Wednesday, February 03, 2010 NC asks

Q: Hospital stay

Could someone please tell me why my father-in-law who has moderate/severe Alzheimer's thinks that people are trying to kill him in the hospital? He went there Monday and is coming home today. But for the last 2 times in the hospital stays in 2009 and 2010, he thought he wanted to be killed there. Later he wanted to die due to such confusion.

Why is that? What caused this confusion? I can understand he wants to go home and eat at home, but to say people are to kill him in the hospital? He thinks hospital staff is crazy. But he wanted to go to the hospital when he was very sick with bad flu Monday and later on he decided that he didn't need to stay there anymore so he didn't cooperate anymore.

He has not slept for 2 nights just because he hated the people there thinking he would die. Caregivers could not convince him that it is ok to sleep and he won't die???

Nina

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Answers (2)

Dorian Martin, Health Guide

2/ 4/10 10:43am

Hi, Nina,

Based on my experiences with my mom during hospital stays, I believe that going to a hospital is a very disconcerting experience for someone with dementia, especially as the disease advances and distorts the loved one's reality. First of all, there's a lot of activity with "strangers" (nursing staff, physicians) coming in to poke/prod the patient on a regular basis and strange contraptions (IVs, EKGs, etc.) that may be hooked up to the loved one's body. And the activity-level is constant - 24/7. Also, if your dad's sharing a room, that situation can be stressful based on what the other patient is dealing with health-wise; your dad may be picking up on the health issues/treatment that is happening with that patient. And finally, in my experience many hospital staff members are not trained in how to deal with a person with dementia and don't have time to spend with the person to calm them down. Often the loved one with dementia is left alone in the hospital room, potentially with a TV on. And in my experience, the TV is not set to a soothing program (such as the old classics), but instead to news or sports, which based on my mom's experience, tends to be interpreted as being a situation that is actually happening to them.

Therefore, I'd suggest that if a loved one with dementia is placed in the hospital, the family member should be a regular presence in the room early on to help calm the loved one down. The family member can help interpret things for the loved one and for the hospital staff, and set some guidelines (such as what's played on the TV).

Dorian

2/ 4/10 11:03am

The family didn't help my FIL either. What happened was when my husband was there in 2009, he blamed him and me saying we wanted to kill him and he said he forgave us!!! Back home in 2009, he asked where to bury him!!! For 8 months, he asked to die thinking we can kill him.

This time, like you said, he was so mean to the roommate that he walked there with the cane and iv and told him to get out and this is "my house"??? Oh Lord! So they put him in a private room ASAP so he does not bother the roommate. (For my own Dad, they took forever to get a private room because my Dad does not have dementia.)

This is definitely a proven fact that my FIL will be very irriated and he could be the one that kills someone!! He is tall and hot-tempered if he wants to defend himself. No, even the son is also hated. He does not care when he felt he is against the world.

The family or familiar caregivers can comfort him but cannot change his wrong mind. Telling hiim things are ok only convince him that we all want to kill him.

Looks like he may not be able to go to Vermont this summer. Will see. He hates strangers.

Thanks for the post,

Nina

Dorian Martin, Health Guide

2/ 4/10 10:48am

Hi, N.C.,

One more thought, based on my mom's experiences as her Alzheimer's progressed: Be ready for your dad to be "discombobulated" when he gets home. I found that when Mom was in the hospital for several days, she was really disoriented for a period of time when she returned to the nursing home. She eventually seemed to right herself, but it was a little disconcerting.

Take care!

Dorian

2/ 4/10 11:23am

You mentioned that the hospital staff or nurses may not have the training for dementia people. It is so true. My FIL's home care nurse kept telling the head nurse or nurses that they need to be patient and that she can help out if my FIL refuse the nurses' actions.

My FIL's home care nurse told me the nurse needs to have patience and etc. She said they do have the tool to calm down a dementia patient according to her own experience at work for 18 years. So the nurses do know somewhat what to do, not that they know how exactly. My feeling is that these nurses are not for dementia care so naturally they won't bother. However, they used the caregivers to avoid the hard work. Seeing my FIL's caregivers doing all those nursing work (they literally changed the stuff and feed him medications), they actually expect them to do it without a break!

There is definitely an issue about hospital staff handling dementia patients.

Nina

Q: Hospital stay

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