How can I make my mom's hospital stay with dementia easier?

3 answers | Last updated: Dec 06, 2016
A fellow caregiver asked...

On top of her Alzheimer's disease, my mom faces surgery for colon cancer. She's 84, and her dementia symptoms are still relatively mild. Do you have any suggestions for how to make her hospital stay with dementia easier?

Expert Answers

Geri R. Hall is an advanced practice nurse who works in the department of neurology at the University of Iowa College of Medicine and at the Banner Alzheimer Institute in Phoenix, Arizona. She's also a speaker and author who since 1996 has facilitated the online support group for the Washington University, St. Louis, Alzheimer's Disease Research Center's Alzheimer List.

Hospitals are fairly inhospitable places for people with dementia. Your mom's symptoms may increase because of the strange environment, routines, and people she'll encounter; the anesthesia, which may take weeks or months to completely leave her system; and the postoperative pain. Surgery can also cause "decompensation" -- a sudden, possibly permanent loss of cognitive (thinking) abilities -- especially if those skills have been stable for quite a while.

Because of these concerns, you may want to talk to the surgeon about how long he expects your mom to live without the surgery. If her cancer is growing slowly, you may want to consider whether it's really worth the effort right now.

If your mother does need to have surgery, schedule it for a week when close family members can stay with her. Don't rely on the nurses to know what to do to help someone with dementia. Ideally, you'll want one close family member at your mother's bedside whenever she's awake. At the very least, have someone there in the evening, when she's most likely to become confused and agitated, and during meals, as she'll need more time to eat.

If at all possible, you should insist on a private room. After surgery, keep the TV off at all times to help keep things calm.

Before the hospitalization, put together a discharge plan and arrange for in-home care. Your mom will require round-the-clock supervision for a few weeks after the surgery. You may want to talk with the hospital social worker about finding help.

From the moment of admission, tell every nurse you see that your mom has Alzheimer's and that you intend to stay with her to assist with her care and help her remain calm. If a nurse reassures you that she can manage your mom just fine, the nurse does not understand Alzheimer's.

Prior to surgery, make absolutely certain that you tell the anesthesiologist about your mom's condition and its severity. He can adjust the type and dose of anesthesia to minimize confusion. Do not rely on the surgeon to relay this information.

When speaking with your mother's surgeon, insist that her Alzheimer's medications be continued throughout her hospitalization. And make sure they give her pain medication every four hours instead of waiting for your mom to ask for it.

Community Answers

Lisbeth answered...

When my mom broke her hip, she had surgery to repair it, stayed in the hospital for about a week, then stayed at a rehab for six weeks until she could come home to live with me and my family. Her dementia became noticeably worse during her hospital and rehab stay, and I came up with a few tricks to make things easier on everyone.

First, I brought a dry-erase board and wrote on it a brief explanation of where she was and why she was there. This included the current day and date. I put it on the wall facing her, and she would see it and be reassured. The nurses were glad to update the date early in the morning.

I also made a sign that told Mom not to get out of bed without help, and to call a nurse if she needed anything. I put a photo of the 'call button' on it and gave simple instructions how to use it.

I asked the nurses to please ask Mom if she was in pain - my mom would not ask for pain medication no matter how badly her hip hurt, and would just become agitated.

When Mom was in the rehab, I got her a notebook to use as a 'guest book' so she could see that people were coming to visit her. I visited daily, and she often became very angry with me because she thought I hadn't been in to see her at all. I also used this notebook to paste the cards she received into it, to make it easy for her to look at them (which she did over and over.)

I also printed out daily readings from her church's web site and put them into the notebook. That kept her somewhat occupied, as well. I also printed family photos, with captions added, which gave her another familiar element in a very unfamiliar environment.

Hang in there, and God bless you and your mom.

Rellim answered...

I may be late in answering this but like Lisbeth's mom, my dad had to have a total hi replacement after breaking his. It was awful at the hospital and rehab later. But we made it through it. One thing though I disagree with is, don't give meds unless they are hurting. My dad would get worse in his confusion after being given pain meds. Finally I asked them not to give them to him at night and he slept great that night, there excuse for giving them when he didn't ask for them was it made him sleep better! WRONG! I stayed with him 24/7 while hew was there, a total of 4 weeks. I really think if I had not been there he would never have made it home! He ended up with 3 infections at the same time, e-coli in his lungs ( because they let him go 9 days without a bowel movement)a staff infection and pnemonia! Also Lisbeths idea of signs is great. I started them after I got my dad home. He seemd to have gotten worse while at the hospital.I put up a sign that tells him it is bedtime, to only holler in case of emergency. If not he would holler all night to ask what time it is, he has 2 clocks in his room. I also have one that tells him where he is and that I put him there. Another one says where I am so he knows I am still at the house. he always thinks I have left him alone for hours at a time. He is never left alone! We don't dare risk it!

Hope ? lets us know how things turned out!

And to Lisbeth, I have been trying to send you a hug and thank you for the hug and kind words, but for some reason it won't let me.

So Heres you HUG!!!!!! rellim