hospital, she returned to normal nighttime behavior (for her) within 24 hours - but the advanced level of dementia (increased memory loss, repeating, loss of everyday functions like how to use the bathroom or where to put things) stayed, and only got worse with each hospitalization.
It's not quite understood why it happens, but it does - and more often than you might think.
About ALZ -- I heard a lecture at a dementia conference about when ALZ starts. Researchers have much better ways of measuring changes in the brain now and the results are surprising. The pathology appears in the brain long before it causes changes in behavior and cognition. A person with ALZ in the brain can appear totally normal until suddenly symptoms appear (they usually appear very gradually, but it is sudden in that now you don't see it and now you do).
The pathology starts in the brain DECADES before symptoms are present.
This means that hospitalization does not "cause" ALZ. But perhaps something about that particular kind of stress triggers the start of the symptoms showing. (That is just my guessing.)
Several pain medications can also cause dramatic personality changes. H
The more vulnerable an older person's brain is, the less it takes to tip into delirium. So although delirium and dementia are not the same thing, people with dementia are especially likely to develop delirium during hospitalization.
Although some people get better within a few days, for many older adults it can take weeks, or even months, for their cognitive abilities to recover. I once had a 91 year old patient get slowly better over a whole year.
Unfortunately some people never get back to their previous mental baseline, but with enough time and support to rest and recuperate, many older people do recover.
The Hospital Elder Life Program website has a lot of good information about delirium...it was founded by geriatrician Sharon Inouye, who pioneered the research into this very common and important condition.
Four months later and my mom has leveled out. She has memory issues but not as profound as in January, mostly she repeats herself a lot. She is on 5mgs a day of Celexa which has been tremendously helpful. She is not, nor will she likely ever be where she was before all this began, but she is back into her treasured activities and is settling into her new home nicely. Today she is coming to terms with the turn her life has taken and I can only imagine how tough that is as she left her home in the morning one day never to return. Prior to this we were getting ready to "have the talk" about an assisted facility due to her frailty, but she wasn't as debilitated as she was post hospital. One last thing, I absolutely agree the Alzheimer's doesn't just appear. Dementia was probably present but mild and likely being masked. Now that my mom has leveled out I see her appear perfectly fine in front of others, stick around long enough though, and it starts to show.
He went in for a simple procedure and he died of something totally unrelated. Obviously being in the hospital did not cause his lung cancer.
He would probably died at home if he hadn't scheduled the procedure, but we may have never known the true cause of death.
Point being that not everything that becomes apparent while you are hospitalized has anything to do with being in the hospital. We distrust it in fiction, but in real life coincidents do happen.