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Why can there be such a rapid decline after the following:
bela
Posted: Tuesday, August 21, 2012 2:12 PM
Joined: 12/15/2011
Posts: 4105


 I am curious why hospitalization is so disasterous for AD patients or



 I met a woman recently.  Her mother with AD lived in a ALF.  The mother fell and broke her hip.  To the hospital then to a NH.  She died 11 days later.  Why does this happen?  Please help!


MacyRose
Posted: Tuesday, August 21, 2012 2:22 PM
Joined: 12/15/2011
Posts: 3935


Bela, it's not just the AD, it's the broken hip.  Most people who break their hips are elderly and most elderly have additional complicating illnesses such as high blood pressure, heart disease, diabetes and so on.  Because of this, post-surgical complications are much more frequent and it is much more likely that the patient will die from post-surgical complications.  That is likely why your friend's mother died.

 

You would have to ask your friend exactly what happened in her mother's case. 

 

"Postoperative complications were seen in 14% of the patients overall, but in those who were healthy before their fracture (i.e. had no preoperative medical conditions) it was only 9%.

 

The biggest factor affecting mortality was the development of postoperative congestive heart failure; those in whom this happened had 65% mortality after 30 days, and 92% were dead after one year.

 

A postoperative chest infection (pneumonia, bronchitis) was also a detrimental factor; mortality at 30 days in such patients was 43%.

 

Preoperative medical conditions were reported in 59% of the patients. They included cardiovascular disease, stroke, respiratory disease, kidney disease, diabetes, rheumatoid arthritis, Parkinson's, and cancer; 35% of patients had one, 17% had two, and 7% had three or more preoperative medical conditions.

Mortality at 30 days was increased in those with three or more preoperative conditions, particularly respiratory and kidney disease. And at one year, just about all the preoperative conditions played a role in limiting survival.

In particular, respiratory disease, taking oral steroid drugs, and greater age were important factors for developing a chest infection post-operatively. Similarly, preoperative cardiovascular disease and being male were risk factors for postoperative heart failure."

 

http://www.healthandage.com/hip-fracture


Johanna C.
Posted: Tuesday, August 21, 2012 3:46 PM
Joined: 12/9/2011
Posts: 10227


Dear bela:   What a sad situation to have happen and I can understand your concern.

 

Every single person and situation is different from anyone elses.  What caused this particular death is not known.  Many complicating factors could have been at play and the death could even have been from something totally unrelated to the fractured hip and facility stays.

 

There are many of our Loved Ones that are hospitalized and go to Skilled Care and do quite well, so as said, it is different for each patient.

 

We have a member whose spouse has AD, lives in a Memory Unit and very recently required an abdominal surgery.  The spouse did extremely well and returned to the Memory Unit in very good condition and in excellent recouperation, in fact, did not even recall having had the surgery; so one never knows.

 

Sometimes, for some of our Loved One's, when they are hospitalized, they become very unsettled and sometimes even agitated and sometimes appear to lose some of their usual abilities in cognition and function.

 

Interestingly, in such situations, much of the time the cause is "delerium" which is absolutely reversible - you can Google this with the words, elderly hospital delerium, and a good amount of material will come up.  The unfortunate bit regarding this, is that many physicians and other healthcare staff fail to recognize such cases as delerium and attribute it to the dementia instead.  Delerium is not long lasting and can be treated, so it warrants a bit of research.  It is good for us to read about this and remember it for future reference should our own LO have such an instance occur so it can be discussed with the MD.

 

As for deaths which follow hospitalizations, our elders are at much higher risk secondary to their advanced age, their other identified and possibly unidentified health conditions and are of course, at higher risk for complications.  Some complications do not occur right away, but can happen weeks later.

 

Rest assured,  that many, many patients do actually do well and do not sustain such outcomes, so that is something to think about.  You care so well for your dear mother and always strive to do your best, I can understand your wanting to learn more so you can be protective of her.

 

I send you best wishes,

 

Johanna C.


Nora
Posted: Tuesday, August 21, 2012 3:49 PM
Joined: 1/23/2012
Posts: 2270


Alzheimer's Reading Room today has an article about this topic:


http://www.alzheimersreadingroom.com/2012/08/Alzheimers-Delirium-Hospital-Mental-Decline.html


bela
Posted: Tuesday, August 21, 2012 8:07 PM
Joined: 12/15/2011
Posts: 4105


THanks MaryRose, Joanna (sp) and Nora.  

Before I posted my concern about hospitals for patients with AD I googled it and got a delirium page and read up on it and copy/pasted it for myself.  Correction:  the article was in the AD reading room.

 

You are absolutely right, just what the article said, doctors and nurses often don't recognize delirium and there are ways to help your LO during their hospital stay.

 

Your comments were helpful and have made me less scared.  Thanks, always, so much for sharing your wisdom and knowledge.  

 

I wouldn't be where i am without you wonderful individuals.

 

 


ADandHFA
Posted: Tuesday, August 21, 2012 9:13 PM
Joined: 7/26/2012
Posts: 90


In a recent Alzheimer's seminar, I learned that a person with AD must have something familiar in the room with them at a hospital, or their chances of survival are greatly diminished.  So, if your loved one needs to be hospitalized or moved into a nursing home, you should be sure to take along something very familiar to them to place within their line of vision or to cuddle in their hands, be it a quilt, stuffed animal, or other such special item.  

 

Just a thought . . .