Struggling for life, absolutely terrified


I can still hear her.

"Please help me," she'd say for hours at a time, squeezing my hand as tightly as she could.

There was terror in her eyes whenever a new nurse or doctor entered the room and came toward her bed.

"Who are you?" she'd cry, then squeezing my hand with both of hers, digging her nails into my flesh.

My 88-year-old mother's last days in the hospital were pure hell. There is no doubt that she thought the members of the hospital staff were trying to kill her.

When she developed pneumonia in January, she was transferred to the hospital from the Michigan Alzheimer's care facility where she had lived.

I knew her dementia - Alzheimer's had robbed her of much of her memory, thinking, language and judgment - would make a hospital stay difficult, but I didn't realize how difficult. At her care facility, she had been comfortable.

My brothers and I hoped that if we stayed with her around the clock it would erase her fear of being in a new place, and at times it did. But whenever she received medication to calm her down or to sleep, she grew more agitated. She couldn't sleep.

Not until I read a story in the paper the other day did I really understand what she was experiencing. The story dealt with a study published in the June 19 online issue of Annals of Internal Medicine. Investigators found that for people with Alzheimer's disease, a stay in the hospital accelerated mental decline and increased the risk of going into a nursing home or dying.

And for those who experienced delirium, a state of heightened confusion or unusual mood or behavior, the chances of a poor outcome, including death, increased by about 12 percent.

My mother definitely experienced delirium.

Dr. Charles Bernick, associate medical director of the Cleveland Clinic Lou Ruvo Center for Brain Health, is aware of the study done on 800 Alzheimer's patients in Massachusetts.

Just like the study's researchers, he said the best thing to do is avoid hospitalization.

"But care outside a hospital is not always possible," he noted.

He said hospital staffs are generally not trained to deal with people with cognitive impairment.

Sleep medications, narcotics and anti-anxiety drugs actually make someone with Alzheimer's more confused and more agitated, Bernick said.

That certainly happened in my mother's case. She got them all in a well-meaning effort to settle her down. And she only grew more agitated, more scared. She fought breathing treatments. She couldn't get well because she couldn't relax and rest.

"It would be good for hospitals everywhere to go through training sessions," he said. "The number of Alzheimer's patients having to go to a hospital for some treatable condition is only going to grow."

Spokeswomen at both University Medical Center and St. Rose Dominican Hospitals say no specific training has been done for Alzheimer's patients. Attempts to reach spokeswomen at Sunrise and Valley Hospitals for comment were unsuccessful.

With 77 million baby boomers heading into retirement, the Alzheimer's crisis grows daily. The disease is expected to affect close to 16 million Americans by 2050, double today's number.

Just as it is imperative for hospitals to learn how to deal with Alzheimer's patients, it is imperative for their caregivers to learn which drugs they can take.

I didn't know, so I didn't speak up when doctors and nurses trying to help my mother gave her medications that only made her more agitated. Her death certificate says she died of pneumonia. But I know she was literally scared to death.

Contact reporter Paul Harasim at pharasim@reviewjournal.com or 702-387-2908.

 

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