Jay*, age 68, had been showing signs of increased forgetfulness, but he was still able to drive and help his wife, Marta*, manage their construction company. After suffering a back injury in January, he met with a surgeon who persuaded him to have a surgery that would require general anesthesia. No one warned the couple that anesthesia can increase symptoms of dementia, sometimes temporarily, sometimes permanently.
Complete personality change
The surgery itself went well, but that’s when their nightmare began. Based on Marta’s first-person account and hospital records, Jay woke up a changed person. In addition to having extreme visual and auditory hallucinations, he was so agitated that, at one point, six nurses were called in to hold him down. Medications prescribed to calm him made him even more aggressive, eventually forcing the hospital staff to secure him to his bed. After a brief and unsuccessful stay at a transitional care unit, Marta decided to bring him home.
Three days later, Marta called Homespire. “Jay had become aggressive with her, even pushing her down on the street,” said Meggan Newbold, RN, Homespire Nurse Care Manager. “He couldn’t sleep so he was awake around the clock, pulling things apart and moving furniture—not a good idea after back surgery!” Because of his insomnia, Marta was now spending her days and nights chasing after her husband, while doing her best not to trigger his anger.
Within a day of Marta’s call, Homespire’s Community Liaison completed the intake and start- care and got Meggan involved. She explained to Marta that Jay’s condition might resolve itself in six weeks or it could be permanent, depending on how reactive he is to the effects of anesthesia, such as inflammation in the brain. “When Marta heard this, she was understandably upset,” Meggan said. “She told me that had someone told them about this risk, she would never have put Jay through this horror.” Now she was grieving the loss of her husband.
Advocating for better care
The hospital had ordered home health services, but they stopped coming when Marta got sick and never returned. Now she was on her own, trying to manage Jay’s pain meds, physical therapy, mania, and aggressive behavior. She felt lost and hopeless.
Meggan saw that Marta needed her support and advocacy as much as Jay did. “I told her that I didn’t know if we would get him back, but that we needed to treat his symptoms and get her some help,” she said, adding that Jay’s pain was likely causing his insomnia and agitation.
To help Marta get some rest, Meggan arranged 12-hour night shifts with Homespire caregivers. Next, she advocated for an in-person assessment and medication review. Since it wasn’t safe for Marta to travel with Jay, Meggan contacted his primary care doctor to request an in-home palliative care consultation.
A nurse practitioner came to the home and saw first-hand what was going on with Jay. “She made some adjustments to his medications, but we also talked about the possibility that if we couldn’t manage his symptoms at home, we would need to place him in a geriatric psychiatric unit,” Meggan said.
Process of recovery
The caregivers had some rough nights with Jay, but eventually he became less agitated. And then one day, exactly five-and-a-half weeks after his back surgery, he snapped out of it. “He got off all his meds, he started sleeping through the night, and he was back to being his funny, witty self,” Meggan said. “He’s doing amazingly well, and in fact, he and Marta just went on their first outing together to celebrate their anniversary.”
While Jay has no memory of what happened, Marta is haunted by her memories. “It’s been hard for her because he has no idea of what she went through,” Meggan said. “She’s suffering from PTSD [post-traumatic stress disorder], so I’ve been encouraging her to get some therapy.”
At Marta’s request, Meggan accompanied them to one of Jay’s doctor appointments. At the end of the exam, the physician told them that they didn’t need Meggan’s services anymore. According to Meggan, Marta looked at that doctor and said, “Oh no. She stays. Meggan is the only reason I made it through this.” The doctor then tried to convince her that these out-of-pocket expenses weren’t necessary. “Marta told him in no uncertain terms does he get to decide what she does or doesn’t need,” Meggan said, adding that every time she visits the couple, Marta tells Jay, “You have no idea what Meggan has done for us. She stays!”
Meggan added that every time she visits the couple, Marta tells Jay, “You have no idea what Meggan has done for us. She stays!”
For Meggan, advocating for her clients and helping them get back on their feet is both fun and rewarding. “In a sense, I become part of their families, but without the drama,” she said. “I wish this kind of support was available to families everywhere.”
If you or a loved one needs additional support, Homespire is here to help! Schedule a free consultation or give us a call at 801-503-3200.
*Names have been changed to protect client confidentiality.