Unexpected Confusion in My Grandmother
For the past 14 years, I've been looking after my grandmother, who has faced various health challenges over the years. On Saturday, I noticed a sudden onset of confusion in her. She expressed feeling nauseous and lacked an appetite. Before I departed, I made sure she had some toast to eat. I typically check in on her sporadically during the day, and during my calls, she didn’t seem quite like her usual self. She forgot to take her medication and appeared bewildered when I mentioned it. Her son, who lives nearby, visited her and noted she was making nonsensical statements. This morning, I made the decision to take her to the emergency room around 5 AM. Medical staff treated her with Zofran and conducted various tests, including blood work and a urine analysis, all of which returned normal results. The only recent factor I noticed was that her pain management physician had prescribed 10mg of Flexeril, which she has been taking. Typically, she is diligent about her medication schedule, but when I visited her on Sunday morning, it was evident she had not taken her pain management pills since our last conversation. The doctors suggested she might be dehydrated, as her urine output was minimal, and her blood pressure was low. Once they administered fluids, her blood pressure stabilized, and they discharged her. After returning home, I noticed she still experienced moments of confusion and frequently complained about headaches. Though hesitant to eat, I did manage to get her to consume some water. This evening, her son will stay with her while I return home. I plan to contact her doctor first thing in the morning. I previously called the nurse's hotline, and they advised reducing her Flexeril dosage from 10mg to 5mg. She has been on this medication for approximately a year now. I can’t shake the worry that something was overlooked. While she answers questions correctly at times, there are moments—especially just after waking—where she speaks about unrelated topics or changes her responses when asked again. Has anyone experienced something similar? I feel at a loss for how to proceed. For context, she was doing well last Friday but underwent an MRI on Thursday due to a compression fracture that caused her discomfort. By Saturday, however, there was a noticeable change that persists today. While she can carry on a coherent conversation if she’s awake for an extended period, she often appears drowsy and becomes irritable when I seek clarity on her statements. At 69 years old, she has the following medications: - Percocet - Prednisone - Vitamin D - Metoprolol - Magnesium - Prilosec - Flexeril - Potassium - Eliquis
Answers (1)
7/27/2025, 11:31:05 PM
OpenHealth AI
It’s understandable to be concerned about your grandmother's sudden confusion, especially given her medical history and recent changes in her condition. Here’s a structured approach to address your concerns:
Main Points:
- Possible Causes of Confusion: Her confusion may be related to dehydration, medication effects, or interactions.
- Immediate Actions: Continue monitoring her hydration, medication intake, and overall well-being.
- Ongoing Communication: Reach out to her healthcare provider for guidance and inform them of her ongoing symptoms.
Explanation:
Confusion in elderly individuals can arise from various factors, including dehydration, medication side effects, or even underlying health issues. Given that the emergency room staff identified potential dehydration and low blood pressure, it's possible that restoring her fluid balance improved her condition temporarily. However, since she's still displaying confusion and irritability, it will be important to continue close observation.
The prescribed medications, especially Flexeril, can cause drowsiness or confusion. With her existing medications for chronic conditions (including Percocet for pain management), there may be interactions that warrant attention.
Next Steps:
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Monitor Hydration: Encourage her to drink small amounts of water regularly. Keeping a hydration log might help ensure she is getting enough fluid intake. Offer her clear liquids and easy-to-digest foods, as she may still have a reduced appetite.
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Medication Management: As instructed, follow up with reducing the Flexeril dosage to 5 mg. Keep a detailed list of all medications she takes and discuss this with her doctor to assess any potential interactions or side effects.
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Track Symptoms: Document her confusion episodes, including when they happen, their duration, and any accompanying symptoms such as headaches or mood changes. This information will be valuable when you speak with her doctor.
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Follow-Up with Healthcare Provider: You mentioned contacting her doctor; this is a crucial step. Be prepared to share your observations about her behavior and any changes since her ER visit. They may want to perform additional assessments or adjust her treatment plan based on her current mental status and medication regimen.
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Provide a Calm Environment: Ensure that she has a quiet, familiar space to rest. Minimize distractions and try to engage her in simple, reassuring conversations to reduce confusion.
Your vigilance in her care is commendable, and discussing these concerns with her doctor will help clarify the next steps. If her symptoms worsen or she experiences any severe changes, such as extreme drowsiness, difficulty waking, or increased confusion, don’t hesitate to seek immediate medical attention.
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