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My mother came down with severe Bronchitis, and then it became pneumonia. She was admitted to the hospital on a Friday. On the following Wednesday she went into a nursing home for Rehab because she wasn't better. She will be in rehab for three weeks. She has been in the home now for one week. I go visit her every night. I've observed that it does appear that she is getting "a little better physically", HOWEVER, mentally she is much much worse. My mother does have Dementia. She is 92 years old. Mentally she just seems more and more out of it now. Her short term memory is totally shot. Her skin tone has a grayness to it. Her eyes have this blank, no one there look to them. Three nights ago she told me that she had been in that home for a month....she has only been there a week. I just don't understand why her mental state has deteriorated so much since she has been in this home for rehabilitation. She put her spoon in her soup upside down the other night, and she seemed utterly confused as to how to make it right. What do you all think of this?

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I'd ensure that any change in mental status is reported to her doctor. They can check to see if she has any new infections, like a UTI. Plus, I have read that some patients get worse after a hospital stay and it may take months to recover. Or, it could be that her dementia is just progressing. People progress at different rates. Do you know what is causing her dementia, like Alzheimers, Vascular, etc?
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I do believe that my mother has Alzheimers, however she has never been diagnosed with it. She would refuse. I have been told by others that sometimes when an elderly person goes into a hospital/home that they can get worse. My concern here now is that I really don't think "in her current state of mind" that she could go home and take care of herself alone. I am an only child dealing with this, so I just don't know what to think.
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Who lives with your mom?
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Willen, I think the adjustment from home to hospital to rehab could be the main factor in your mother's change in mental status. When you think about it, it's traumatic, and more so for older people. They go from a familiar situation to an unfamiliar one in which they're poked, prodded, awakened for blood draws, and more.

The atmosphere is dry, tissues (especially nasal and mouth ones) dry up and the person becomes uncomfortable, often very, very uncomfortable.

Then there's another change at rehab, where everything is done for them - there's not much choice when to get up, when to get therapy. You live by a facility's schedule.

If there's some dementia involved, the change can be even more startling. I often wonder if people in that situation could articulate the confusion and would say that their lives have literally been taken over by strangers.

There are a few things you could try. Is there anyone, or can you, visit during the day, to help create a more personalized atmosphere? If so, can someone bring a CD or some type of portable device to play her favorite music? Even a portable radio could help. If she can relax, there's at least a possibility of lowered stress level.

Ask the staff for a calendar if one isn't posted in the room. Help orient her as to date, but also check the schedule and see when pet and music therapy are scheduled. Both are soothing, calming, and can help bring people "out of their shell".

Sometimes taking someone for a walk (or wheelchair roll) around the facility to see outdoors can help; viewing outside areas, especially lovely ones, in my experience helps people to relax, and reorient themselves.

I think the effort would be to try to stabilize her mental state as much as you can, help her relax and feel oriented, not overwhelmed by being in a strange surrounding, and become a little bit more comfortable to the point that it will help her recover and go home.

You might also want to begin researching either private duty or another place with higher level of care than she can get at home. Neither is an easy option to accept. I've found in my search for qualified private duty people that there are a lot of franchise operations with dubious management and staff. It was not an easy search or choice.

Assisted living or memory care would mean yet another move.

I don't want to frighten you, but perhaps your mother has reached that stage of tough decisions.
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Ah, she's still in rehab! I misread. Can you have the nursing staff take a look at her. Is she possibly dehydrated?
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This happened with my mom too. During rehab I was terrified at her mental decline. She said things like she was in a hotel - said she woke up and started making cookies for everyone (no, never did) - would ask to go upstairs to her bedroom (like our old house 20 years ago) - forgot friend's names who visited. Didn't know time and place. She too had that blank look in her eye. Her appearance was alarming. When rehab released her, I thought NO WAY would she be able to live at home independently with dad again. However, she recovered after a couple weeks. Now she is back to where she was before the whole hospital/rehab began.
I've come the the conclusion that hospital and rehab is extremely draining for those with dementia. However, they can recover once back at "home". I hope this happens to your loved one too. If all blood tests come out OK, then please just help her get comfortable again once released.
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I think Pnemonia can cause confusion. And like said, change can do it too. Grayness bothers me. This means her heart may not be working or she needs oxygen. Ask the DON to check her oxygen level. If below 95 she needs oxygen.
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Lack of oxygen would cause confusion too.
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UTI or any infections, dehydration, change in medication. Ask if they changed any of her meds. They don't always keep family informed.
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I wonder if there has been a big change in her diet. Foods affect our body chemistry, which can affect the brain.
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This happened to my mother after a hospital stay to rehab n.h. It took almost 6 months for her to mentally recover what she could. We think it really put her dementia on fast forward. Don't feel alone! This is how I came to find this site. My girl did the same thing yours is doing. She does need checked because my mom picked up MERSA in the hospital too. Also she had a yeast infection and a U.T.I. that were both awful. It was just too much change, everything different, they all want to go home and who wouldn't? It will get better. After finding this site, I realized our family was not the first people to go through this. My mom had to have a stop in a geriatric psych. Hospital. Hang in there. Grace and Peace love.
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A little better physically... how much better? If your mother still has active pneumonia I don't suppose her brain is getting as much oxygen as it would like.

You really ought to speak to your mother's main doctor and ask for a clear explanation of what her current physical state is, and what you might hope for/expect to happen over the next week or two. I hope it will be helpful to have a discussion like this, and that your mother continues to improve.
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My dad whose 93 and has dementia was hospitalized for pneumonia. After 3 days he was transferred to a rehab facility. For him ,it was too much change in a short period of time. It took another 2 weeks to get him out of there and back home to his assisted living facility. I literally had to really push to get him home. They started running all sorts of tests that had nothing to do with the “pneumonia “ that he was recuperating from. They phoned me to tell me that he was weepy and depressed and wanted me to sign off on a psychiatric evaluation. I refused. He was weepy because he wanted to go home and because of the dimentia , couldn’t verbalize what was wrong.
I’m happy to say that he out of there with visiting nurses and some follow up PT. It was quite an ordeal. He also lost 10 lbs because he wasn’t eating his normal meals in a dining hall with people that he knew.
Dimentia really wears you out. It’s tough. Hang in there. Thank God for support sites like this.
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My mother also experienced a steep mental decline in NH for rehab after a hospital stay. She was angry, paranoid, accused me of stealing her house and wanted me to call the police on her roommate who she said was running a drug ring and selling explosives. When she returned to AL she seemed to forget she ever had lived there for a while (it had been nearly two years). Some of her memory came back and she is no longer hostile, but she is not the same. At the AL staff told me they see this a lot. I doubt very much whether your mother can return home though a memory care facility might be possible. . I am also an only child so I know the stress you feel. I console myself with the thought that I don't have to argue with siblings about my choices.
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Hi.. My mom had same problem...in the elderly any change is very traumatic and confusing to them. Every time my mom went in hospital she was so confused even when she went home it took awhile. She is now in NH since she fell too many times and broke her tibia. She was so confused I. The first few months, but now she is doing great and has 24/7 care. Best to you.
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It's traumatic for someone of that age to be moved...and twice. That alone will create confusion, disorientation and decline.
I thought my mom was going to die. They also wouldn't let her walk due to being a fall risk. She bounced back though.
The other suggestions are good, too. Check for UTI and oxgyen levels.
All the best to you and your mom!
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My mother went through the exact same thing. It is difficult but persevere. Anger, paranoia, verbal abuse, confusion, she exhibited all of these things, At some point I realized she couldn't return home to live alone, even with home care. I found an assisted living to transfer her to directly from rehab, where she found gentle yet strong care. She didn't like that either, but at some level realized that she needed that care and I just couldn't do it all. She's been there two years. It's expensive, but we are dealing with it day to day balancing money and care and life. Good luck. Oh, yes, she will come back, but don't expect it to happen immediately. I'd say it took Mom 6 months to get her mental state balanced (as acceptable).
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Have they made some changes in her meds? Have you discussed with her doctor?
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Agreed that UTI, dehydration, and confusion can be affecting her mental status. Older people become "deconditioned" after hospitalization and transfer to a nursing facility for rehab. She is unfamiliar with the surroundings and the staff who are caring for her. Talk to the staff and her physician and request lab work. Then ask for a geriatric psychiatrist and her regular physician to evaluate her for competency. Do you have power of attorney? Does she have an Advanced Directive? Is she eligible for Hospice? Unfortunately, she may be at the end of life stage.
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See if they have made any med changes-that would be my first question.
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UTI Wife became an autistic 5 year old in 2011. UTI. Wife became an autistic 2 year old in 2012. UTI. We learned how to prevent UTIs. No UTIs since 2014. Wife never recovered and remains an autistic 2 year old. Doctors said women always recover from UTIs when sepsis cleared. Not so.
I have been caring for my wife at home 2011 - now 2018. Wife is still autistic 2 year old diagnosed as FTD frontotemporal dementia
I was recently in hospital 10 days and had an agency worker replace my home caregiving. Worker didn't follow the UTI prevention methods. I returned home to a wife with a UTI. It showed in her character. We cleared it in 2 days. New doctor confirmed that indeed some women do not recover from UTI sepsis.
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The experiences written here cover the gamut of possibilities so I will be brief. My mom steadily declined from a fairly stable, but acknowledged dementia, very functional in assisted living state. It was over a 2 year period of hospitalization and rehab stays, finally to memory care and nursing home. Having probable Alzheimers, the repeated assaults of change simply accelerated the process. This I learned as it happened and sadly was as unprepared as you are. While stories of full return to pre-hospitalization/rehab is wonderfully hopeful, I was finally told that is not the norm. The Alzheimer brain is declining anyway and these majorly out-of-routine, changes in health and environment does a real job on what is already happening. No ones fault. We all do the best we can with circumstances as they occur. Biggest help? Someone who can come alongside and inform when this is not in your prior experience. Best wishes to you for sure. Treasure moments of peace in the journey because they also come from time to time.
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I have not read all the responses but went through something very similar with my mother who passed a year ago ay age 95. I too am an only child and it is difficult to try to handle all this alone. The last 6 months of my Mother's life was hospital, Rehab, Care home and repeat all that. She had lived with us for almost 3 years but was needing more care so put her in a small residential care home. Her dementia was progressing. Doctor told me it was just old age dementia. I noticed a decline in her mental status during all this too. I was having to help her meat and she did not have much of an appetite. She was saying very strange things one day and I spoke to the Charge Nurse. They did lab work and she had a UTI. Once they started meds, her mental status improved, somewhat. So, yes, these UTI's can cause mental issues so have to be monitored. They are laying in those beds a lot and I woukd try to encourage her to drink more fluids. Truthfully, I knew I was watching a general decline, esp at that age. I can only suggest you keep on top of her care daily. Make sure you know what meds she is getting. Whether in the hospital or Rehab, first thing I would do is check with her nurse about her status, what she ate, had the doctipor seen her, etc. Any questions or concerns, talk to the nurse. I woukd call the Nurse's station every morning to check on her status. Most of these places are understaffed and can have a frequent turnover of caretakers. I would have them check for a UTI. Tell them you want it checked! Very hard to watch our loved ones decline but you have to consider her age and general health. Good luck!!
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Can you not stay with her?
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1 - a move shows how deep the dementia is because routines hide the deteriation - the move doesn't cause it rather the move high lights it because the routines are different - after a few weeks she may have same issue when she goes home
2 - she may be on new meds that make her a bit confused/not as with it, then add the above issues so there is extra problems
3 - how often does your family members 'fill in' for her - a friend said when they went with her mom for an evaluation but were not allowed to speak so when the mom was asked questions she repeatedly deferred to other family members to finish her thoughts ... however it was good for the family to see how much they were enabling the mom by finishing sentences, helping her with simple details, etc & they didn't really notice how much she was slipping because they 'covered' for her - does any of this sound familiar?
4 - your mom may just be showing her true colours of where she is in her long journey - she may actually be farther down the trail than you thought she was - those of us who have been there & seen that know where you are today & send our positive thoughts for you & your family
5 - check out 'TEEPA SNOW' who I call the dementia whisperer - well worth your time to start with 'TEEPA'S GEMS' then do some others - she has many videos from 4 to 9 minutes long - she has 13 just on how to visit someone with dementia that will open your eyes but there are many others ... WELL WORTH THE TIME
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make sure they're not giving her an anti-depressant. my mom was in a rehab facility and due to dementia she had meltdowns pretty much every afternoon. Their dr. prescribed zoloft and it made a zombie out of her. once we got them to cut way back on it she returned to more of her normal self, and after she got home and we got her off of it completely, it improved more. if she by chance is having meltdowns, try using lavender essential oil every day prior to the meltdown. it works!
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Dear Daughter,

Check all medications that are being given to your mom and research the side effects. Sometimes prescribed meds are not ALL needed, and can cause harm to the liver and the kidneys which can cause mental decline. Toxic medicine has negative effects on the entire body, mind and soul. Be vigilant as the advocate for your mother, in ensuring that proper care is being offered to your mom. Get to know the entire staff and make your presence well known. Discuss your concerns with the doctors and nurses. Don't except any old weak answer. Keep your mom well hydrated with good quality alkaline water. Daily, for my mom, I make fresh lemonade with the herbal sweetner stevia, to avoid blood sugar spikes. You may want to have your mother's thyroid checked for hypothyroidism, which causes a decline in cognitive ability as well as memicing dementia.
I have had to work like a detective, to ensure that my mom receives the best care possible coordinated with her primary doctor and the wholistic center that provides great care.
Stay Encouraged!
Many Blessings!
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When you mention your mothers skin color as "grayness", it is telling me she might be very dehydrated. This is the same thing that happens to my husband time and time again, because they don't monitor his fluid intake. He starts getting very confused, tired, sleepy, but most of all, the grayness of his skin. When I bring it to their attention, I will usually get a call that evening that they are going to put him on IV fluids because he's dehydrated.
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