Helen Chapman is my mother. She turned 98 last August. Mom had been living independently in her own condo until very recently. I saw to most of her needs but she is unstable on her feet and had fallen twice in the two weeks preceding her recent hospital stay. Neither fall was serious although she did tear a patch of skin on her forearm in one of them. She also has short term memory problems resulting from a stroke that she suffered about 8 years ago but that doesn’t really affect her ability to function. Her long term memory is pretty good but more and more she is not able to recall things like when she moved to Minnesota or what her last job was.
On Thursday, October 16, I got a call from someone in her condo building that she was in the lobby talking strangely and unaware of where her own condo was. This was not usual behavior for her so I rushed right over. (I live in the next building.) When I got there she as clearly confused and was having auditory hallucinations – constantly hearing music. She was talking about wanting to call her sister-in-law, who passed away a year ago, so that she could in turn call Grandma, my mother’s mother who has been dead for almost 50 years, and tell her that she was coming home. This was eerie and upsetting to say the least. The woman who called me accompanied me and my mother back to Mom’s condo and we talked for awhile until we all gained some composure. I left Mom in her condo for awhile and returned to my own condo to take care of a few things but soon I got another call from someone else in her building telling me the same story as before. This time I went over and got Mom and brought her back to my condo.
Norma is Mom’s best friend and she lives down the hall from me. I called her and invited her over. The three of us talked for an hour or two and, while Mom recognized and was happy to see Norma, she continued to hear the music and make odd comments. As soon as Norma left, I decided that I needed to bring Mom into the emergency room to see if there might be a medical reason for her sudden change. My older sister thought that it would be useless – that Mom was just demented and that there would be nothing that fix that. But the suddenness of her decline made me uncertain if that was true. So off we went to Methodist Hospital ER in St. Louis Park. And I am glad we did.
Mom was diagnosed with a UTI (urinary tract infection) and minor dehydration and was admitted to the hospital. That night they put her on a saline drip for the dehydration and an antibiotic to kill the infection. The doctor explained that they immediately suspected the UTI because of the sudden confusion. He explained that what she was experiencing was delusion, not dementia, and that it is a very common result of infections in general and UTIs especially. He gave me an information document about delusions and it described exactly what had happened to Mom and even said that the most common cause in elders is infection. Apparently the infection causes a chemical change in the brain that in turn causes the delusions. This was all news to me but a very important thing to know if you have older relatives or friends who have a sudden change in behavior. Interestingly, Mom did not have a fever.
By morning her infection was gone and she was no longer hearing music. Her confusion was not completely gone but she was no longer obsessing about letting her mother know that she was coming home – which was a big relief to me. Before releasing her, the doctor wanted Mom to be examined by both a physical therapist and an occupational therapist. The PT determined that she was not stable enough on her feet to be released to her own condo. She had to have 24-hour supervised care from now on. The occupational therapist did a mental capacity test, which Mom did very badly on, scoring a 4 out of 30. It was very painful to watch her struggle through the test. She confirmed the decision of the PT that Mom could not return to independent living.
It took all day Saturday for the damn doctor to get back to us about releasing her – not answering her page or phone calls from the nurse for six hours. (I hate hospitals and the interminable waiting.) But finally she sent in a release order and after the nursing staff set up home visits from a nurse, a PT, an OT, and a personal care (bathing and hair washing) professional, she was released to me – as long as I indicated that she would come home with me and not back to her condo.
And so it is now that Mom is sharing my one-bedroom condo with me. It has been 11 days now and there are challenges but Mom is getting much better. Her weight as of Monday was 100 lb, up from 96 when she went into the hospital. We are eating three meals a day,something that she was not doing when living alone. I always saw that she had a good evening meal but breakfast and lunch were up to her and more and more she wasn’t fixing anything for herself. So this is a big improvement. I also try to enforce the no-walking-without-the-walker rule and she is pretty good about it but sometimes wanders down the hall to the bathroom without it. I do gently scold her though and the PT and OT and nurse who visit us twice a week each, all reinforce need to be good about using her walker. I also make her drink a few glasses of water every and she always grimaces a bit but then downs the whole glass. So that is another big improvement – she hardly ever drank water before.
Today the home care OT came and re-administered the mental capacity test (I don’t think that is the exact name). It was the identical test that she took in the hospital but this time she did much better, scoring 14 out of 30. It is still a little painful to see her struggle to answer questions that she wouldn’t have had any problem with even a few months ago.
Well, that’s it for today. I took videos when she was doing her PT exercises and will post them and some photos as soon as I figure out how to do it with WordPress.