Anaesthetics – avoid them if you can!

Ma’s health in the last 6 months or so has been a bit of a nightmare, one you want to wake up from and go back to the way things were before.  It all started with her UTIs (see my other post) and subsequent hospitalisations and the discovery of kidney stones (both sides).  This led to anaesthetics in January, March and May.  Each hospitalisation and anaesthetic resulted in delirium with paranoia, confusion, hallucinations and disorientation…

My Ma is one tough old bird and managed to recover quite well after the first two surgeries however the last one in May has left her with a long lasting delirium which comes and goes as it pleases.  A month later and she is still suffering disorientation and confusion with the occasional hallucination.

When I picked her up the day after her operation she was highly paranoid and didn’t believe she was in a hospital, she had flushed her medications down the toilet and was demanding I get her OUT!  The nursing staff were highly unsympathetic and probably couldn’t wait to see the back of her, subsequently, I didn’t get any aftercare instructions.. but that is another story (oh I have sooooo many).  Back home:

• she didn’t believe it was her house even though she had been living there for 50 years;
• she couldn’t find her bedroom or toilet (this still happens on a daily basis);
• she constantly refers to returning to another house, room, place;
• thinks people are in the house;
• sees people in the house wearing her clothes, interfering with her walker;
• thinks she is locked in to the point she has a full on ‘melt down’
• she has no sense of time, in the dead of night she thinks it’s time to get up.

In the beginning I had to stay with her constantly.  In about a week I thought she’d recovered, on the weekend she was ‘normal’, finding her way around the house etc. I went back to work and by Monday afternoon she had regressed back to where she was when I’d first brought her home from hospital.

Ma’s doctor and geriatrician both attended with the geriatrician blaming the anaesthetic and her pain medications and he believed she would improve although there was a possibility she could remain the same.  He said she did not have dementia.

Even now as I sit and write this, nearly a month after her operation, she still ‘loses’ the toilet and her bedroom.  In the beginning I tried to convince her otherwise and learnt that the only thing I was doing was making the situation worse.  I think I was causing her extra stress which was making her delirium worse.

Things I do:

• signs in the house with arrows pointing the way to her bedroom and the toilet;
• if she insists the room isn’t her room I’ll ask her to stay there for me for the time being;
• if I’m not there and she is getting disorientated, I re-orientate her over the phone by asking her to describe where she is and then ask her to turn her radio on or read a book until I can get there;
• She has two cats that are constantly on her bed which I thank God for every day.  They orientate her!  I just have to mention that’s where the cats are and she will settle down with them.
• As the afternoon gets later I will ring her every half hour until I’m leaving work giving her a count down.

Some days are worse than others, I’m very blessed I have a job where I can work from home, access carer’s leave and flexible working hours.  Every day is an adventure, I never know quite where she or I will be.  Some days I just want to have a good howl.  When I feel myself ‘losing the plot’ I grab a glass of wine and head to what I call the ‘naughty corner’.  A good time out for 15 minutes gives me the strength and patience to come back and deal with the situation.

Tips:

• I can highly recommend the Dementia Australia’s Fact Sheet on ‘Anaesthesia for older people and people with dementia’ for a valuable insight.
• Discuss your concerns with the Aneasthetist.  Ok, so it didn’t work for ma but you will be more informed than I was!
• If they are disorientated place signage in the house with arrows to show the way.

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