When dementia family caregivers compare notes about hospitalizations, you often hear stories of loved ones who seemed to go downhill or who never seemed quite the same cognitively afterward. A new study in Annals of Internal Medicine blames the combination of dementia and delirium, which is a state of heightened confusion or unusual mood or behavior, for serious declines in people with Alzheimer's who are hospitalized.
As a result, about one in eight hospitalized Alzheimer's patients faces a major complication within a year of hospitalization, including increased risk of winding up in a nursing home or of dying, reports Reuters.
The Boston-area study tracked almost 800 people with mild Alzheimer's disease at the Massachusetts Alzheimer's Disease Research Center between 1991 and 2006. About half were hospitalized for falls, infections, or other problems. They then used other federal data to see what happened in the year after the hospitalization.
Hospitalization was associated with nearly twice the likelihood of a poor outcome, including mental decline and death, and delirium seems to be the common risk factor, researchers say. The data works out to about one in 16 dying, one is seven being put in a nursing home, and one in five suffering a mental decline within one year of getting out of the hospital. Those who never went to the hospital and those who went to the hospital but didn't have delirium did better.
Delirium is an often-overlooked complication in hospitalized people with dementia.
Doctors say the takeaway messages from this research are:
1) Hospitals should take steps to prevent delirium, such as having eyeglasses or hearing aids available and not giving unnecessary pain medications that can worsen confusion.
2) Family caregivers need to be educated to expect delirium in the first place (since many have never heard of it), including what delirium is and how to spot signs of delirium in someone with dementia who's hospitalized.
3) Families need coaching on what to do if they suspect delirium. When a hospitalized loved one with dementia develops delirium, caregivers can actually do a lot to help minimize the problem.
Image by Flickr user ribena wrath, used under a Creative Commons license.
I have been milling over this issue for a few days now. Could there also be a link between the contrast in the CT scans? Mom had many while in the hospital and extended care after her fall last year. I realize CT scans of the Brain are needed but could either the contrast of the radiation be causing the rapid decline? Just throwing out the idea for discussion and possibly someone can do some research on the issue.
my experience was that Dad was given medication in rehab that had already caused a terrible reaction. One time the nursing home was reprting that my easy going Dad needed to go to hospital because of combativeness. A neurologist friend went over his records, it was a medication which often caused problems. With mother, once in rehab and again in respite care, they drugged her up because she did not want to get up at 6 am ( after being up all night with sundowners syndrome.) neither place told me of the problem, even though I was in frequent contact. I came back both times to find Mom totally unconscious.
When one realizes how most of the anesthesia drugs used these days are fluoride-derived, there is ample reason to understand why there would be a significant post-surgery incidence of "brain injury." Additionally, folks are being compromised by the fluoride-derived prescription drugs [i.e. Prozac, Zyprexa, other anti-depressants, anti-psychotics] as well as so many of the municipal drinking water supplies which are now contaminated by this heavy metal. While fluoride may be helpful on one's toothbrush, it should NEVER be ingested like a one-size-[dose]-fits-all drug...in the water supply. Please do your own homework to confirm why it is especially the elderly who are seriously harmed because the aged body is far less able to completely purge or adequately provide necessary detoxification of heavy metal exposure; be it from anesthesia, drugs, or drinking water...and especially when, over time, these heavy metals are accumulative in the human body; via skeleton, tissue...and brain.
I had a total knee replacement in April. For almost 20 days I was completely out of it--making myself sick and my family very concerned about me. I was saying totally irrational things, thinking delusional thoughts, and doing a lot of crying. My mind starting clearing at about the 20 day mark and since then I am fine. I am 70 and can totally relate to patients having a long anesthesia and then waking up confused. I never thought it would happen to me, but it did.
I saw the same thing happen with my mother with her hip replacement surgery; since on one of these posts I've read older people are opting to have it with a local rather have the usual anesthesia for that reason.
Every time my mother was hospitalized over the last six or so years, she received anesthesia for surgery. Every time, there was noticeably less of her mind left. After the fact, the caregivers acknowledged that this is something they see regularly. There isn't much discussion about the affects of anesthesia, especially on older patients and especially on older patients with Alzheimer's.