I hope your father in law is improving somewhat at least.
It is common for elderly patients to have a cognition decline simply because of a change in surroundings like a hospital stay. Of course for something like that they are also having a medical crisis at the same time so that may have some affect as well. Many times they experience a rebound effect as their medical condition improves and are able to either return to familiar surroundings or return home.
Agreed. My grandmother did this several times when hospitalized during the final decade of her life. She always recovered when she went home following her hospital stay.
I've seen this countless times as a nurse also. Not only can it be a frightening experience for family, but it's frightening for the person experiencing these changes. I've had older 100% lucid patients who came in for simple overnight procedures (like a hernia repair or similar) who experience "sundowners" events and they were horrified when their clarity returned. It's a scary thing knowing that you cannot always control your own mind. And... there's no way to know who might experience these types of symptoms/events until it happens.
These events do seem to relate to:
1. disorientation (change in environment), combined with
2. stress on the body (illness or injury),
3. changes to or addition of medications,
4. compounded (I believe) by lack of rest/recovery time.
This last one is underappreciated, I think...
I work on a surgical floor, with patients who have had various surgical procedures from hernia repairs to hysterectomies to knee replacements or surgically repaired fractures.
I'm required to assess my patients every four hours - i.e. fully wake them, check vitals and their response to our treatment (like ensuring the circulation status of an affected limb - you can't really ensure all is well if your patient is sleeping), monitor their orientation status because clots and strokes are always a potential risk, etc)
How many of us would respond well to be jarred awake every four hours, possibly for nights on end?
We have IV pumps or other equipment which will beep through the night. We change out fluids or antibiotics (which includes scanning arm bands and confirming the identity of our patient. We try to combine all these interruptions, but it's still an interruption.
The bed is different, the blankets are different, the lights are different, their are different sounds. All of which can interfere with sleep (shoot, you can experience this on vacation).
There are people walking outside the door with rolling equipment at all hours. There are noises from the room next door (or even from a few doors down).
AND I'm required to perform hourly room checks (even if I just lean in quietly this can disrupt light sleepers).
Some people can be reoriented quickly, others may remain confused throughout their stay.
Full on hallucinations (there are cats climbing on my walls) are not uncommon.
Some patients fluctuate between oriented and disoriented. Some can be reoriented quickly with a few reminders (you had surgery, you were in an accident, I'm a nurse, see my stethoscope?)
Some trust NO one, not even family ("you're all in on it"... That's a rough one.)
Oh, my mother-in-law basically never left. We had to beg her. One night she did let DH spend the night. Another night, one of his other brothers stayed. One afternoon, she went home to shower & run some other errands. But a family member was always with him.
And you're so right about the familiarity & the trust of family members over unfamiliar medical personnel. The nurses & techs would give his meds to either my MIL (or one of his sons if she just happened to not be in the room) to give to him - that was the only way he'd take them.
The window of his room overlooked a lot of "industrial" pipes & metal boxes on the roof from the other wing of the hospital. That was basically his "view." The neuro surmised that, for whatever reason, that view triggered him into thinking he was back at his former place of employment where he worked w/ a lot of machinery.
On two occasions, I've even had the family of patients, (someone like your MIL...) who suffered a sundowners type event while staying at the hospital with a family member. That's quite an experience for everyone involved. They may not be our patient, but their health and safety is in our hands also.
Sorry to get so far off track, but I can't help sharing when this topic comes up, it's a complication of hospitalization that is near and dear to me since I see it so often and the stress it can cause. Blessedly, we often have only to wait for dawn (or discharge) for things to improve.
In the case of alzheimers/dementia (like the OP's father) this is a process that is not going to improve or change. Imagine dealing with these types of symptoms day in and day out for years as a primary caregiver when you yourself are elderly. It's no surprise the OP's mother is struggling. I hope and pray their family can come together to give her more support and assistance.
God Bless all the posters who have shared in this thread, having been caregivers to family with these issues. You are a true blessing to your loved ones...