My father (76/3) was hospitalized in December after a fall.
Before his hospitalization, he had some episodes of confusion,
but could walk, feed himself, and generally function with some
assistance. He had some bouts of hallucinations/paranoia,
possibly due to Sinemet (although he wasn't taking a huge
dose... 5.5 25/100 (I think 25/100) per day).
He was not seriously hurt by the fall (onto carpet), but the
doctor wanted to observe him, so he planned for Dad to stay
in the hospital for a couple of days. He wanted to do an MRI
and some other tests.
About 24 hours after going into the hospital, he became
very confused and occasionally violent, and they had to
restrain him to prevent injury to himself and others. The doctors
cut off his Sinemet, and put him on Haldol. As I understand,
confusion after hospitalization is not uncommon. However, this
has lasted for five weeks or so.
A week or so after Dad went into the hospital, he was not
eating or drinking much, but I discovered that he would often
bite, chew, and swallow things (orange sections, ice cream) that
were placed in his mouth. He was delerious, and often muttered
incoherently, but he would stop trying to talk when hand fed
palatable foods. The hospital staff was NOT trying to do this,
however... it was apparently more convenient to put an IV in
him (which he wanted to pull out).
I also made the hospital put a humidifier in his room, since
they kept the rooms at 73-plus (that's 23 C for Europeans and
Australians) degrees in mid-winter, when the outside air is
very dry. (Brilliant, when you have a patient who is not getting
enough moisture... I'm not even a health care professional. You
can lose a lot of moisture through your lungs.)
I therefore hired private duty nurses' aides, at considerable
expense, to stay with Dad 14-16 hours a day, and hand feed him
juices, oranges, ice milk, and so on. As time passed, he became
less agitated, and he was discharged to a nursing home for
physical, occupational, and speech therapy.
Although he is much less agitated, he is almost immobile
(the doctor took him off the Haldol and later started him on
Eldepryl: Dad is displaying what I think is the "Parkinson's
mask.") He is still very confused, cannot talk coherently, and
cannot cooperate well with the physical therapist. I still have
nurses' aides with him 14 to 16 hours a day.
Is there anything the doctors should be looking for that they
haven't? They did a CAT scan, which came back negative for
anything like a stroke or hematoma. They also did an EEG and
EKG after what seemed like a seizure (in the hospital). Did
someone mention that hypothyroidism could cause dementia
in elderly patients?
What's really disturbing is that he's far less functional than
he was before he went into the hospital. The problem started
about 24 hours after he was hospitalized. His inability to walk
doesn't surprise me, since they had him in bed for almost a
month and (as I understand) failed to obey the doctor's
instructions to sit him in a chair for a while each day.
Any advice/help would be useful. Dad's primary doctor
is a gerontologist, and I think he is good (he has a clear
explanation for everything he does, and it sounds rational
to me), but is there anything I should ask him to look for?
-Bill
