Does This Resemble Hospital Delirium? My Dad Was Restrained Multiple Times Last Night
Update: I recently discovered that he wasn’t adhering to his blood pressure medications, and it’s possible that he neglected to take his blood thinners as well. I’m unsure if this is due to forgetfulness or negligence on his part, which is quite concerning. Background: I recognize that it’s challenging to reach a diagnosis through a message like this – I’m merely seeking input on whether this aligns with common instances of hospital delirium. My father is a 64-year-old man, approximately 5'6" tall and weighing around 200 pounds. He has a medical history that includes high blood pressure, an aortic valve replacement, type 2 diabetes, as well as anxiety and depression. He is on medication for all these conditions, but I’m not well-versed in the details. He was hospitalized a couple of days ago due to dehydration, stemming from weeks of not being able to retain food or liquids. He even experienced some vomiting that included traces of blood. After receiving intravenous fluids, he felt somewhat better. However, the next day a nurse mentioned that although he was mostly coherent, he appeared slightly disoriented. It was noted that this confusion might be due to the fact that he was in an unfamiliar hospital, not knowing their procedures. Despite feeling a bit improved, he was kept for observation because his blood pressure readings were alarmingly high, which raised concerns regarding his PTT (partial thromboplastin time). A cardiologist assessed him and prescribed blood thinners. An esophagogastroduodenoscopy (EGD) was performed, revealing mild gastritis, which the doctors concluded was responsible for his digestive troubles. However, later that same evening (around 6 to 7 hours post-EGD), he became confused and attempted to leave the hospital. He wasn’t aggressive but was insistent on gathering his belongings and departing, resulting in staff having to restrain him. Remarkably, he managed to free himself from the restraints and reached the hospital door before he was stopped. As of this afternoon, he remains confused and is still restrained. According to a family friend, he isn’t making much coherent sense, and he’s been trying vigorously to remove his IV and restraints. The nurse speculated that his behavior might be a reaction to the medication given during the EGD, though she wasn’t certain, and I haven’t had the opportunity to speak with a doctor yet. She mentioned they plan to do a CT scan once he has settled down, as they administered Zyprexa (or a similar medication) to help calm him. Does this situation sound like it could be hospital delirium to you? Might it be induced by the anesthesia? I’m uncertain about the latter, considering he has undergone several surgeries before without experiencing such behavior. Once more, I understand that a definite diagnosis cannot be made; I'm simply looking for insights from a medical standpoint.
Answers (1)
3/20/2025, 7:21:28 PM
OpenHealth AI
It sounds like your father's situation is quite concerning, and it's understandable that you're seeking clarification. Based on what you've shared, his symptoms do resemble hospital delirium, which can occur in patients in unfamiliar environments, especially following significant health changes or procedures.
Explanation
Hospital delirium, also known as acute confusional state, can be triggered by various factors, including changes in medication, dehydration, unfamiliarity with the hospital environment, and underlying medical conditions, especially in patients with a history of anxiety, depression, diabetes, and cardiovascular issues. The combination of his recent health troubles, medications (including any administered during the EGD), and the stress of being hospitalized can contribute to confusion and disorientation.
Delirium can indeed occur after anesthesia or sedation, even if he has tolerated it well in previous surgeries. Factors such as older age, underlying health conditions, and even dehydration can increase the risk of delirium. It's also possible that missing his blood pressure and blood thinner medications may have contributed to his condition, as stable blood pressure and proper anticoagulation are crucial for his overall stability.
Prioritized Next Steps
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Ensure Medication Adherence: Confirm that hospital staff are aware of all his medications and are managing his blood pressure and blood thinner doses appropriately.
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Monitor Symptoms: Keep track of any changes in his confusion or mental status, noting when he is more or less coherent. This information will be valuable for medical staff.
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Communicate with Healthcare Providers: Speak with the doctors about your concerns regarding the potential causes of his confusion, including medication effects and the impact of his recent procedures. Ask them about steps being taken to manage and monitor his delirium.
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Assess Environmental Factors: Make sure he is in a quiet area that’s conducive to rest, as minimizing stimulation can help reduce confusion.
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Encourage Hydration and Nutrition: If possible, ensure he remains well-hydrated and receives proper nutrition, as this can aid recovery and stabilize his condition.
It's understandable to feel worried in this situation. Your vigilance and communication with the healthcare team will help ensure he receives the care he needs. Stay proactive, and reach out for updates from the hospital to get clarity and support.
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