While I was in the hospital, 13-15 April 22 with a painful Small Bowel Obstruction, something rather strange happened to me. I hallucinated and lost my short-term memory. Here’s what happened: During the night of the 14th, I “saw” a huge fire outside the hospital and heard explosions. Like an old snapshot, I have a fuzzy mental picture of that fire. I don’t remember walking out of my room, but I did and ended up at the nurses’ station.
My next mental picture is at the nurses’ station telling them that there is a fire outside and raising my arm pointing to it. Then my memory goes dark, but wakes up for my final snapshot image of that night. I’m standing at the side of my bed in darkness but with enough light that by turning my head I could see the outline of someone standing behind me. It took two more looks to realize it was a nurse who probably escorted me from the nurses’ station to my bed. That’s it.
The next day, I have a snapshot of my granddaughter in my hospital room and another fuzzy picture of my daughter-in-law sitting on a couch next to my chair with a notebook on her lap. Later, I was told that I sat facing a nutritionist who was explaining my new diet. My son later told me that I seemed perfectly normal as I listened to her and asked questions. What isn’t normal though is I don’t remember that event at all. Nothing other than those fuzzy snapshots. The rest of the day is blank.
I remember getting out of a wheelchair outside the hospital and getting into a car to go home, but I don’t remember the ride home or being at home. Strangely, I can’t pinpoint when my short-term memory returned to normal, but it did sometime during the next day or two (at least I think it did). I suspect I seemed perfectly normal when I got home, but like with the nutritionist, I don’t remember anything. I’ll chalk it up to a faulty flux capacitor.
When I was more or less normal, I noticed that my balance was off. I staggered and lurched a bit, and scrapped the edges of doorways as I passed through― rather klutzy. And my speech was slow and halting as I searched for words and tried to speak them. I could mostly recall words but getting them out took effort. I found this very upsetting, so my daughter-in-law, who was a big help throughout this event, arrange a telephone visit with a psychiatrist, which I do remember. I told him I feared hallucinating again while driving or at the store and wondered what I might say or do. He said Delirium is usually associated with hospital stays, but said, if it happened, that I would be normal, I just wouldn’t remember it.
I expressed concern to him that someone could explain something to me that I seem to understand but later wouldn’t be able to recall. I also told him that I plan to put my next colonoscopy on-hold since I read that most cases of Delirium occur in a hospital setting. Plus, you’re more susceptible to getting it again once you’ve had it. He didn’t believe the colonoscopy procedure is performed in a hospital-like setting. I politely told that to me it is.
How do we or the hospital staff know if our loved one in the hospital who seems normal, might have Delirium, and not remember anything we say? Little by little I learned what had happened to me and that’s the subject of this blog. Interestingly, the hospital discharge booklet had an entire page devoted to Delirium that I only discovered after I’d been home for a while. Part of the page on Delirium is shown below.
My son told me that the morning after the “fire,” I sent out a string of nonsense texts which I can’t recall doing. As a result, he discussed my strange behavior with the head nurse who said it was Delirium and would resolve itself over time. If anyone at the hospital talked to me about my behavior, I don’t remember it.
I had never heard of Delirium before this incident. So, what is it and why would the topic be in my discharge booklet? Is it that common?
Definitions of Delirium
According to wiki, Delirium is one of the oldest forms of mental disorder known in medical history. The Roman author Aulus Cornelius Celsus used the term to describe mental disturbance from head trauma or fever in his work De Medicina.
English medical writer Philip Barrow noted in 1583 that if delirium (or "frenesi") resolves, it may be followed by a loss of memory and reasoning power.
The Mayo Clinic offers a short succinct definition: Delirium is a serious change in mental abilities. It results in confused thinking and a lack of awareness of someone's surroundings. The disorder usually comes on fast — within hours or a few days.
Delirium is a mental state in which you are confused, disoriented, and not able to think or remember clearly. It usually starts suddenly. It is often temporary and treatable.
Delirium is a sudden and severe change in brain function that causes a person to appear confused or disoriented, or to have difficulties maintaining focus, thinking clearly, and remembering recent events…. Older patients, over 65 years, are at highest risk for developing delirium. https://www.uptodate.com/contents/delirium-beyond-the-basics
How common is delirium?
Hospital-acquired delirium is a common and dangerous condition that often goes unnoticed and untreated, an oversight that experts in geriatric medicine say is costing the health care system untold millions of dollars.
“Delirium is often under-recognized and underdiagnosed,” says Dr. Roger Wong, president of the Canadian Geriatrics Society.
…a temporary but severe form of mental impairment that can lead to longer hospital stays and negative long-term outcomes, is commonly acquired by elderly patients in acute care settings. Up to a third of patients 70 years old and above experience delirium, and the rate is much higher for those in intensive care or undergoing surgery. Until recent decades, hospital-acquired delirium, which typically lasts anywhere from a couple of days to several weeks but can even last months, was chalked up to old age and not considered a condition to be prevented or treated.”