Older woman in a hospital bed.

Mom Doesn’t Know Where She Is!

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Older woman in a hospital bed.Carol Coultraine pushed through the double doors marked Coronary Care Unit. She had driven straight from work to see her mother, who had suffered a mild heart attack three days before.

Mother’s care has been excellent here, Carol thought as she walked down the now-familiar corridor toward the room where mother was recovering. For the last two days Mother had received multiple tests. Yesterday the heart doctors had done a cardiac catheterization and decided that mother only needed a stent to open up the artery in her heart.

Mother should be ready to go home in few days, Carol reminded herself as she went into Room 14. Mother sat slumped in her chair, tied upright with a sheet. She stared blankly, straight ahead. For a moment Carol wondered if it was her mother at all.

She was talking to me plainly yesterday, she thought. Talking about how easy the cath had been – how pleased she was that it had all gone so well.

“Mother? Mother! Are you all right?” Carol shouted, trying to get a response.

“Mrs. Coultraine, don’t shout.” CCU Nurse Judy Johnson walked in.

“Mom doesn’t know where she is – or even IF she is!” Carol exclaimed. “What happened? She doesn’t even know me!”

“The doctors think it is delirium.”

“Delirium? You mean like Alzheimer’s? But she didn’t have it yesterday.”

“No, it’s not like Alzheimer’s at all,” the nurse said, guiding Carol to a chair on the far side of the room. “Delirium is confusion or disorientation, probably brought on by all the noise and tests and stress she’s been under.”

“Well, it’s for sure she hasn’t been sleeping here where the lights are on twenty-four seven,” Carol said, looking up at the florescent bulbs.

“Yes, that’s another possible cause of her delirium,” the nurse agreed.

“But I thought delirium is when you act wild and crazy,” Carol watched her mother.

“This kind of delirium can be either very wild or very quiet. It’s really the rapid onset – just since yesterday – and her inattention to life now – when she was so obviously involved with her care yesterday. And her altered state of consciousness. She’s not totally awake,” the nurse said.

“Today we had a case conference with her doctors. They decided to discontinue as many medicines as they can – or cut down the dosages. That can sometimes be a cause. And they’re going to move her into a quieter room – more private and darker at night, you know.”

“Is there anything I can do?” Carol shook her head in disbelief at her mother’s condition.

“Yes, actually, there is,” the nurse said. “Tomorrow bring pictures – of your family or her house – anything to remind her of familiar surroundings. Put them in her new room close to her bed where she can see them, concentrate on them.” The nurse leaned forward. “Can you come stay with her this weekend?”

“I can come tomorrow and stay through the weekend – as long as it takes.” Carol was grateful to have something she could contribute. “But what do I do? What do I say?”

“Just talk to her,” the nurse said calmly. “Talk to her about family, what you’re doing, events from your childhood or plans you and she have made. Oh, yes, and bring a calendar to hang on the wall – one with large numbers. Do you have one like that?”

“I’ll get one,” Carol said emphatically. “Whatever it takes.” She turned to face the nurse. “Does she need medication?”

“Sometimes certain kinds of medication can help, but we like to try the environmental interventions first. Let’s see what the weekend brings, shall we?”

Carol spent every waking hour with her mother, talking about family, reading favorite stories, describing pictures she had brought from home. The nursing staff made sure that Mother’s sleep at night was undisturbed.

On Sunday morning, when Carol walked into her room, her mother looked up from the Sunday paper she was reading and said, “Oh, Carol, how nice of you to come visit me.”

Author

Max Wayne Hammonds was born Aug 3, 1943, in northeastern Indiana, in the county hospital in Wabash. He attended high school and college in his home town of North Manchester and attended Indiana University Medical School in Indianapolis. Following an internship in South Bend, IN and a year of flight medicine in the Air Force, he took a residency in anesthesiology at Wilford Hall Medical Center at Lackland Air Force Base in San Antonio, TX.