ICU psychosis?

[krcit]

Anyone familiar with it? My mom has been in the ICU for 2 weeks now and finally seems to be turning the corner. However, she is so confused. This woman is sharp as a tack normally but not now. She keeps asking where my dad is and he has been dead for 20 years. It's so difficult but I'm assured it's normal? they say with what she's been through..major surgery, septic shock, pneumonia and being in the ICU she just is confused. It's breaking my heart. They may be moving her to a step down unit in the next few days and said that should help. Anyone been through this? I'm on such a roller coaster..preparing for the worst and then she gets a bit better...then a step backward. So draining.

 

[Chernabog#1fan]

I am not familiar with it, but just wanted to say that I am sorry you and your mom are going through this. I will keep the 2 of you in my thoughts and prayers.

 

[mom2kazkids]

ICU RN here, yes ICU psychosis does happen. As I tell my patient's families, there is really no night and day in the ICU, assessments, and medications happen around the clock. In our unit the doors are glass and we do not pull curtains all the way when we are not in the room with the patients, so it is never dark for true sleep.

Also I am sure with all that she has been thru she had lots of sedation and pain meds, so those too can linger and cause confusion.

I wish the best to you and your mom.

 

[Agri]

I'm not familiar with it either. (From the above description, it sounds like my mom DID deal with it even if it wasn't specifically labelled as such.)

FWIW, my mom was in ICU a few days following her brain surgery and she was always confused until she got into the step-down unit. She wasn't eating properly, they would wake her up to take her vitals and ask her questions (which she would frequently answer wrong because she's a heavy sleeper and would do the same thing to me years and years before the surgery), and well it's post-major surgery! Painkillers and just generally feeling out of sorts is going to happen. My mom's medicines were also screwy - they had her on dilantin which more than did not agree with her.

There was less *constant* attention in the step-down unit, so she was able to finally really sleep as much as she needed to and after a few days she was much improved.

A lot of her problems were later attributed to the dilantin - I was panicking when they told me they were going to discharge her because she was just so 'floppy' and I'm her only relative for the most part, but it turned out that it was hard for her to maintain the right amount of dilantin in her body and once she was off the medicine she was like a whole different person. She went from being dependent on a wheelchair and needing assistance to go to the bathroom to being able to walk freely without assistance! So that's another thing to consider - some of it might be wacky side effects from some of the medicines she is on, too.

My mom was asking for people I know she didn't *really* want, a lot of what she said was out of years of habits. I just ignored a lot of it and told her to go back to sleep. (She asked for my dad, a real scumbag who had left her years before, my grandmother who had passed away years before, and my grandfather - who was in a nursing home and only 'with it' on his very good days. When I told her when she was feeling better what she had asked for while she was in ICU she laughed and said "Well, that was stupid!"

I know the circumstances are different, but I hope you see a difference when your mom moves to the step-down unit, too. It was definitely a scary thing to deal with because they originally thought they were just going to go in and it'd be a simple surgery and she'd be out of the HOSPITAL in 3-4 days. She wasn't out of ICU until her 4th day!

Maybe see if they'll let you bring in her favorite food for her to eat when she's moved? Our ICU was very strict about bringing in outside food, so I don't know if you can do it now. (I was allowed to bring in stuff her last day in the ICU because she was refusing to eat any of the hospital food and they thought as long as they got something on her stomach it might trigger her desire to eat.)

I also brought my laptop so she could watch things that I knew she liked to help trigger good memories - that might help with your mom, too. Hospitals can be so sterile and unfamiliar, I think that can add to the feeling of confusion. Anything familiar you can bring in might help her, too.

 

[krcit]

Thanks guys. I can't bring food because she can't eat I will bring pictures when she is in a real room.

 

[christineann]

It's called "sundowner syndrome" and is not at all unusual. I became all too familiar with it when my dad was in the hospital after suffering a lacunar stroke. He is mentally sound, but he was seeing things flying above his bed and thought there were people painting the walls of the room, etc. Every night was like that. A few hours later he was speaking with the CEO of the hospital, who went to the same college he did, and Dad told him every dorm he had lived in, who his roommates were, etc. Dad was in the hospital for 10 days, and he does not remember a minute of it! He was fine once he came home.

Please hang in there. It WILL get better if it's sundowner syndrome. Ask your mom's doctor or a nurse about it. to you.

 

[Agri]

Thanks guys. I can't bring food because she can't eat I will bring pictures when she is in a real room.

Pictures would probably be good.

I'm quoting you because I remembered some other things I did for my mom that really helped her.

I would bring her something from her room everyday when I visited her - like trinkets from her dresser, etc. When she was in ICU, of course, I took it back home with me, but I would bring her something that she saw everyday and asked her questions about it - when she got it, why she liked it, etc. She'd hold it for a little while (for the short time she was awake) and it was like having a bit of home with her. Once she moved, I brought something new to decorate her room everyday. I also had pictures on my cell phone that I'd show her of our pets and some rooms in the house and would give her a pep talk when she seemed down.

Another thing that happens in the hospital is that its so easy to lose track of time (and thus, reality). I made sure everyday that I talked about what day it was and what was going on in the world - something to really remind her of the passage of time. Even if it was "today is Thursday and its chili bread bowl day in the cafeteria", it helped her.

Again, different surgery and circumstances, but her therapists said what I did really helped her because when people are in the hospital long-term, its easy to just sort of 'veg out' mentally and anything that helps exercise the brain is good for them. (It was just more important with my mom because her surgery involved the brain.)

 

[Luv Bunnies]

My dad experienced something similar after his surgery in December. He had a benign tumor removed from his chest wall and had a chest tube in for four days. To counter the pain of the chest tube, he had a epidural in place. It delivered medication that numbed him from the chest down, but the nurse explained that it went throughout his body and was making his mind foggy. In the four days he spent in ICU, he only remembered my sister coming in once, even though all of us were in twice a day. I sat and watched him have lunch one day and he didn't remember it at all. He told me he had been out in the parking lot in his hospital gown and it was cold. He told my mom he was walking in the hills that he could see from his room, but the park ranger told him to leave. He said he'd been chewed out that morning by a police officer (my dad is a retired police officer) because he was trying to find out why the officer was walking around the ICU (didn't happen). He also told my mom that my 12-year old son drove to Las Vegas and was wondering why I let him do that?

My dad is 85-years old, but is sharper than most people I know! The nurses assured us that he'd clear up as soon as the epidural was pulled. We were a little worried, but hoped they were right. Well, they were! As soon as all the tubes were out and he was moved to a regular room, he was back to normal. He couldn't remember much about his ICU stay and certainly didn't remember all the strange things he said. He still can't believe it when we tell him all about it. He can just laugh and trust that we're not making it up.

I hope your mom does well. I have a feeling she'll be fine when she gets settled in another room and things get back to normal for her.

 

[nmmom95]

I was in ICU for 5 days and I was seeing things that weren't there. I also claimed that I was doing things that I did not do. For example, I told my family that I changed the sheets on the bed. Now considering that I was on a vent and had iv's in both arms and my neck, I'm gonna say it didn't happen. I think mine was mostly caused by medications, but it went away in the step down.

 

[laurie31]

Anyone familiar with it? My mom has been in the ICU for 2 weeks now and finally seems to be turning the corner. However, she is so confused. This woman is sharp as a tack normally but not now. She keeps asking where my dad is and he has been dead for 20 years. It's so difficult but I'm assured it's normal? they say with what she's been through..major surgery, septic shock, pneumonia and being in the ICU she just is confused. It's breaking my heart. They may be moving her to a step down unit in the next few days and said that should help. Anyone been through this? I'm on such a roller coaster..preparing for the worst and then she gets a bit better...then a step backward. So draining.

It's not uncommon at all, due to the mix of sleep deprivation, pain, and lots of medications. It happened to DH's father last summer. He didn't recognize my DD12 who he's seen 3-4 times a week since she was born, and was talking complete nonsense. He's back at work full-time now, and was back to himself long before he got out of the hospital.

It happened to DH's grandmother too, years ago. She was VERY sick (nearly died twice) and was in the hospital over 2 months. It actually took her awhile after she got home before she got "right" again, but she finally did.


Oh, the two steps forward, one step back is classic for ICU patients. Frustrating but normal.

 

[SandrA9810]

My grandmother had a TIA and after being in ICU for a few days, she got very very loopy. But they put her on a drug that makes loopy people more normal in the head, well it'll take a normal person and make them loopy. Once she was off the drug, she was fine.

One advice that my aunt received from a nurse there, was to put any of those kinds of drugs on her "allergy list". Doctors won't administer something if they believe the patient will have a reaction to it. My grandmother gets loopy enough after a TIA, she doesn't need drugs to make it worse.

 

[LuvOrlando]

That must be scary to see, I hope your Mom stabilizes soon OP.

I just leaned something new.

 

[allison443]

OP we went through this with my father a couple of years ago. He went into the hospital for surgery, ended up having a heart attack during surgery, ended up in the ICU. In the morning before he went into surgery he was doing the NY Times crossword puzzle (in ink ) and that night he didn't recognize us family members, didn't understand where he was, was combative (the complete opposite of his very calm personality.) It was very frightening.
The nurses described it as "hospital psychosis" and it took a good 5 days before he came out of it.
He was in the hospital for maybe another ten days, then rehab for about two weeks. He doesn't remember any of it which is the really weird thing.

I'm sorry you're going through this with your mom and I wish you the best.

 

[suemom2kay]

It's called "sundowner syndrome" and is not at all unusual. I became all too familiar with it when my dad was in the hospital after suffering a lacunar stroke. He is mentally sound, but he was seeing things flying above his bed and thought there were people painting the walls of the room, etc. Every night was like that. A few hours later he was speaking with the CEO of the hospital, who went to the same college he did, and Dad told him every dorm he had lived in, who his roommates were, etc. Dad was in the hospital for 10 days, and he does not remember a minute of it! He was fine once he came home.

Please hang in there. It WILL get better if it's sundowner syndrome. Ask your mom's doctor or a nurse about it. to you.

Sundowner's is a form of dementia and it is chronic. What your Dad experienced is ICU psychosis. Between the stroke and the ICU setting as described by the other great nurses here, it causes the halucinations, etc.

Sundowner's tends to start at Sundown and end at daybreak. ICU psychosis generally doesn't break without medication or discharge from ICU.


I hope your Dad is doing well now.

 

[Christine]

My uncle gets hospitalized all too often AND several stints in the ICU. He always seems to have episodes of hallucinations. It's odd.

 

[indimom]

I'm with the others, very normal, but very scary when you are witnessing it firsthand. My grandmother got like this when hospitalized. It upset my mother (her caregiver) a lot because she didn't think she could come back from it. Once she was home again, she was fine. Completely back to normal. She lived to 96 and was sharp as a tack right up to the end.

My mom was hospitalized in a regular room, with a roommate, for about a week when her blood pressure went out of control (She was around 60). They had her on tons of meds trying to regulate her blood pressure and get it back down in the realm of normal. And her roommate was keeping her up at night wanting to talk and watch TV. And, even she, had a few loopy moments. She wasn't sure if things happened quite the way she remembered, etc.

 

[gator75]

Thank god someone posted about this and i opened the thread. My mom is having open heart surgery in 3 days and the DR has warned us that this may happen. she will be in ICU for at least 3 days and they said it usually happens. Thanks to everyone for sharing you experiences.

 

[EMom]

Years ago. my mother was in the ICU for 2 weeks, near death. At some point, when she was able to talk, she told me about watching the gray and white kitten playing above her on the ceiling and how it kept her entertained. (She was looking at the acoustic tiles.) A few months later, she did explain that on some level, she had known that the kitten wasn't really there, but it had been such a comfort when she was (rarely) conscious that she just went with the flow.

Then she went to cardiac ICU for at least a week and seemed okay there. Weak and slept a lot, but okay. From there, she went to a regular room for another week and that's when we noticed the weirdness. It would take too long to explain, but she'd have decent stretches of bieng herself and then just lose her mental faculties. Suddenly. She'd be unable to use the right words, start frantically searching for things that she could not explain, get lost in a fog.......so many odd things. We thought it was a stroke, but they said it wasn't. The hospital discharged her since there was nothing to treat and we had to take her home. She lived alone.

It was summer and I was a teacher, so I stayed with her. She could not be left alone for 5 minutes because you never knew when she might "lose her mind." One night, my sister stayed with her and our fragile mother spent the entire night moving furniture and TVs and could not be stopped. I was at the point where I thought I'd have to quit work and move her in with us, because I refused to put her in a nursing home and she could not be left alone. (She was in her mid-60s.) For 18 days after leaving the hospital, she was like this.

We kept logs and noticed that when she got a decent amount of sleep, the craziness would stop for a while. Sleep seemed to change things. We took her to a neurologist, who couldn't really find anything and of course, she was fine and dandy and sharp as a tack during the exam. I think the dr. thought we (the DDs) were the nutty ones. Thank God she didn't have money or he'd have thought we were after it.

He did mention she might have a sleep disturbance. I mentioned how long she'd been hospitalized and he said that if her sleep patterns had been seriously disturbed during that time, it would take a while for her to get back to normal. And after the 18 days of craziness after checking out of the hospital, she slept one day for 14 hours or so and was never "off" again. All was well.

When she was back to her normal self, she said she usually realized when she was acting crazy weird, just couldn't communicate well enough to use the right words or stop her behavior. And she said she'd never gotten any decent sleep in the hospital because every couple of hours, at a minimum, they were taking blood, running tests, giving her meds, etc. She was sleep deprived, much like a POW. Her mind cracked.

I hope this helps. I truly thought she would need 24 hour a day care for the rest of her life, that's how bad she was. And it did last after she left the hospital, until she re-established her sleep pattern. But she was fine for 15 years after that, until she passed away. Just know that it happens and it can certainly go away.

Good luck.

 

[charming23]

I am so sorry you are going through this ordeal. It is very hard to see family members go through this. My dad had the same thing about four years ago when he had a mjor surgery and was in the ICU for two weeks. He kept asking the nurses to call my Grandma, she had been dead for 13 years. He alos kept insisting that I was 9 years old, the age I was when she had passed away. It was hard to watch but he eventually got moved to a regular room and went back to normal.

 

[nmmom95]

For all of those who have dealt with this with a family member, my family said the hallucination were very upsetting, but I remember only bits and pieces like a dream. Your loved one is not aware that this is happening.