Aging Parents: Frightening Hospital Psychosis

It’s not uncommon for aging parents to suffer what is referred to as hospital psychosis in the acute care setting {think hospital, emergency room, ICU}. If your mom or dad already suffers from dementia or memory impairment, the chances are even higher. Signs and symptoms include disorientation, paranoia, hallucinating, delusional thoughts and nightmares.  They may become agitated, combative, try to pull out IVs, or climb out of bed unassisted. You may hear the staff refer to this as delirium, altered mental status or hospital psychosis. Your parent could seem fine the day before a hospitalization then quickly become someone you don’t recognize.   It can be disturbing and downright frightening to watch.  Being aware will help you navigate the situation!

Tips for navigating hospital psychosis

Communicate with staff so they know this is “not normal” behavior for your mom or dad

Visits from family and friends may help

Stay open to the possible use of medication to help in the short term

In severe cases, you may need to camp out as a family to provide comfort and advocacy

Sometimes it helps to have 1:1 companions available to provide support and prevent injury

Providing a quiet consistent routine may help

Report any history of depression or other mental illness as this may be an important factor in the big picture of what’s happening.

Hospital psychosis is usually temporary but if your mom or dad experience a decline in cognition or just don’t “seem like themselves” following an episode of hospital psychosis, be sure to report this to your primary care physician.  Hospital psychosis is one of those things where you are going to need to tie a knot at the end of your rope and hold on for dear life. It can be a bumpy ride but usually a temporary one. If your aging parent has experienced hospital psychosis, please leave a comment about your experience!

For more ways to navigate your aging parent’s hospital stay, go here!

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15 thoughts on “Aging Parents: Frightening Hospital Psychosis

  1. My mother has just been diagnosed with hospital psychosis. It came on overnight as confusion disorientation and restlessness. She had a cat scan that showed no sign of stroke (which I was sure was the case). She has high calcium so her electrolytes were way off and low heartbeat. She was delusional and hallucinating hearing voices (her hearing is very bad) and nightmares. She is improving on the third day of her stay to where she is describng her experiences and saying that she was probably dreaming or having a hallucination. It sure looked like a stroke with aphasia and slurred speech langage. It was very stressful to see her in this state but am seeing improvement.

    • I just brought my dad home from the hospital last night. He experienced hospital psychosis while there and had to be restrained.`He kept climbing out of bed, removing his IV and became so combative security had to be called. Anti psychosis medication had no effect on him.
      The only way we got through the night without all that drama was when I spent the night in his room. I insisted we keep all the lights but the tv turned off, his room door shut so he couldn’t hear the beeping/ringing of machines in other rooms and no staff was to approach him at night until I woke him up first and told him what they wanted to do to him (ie take his blood pressure, give him meds). This worked really well for us.
      He was supposed to go to rehab from the hospital but I ran into difficulty getting him into rehab because of the psychosis. He was so upset in the hospital that I decided to bring him home and arranged for in home physical therapy.

      • Sorry to hear that about your father and glad to know that you staying with him helped. It doesn’t surprise me that you had a hard time getting him in to rehab with that psychosis.
        Here’s a tip: you have a 30 day window after leaving the acute hospital in which you can still utilize his Medicare A benefit in a skilled nursing facility. If you get him home, he settles down and you sill think he could benefit more from skilled rehab, I’d make another run at it. Good for you for staying with your father and working through that psychosis. Good job Nichole!

        • The hospital stay seemed to advance his dementia but the downhill slide eventually tapered off. He’s living with me now and it’s been an adjustment for both of us, but overall he’s doing pretty well. Thanks for asking!

  2. I am so glad I read this article and the comments. Both my parents had been admitted to the hospital for serious illness when they were elderly, and their mental status changed markedly once they came home from the hospital. I never could understand what hospitalization had to do with their changes in behavior and thoughts, but this helps clear things up a great deal.

  3. My Dad, 90, is in the hospital now (since yesterday). This is the second visit inside of two weeks. With the problem he entered ER with apparently taken care of, he has been diagnosed with “Hospital Psychosis”. I just got home from being there all afternoon. He is only semi-lucid, he only occasionally recognizes us (my sibs and me), and they cannot keep his IV in.

    At first, when I heard the term, I had doubt… because he looked and acted as if he were in pain. We have, over the past 3 months, (at least me), been deeply involved with his care and questioned many things. It has been like pulling teeth; we’ve gotten into arguments (on extreme), been involved with any debates, assured over-busy, or “un-caring” staff paid attention when needed.

    I’ve learned alot…

    • It’s a real eye opener isn’t it? I hope your dad feels better soon and that you and your family can find some peace in the process. Do you have any recommendations for families that may be dealing with their own hospital psychosis? thanks for stopping and leaving a comment… LuAnn

  4. So here is my question – my mother most likely has “hospital psychosis”, but how can we know that it is safe to take her home with my elderly father? She is in the hospital right now, and she is hallucinating and combative with the nurses, and has thrown things at my dad. She was not found to have an physical problems but does have progressing dementia. No relatives live nearby, but we can stay a few days at a time.

    • You have basically two options upon discharge Barbara…

      One would be to transition to a skilled nursing facility (nursing home), for possible short term rehab. If she has her 3 days of qualifying stay in the acute setting, Medicare A will possibly cover 20 days 100%. The thought of going in to a nursing home is scary; I’ve been there with my own dad but we had no one to care for him so we felt it was the best option for us and it was. Be aware however that if her psychosis interferes with her ability to participate in medical rehab services and there are no other professional services being provided, that Medicare A coverage will be very short term not necessarily 20 days. Second, you could discharge to home but I would highly recommend that someone stay with your mom and dad for a couple of weeks to see how long term her psychosis will be and be available to provide her daily care needs. You may also be able to access Medical Home Health under her Medicare Part A benefit for some short term nurse monitoring and rehab. I was also find a non-medical home health agency that can provide you with support. The huge advantage to your mom going home is that she will be in a familiar environment with people she knows; this may be an intervention that works for her but be prepared in case it doesn’t. My heart goes out to you and your family. I hope this information helps in some small way…

  5. Thank you for the information. This is all very new to me. The “funny” thing is that my mother was only admitted for “observation” because there is nothing whatsoever physically wrong with her, so the three days thing doesn’t count (so they say). They have moved her to a geriatric psych floor in a nearby hospital. I guess they figure she is too unruly and psychotic to go anywhere else. I believe her doctor’s plan is to try to get some medication into her and hopefully get her back to reality. I surely hope it works…

    • The observation period versus admission is becoming common place across the country as hospitals figure out their loopholes related to new Medicare regulations. It really puts people in a bad spot and I could go on about this forever; so I wont. Moving forward the geriatric psych unit isn’t a bad idea but as a family I want you to keep these two things in mind. One, medication can be a wonderful thing but there are often side affects and you don’t want her to be zonked out. Ask a lot of questions about dosage, side affects and diagnosis. Secondly, ask the hospital physician and staff what type of non-pharmaceutical interventions they are attempting or have care planned. As a family, you can help the staff by providing ideas of your own since you know your mother best. Third, I recommend you get a list of medications and hospital records upon discharge to take to her primary care physician. Often times the PCP is not in the loop and they obviously need to be; families need to make this happen. I know it must feel like there is no end in sight. It sounds like her situation is very fluid and may change day to day; tie a know in your rope and hold on tight. Best wishes to you and your family…