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Haldol and Post Operative Dementia
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Haldol and Post Operative Dementia

My Dad is 73 yrs old. He has very mild dementia, mainly forgetfulness,slight short term memory loss. He was very alert and cognitive abilities were ok for his age. 7 days ago he underwent CABG x 6. The following morning, he recognized and verbalized family members, and knew he was in the hospital. He was moved from ICU to a room the following morning after surgery.  Within a few hours, he started talking like a child and being silly, a few more hours later he could recognize family memebers or resond to questions properly, by that evening he was combative and it took 9 nurses to hold him down. During this time he was givien 2-3 injections of Haldol not sure of dose. He seem to get worse with each dose. Now this is his 6th day back in ICU. They continue to given him Haldol with Ativan and Lortab for pain. He has not made any cognitive improvement. Is this normal? Could the Haldol be the cause? Please, help ! We try to talk to the doctor's and they give short vague answers, basically saying it is not the Haldol. If anyone has had similar experiences or can give any suggestions, please do so. I feel like I am losing a little more of my Dad everyday.
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874521_tn?1375890587
hi Lt...I see u have had no answers to your post....u really should direct this question to one of the very fine doctors listed on this site.
In my experience(not a nurse)...but I did work in a long term care facility for many years and watched the changes both good and bad from the use of many of these drugs especially how they affected the elderly, I also went thr a very similiarexperience with my own dad back in the 90's...Haldol was administered to calm him and it did just the opposite.
Haldol in my own opinion sure can give all the symtoms (symptoms) you have listed especially for the elderly....for them the side effects seem to be compounded.
Please check with a doctor who you trust. I hope by now things have improved for your dad.
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144586_tn?1284669764
I cannot tell you how inappropriate the medications were. That is just a personal opinion. These "chemical straitjackets" are commonly used, unfortunately.

Yes, the Haldol could cause brain damage.

If he were my dad I'd get him out of that hospital immediately.

When they tried to give my 103 year old Haldol (she was 102 at the time) I grabbed the syringe from the nurse and stepped on it. All she needed was to be held and reassured. I took her from the hospital AMA at midnight (she assured me she would die), took her to the park in her wheelchair and held hands for an hour, then took her home and at five A.M. cooked her a three course pureed meal with desert.
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Avatar_f_tn
It is not unusual to have post surgery confusion and develop ICU psychosis post op. we all respond differently to medications. A a nurse I can tell you that because everything we eat, drink and take into our bodies responds with some sort of chemical reaction. Some respond differently than others. Pain medications can cause severe mentation changes in anyone, let alone the elderly.
No one can tell you if haldol or ativan is bad for your dad. Some have a paradoxical response  (opposite) to the action the drug is to have on an individual.

you have to realize that as we age, some individuals function at home, in their routine just fine.Take them out of their familiar environment and you have a confused and frightened individual. with the mild dementia and short term memory loss, his response is not to be expected.
The medical delivery system is broken, and the ball is often dropped by the doctors and other health care professionals. It should have been explained to you that this may have been a complication post op.
it may take time, but he may return to his baseline behavior post op. I do not believe that anyone can tell you what your dad's cognitive status will be during his recovery.
it is important that you ask the doctors specific questions and do not let them get away from you with out getting a clear understanding of what they are saying. You may not want to hear the answer or get an unwanted response, but you need to know , what the prognosis is for a recovery on his mental status.
As a nurse, of 35 years, I did orthopedics for many years. we would get the most wonderful, alert and interactive patients. many in their 80's and 90's. More often that not the medications post op affected their cognition. some never returned to baseline. you have to be prepared for this. then again, he could come out of this fine.

Doctors treat symptoms. they see their part of the patient and often to not see the entire picture. Anyone that is considering surgery has a chance of a change in cognition occurring. Doctors do not take the time to make patients and families aware that he may have a better heart function. they fail to tell you his mental status may never be the same.
i believe that many individuals would elect not to have surgery if they knew that mentally, their quality of life they may never be the same.
Do not be discouraged. i understand your concerns and worry. It is so hard to see your dad this way. Be firm with the doctors and ask questions until you feel satisfied with the answers. you may want to ask for a neuropsychological evaluation be done

Ask if they did a mini mental on him prior to surgery. Ask that he be seen by a geriatric psychiatrist.

I know I sound bleak. I am just trying to prepare you for the worst case scenario. it could all change tomorrow and he will be back to his old self. prepare for the worst and hope for the best.

Diane carbo              
      
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144586_tn?1284669764
Actually, the question of whether or not "Haldol is wrong" for a 73 year old post-op is a no-brainer.

It is wrong. It is inappropriate.

Just an opinion of "one".

These drugs are what are called "chemical straitjackets". They are cheap alternatives to genuine nursing care. I have yet to see a frightened geriatric patient that could not be calmed down by someone holding their hand.,

Having been involved in the healthcare system on and off for decades, I have very little fait in "the system". I am singularly unimpressed by medical credentials.

I am also dismayed by the defense of drugs on the elderly that have unclear mechanisms of action and numerous documented adverse side effects.

As for seeing a "geriatric psychiatrist", my personal opinion is you would be better off seeing a witch doctor. The psychiatric "profession" treats elderly patients with drugs. That's what they do.

Is there a place for drugs?

Yes. But that niche is a small one.

The problem is with the entire medical profession - the way it is structured - the way insurance payments are directed - the treatments that are approved. Your insurance company will approve thousands for "psychiatric hospitalization" but nothing for a caregiver to hold a dying patient's hand.
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Avatar_f_tn
caregiver222,

I too have been involved in the medical delivery system for the past 35 plus years. I really do not have faith in the system and feel that the medical delivery system let's individuals down all the time.
I would even go as far as to say that most psychiatric hospitalizations are not productive. I feel that many times it is just a place to take care of someone until they got through their  difficult period.

I have actually done geri psych nursing and can tell you that there are times that meds are needed. I am a firm believer that you try every behavior intervention to calm some one down that you can. when behaviors are such that no matter what you do works, then, medication may be the only answer.

I am an old time nurse. You are right, there are times, more so than ever when  when families must get involved and provide the much needed hands on care.

I will not tell you that in today's medical delivery system, that chemical restraints are not abused. And you are right, it is often used to replace genuine nursing care.
As an individual that have seen elderly patients become anxious, agitated, and combative, putting themselves and those around them at great risk, medication is often times the only answer.

Medications are beneficial for so many things. To control blood pressure, control blood sugars, help with depression, help with schizophrenia and other mental disorders.Confusion in an aging senior may be the result of a urinary tract infection that can be treated with an antibiotic. many individuals seek alternative treatments, trying all natural "cures" and in the end they are still taking in a form of "medication."
In my personal opinion that there needs to be a meeting of the east and western approaches to medicine.

When a patient is pulling out tubes and wrestling to get out of bed and that behavior is going to result in harm, I am all for a medication to calm someone. i do believe that family members, such as yourself, that feel that strongly about the use of medications should be permitted in to provide that behavioral interventions needed to avoid medication administration.

i understand that you had a bad experience with your 103 aunt. The unfortunate thing and a lesson for all of us to learn from your situation, is that it appears that she did not have an advanced directive in place. If she had, she would not to have been hospitalized in the first place and gone through the unnecessary treatments she was exposed to.

the bottom line is, when an individual is taken out of their comfortable and familiar surroundings, they become disoriented and there is an increase in confusion. every one responds differently. Put the introduction of surgery and anesthesia into the mix and you have affected the bodies and brains chemical make up. some react violently, others react with pleasant confusion.

in an ideal world, we would not experience any of this. the reality is, as broken, frustrating and frustrating our medical delivery system is, it is still one of the best in the world. And that is why , we as caregivers oversee and advocate for our loved ones. we need to speak up when we see a something that we perceive as wrong and question the judgment of the medical professionals. Trust me, I do not trust any one just because they have MD or any other form of the alphabet after their name.                    
Some insurance companies will pay for the family member to provide care in the home. I know that some long term care insurances will as well. However, those companies are few and far between.

it is important that we as caregiver's keep in mind that no one in the medical delivery system knows our loved one and what is best for them. we employ these individuals for their knowledge and expertise. We are obligated to question, and even badger those professionals that do not take time to help us understand what is being done, what are the anticipated results and what is the downside to the treatment or medication proposed.  We also have to be prepared to ask the tough questions.

Denial is a very strong coping mechanism. Denial helps us all get through some difficult times. because we do not want to face that our loved one is sick, becoming frail or even beginning to decline, we choose not hear or accept some things that are said to us. many of us do not consider quality of life issues. We just want to hold on to our loved ones.  many choose quantity of time on this earth over the quality of time we have. this will be an ongoing issue until the end of time. Some people just want to live forever. The problem is, none of get out of this world alive.

caregiver222,I know you must know this, but hospice is a program that is provided to allow you to be able to hold a dying one's hand. They will pay for the program, but not the family's involvement. families can be involved as much or as little as they want to be.

it is sad that you had such a terrible experience with your aunt that resulted in signing her out AMA. This is a good example of how lack of communication had  a negative effect and resulted in such a strong response. I am glad that everything turned out OK for you and your aunt. She was blessed to have an advocate and you had such a positive response. I hope she never had to return to the hospital again and her last days were filled with peace and comfort.                    
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144586_tn?1284669764
One of the biggest problems with haldol is that it masks symptoms, has an extraordinary half-life, and makes it almost impossible to obtain a proper psychiatric evaluation of an elderly patient. These evaluations take place in from three to six seconds, depending on the schedule of the psychiatrist in the nursing home or hospital, and have an unbelievable effect on the long-term care of the patient.

It is one thing to recommend a chemical restraint for someone with chronic brain syndrome, and quite another to administer it to a frightened elderly person coming out of surgery.

One sad event was the classification of valium as a schedule one drug. In years gone by one could obtain it and administer it without even signing for it. It was an excellent drug for calming down patients without compromising respirations.

As far as the 103 year old, I don't believe her treatments in the hospitals she was admitted to were totally unnecessary. The only treatment she needed in one case was intravenous hydration, and they screwed that up, blowing every vein in both arms. They took enough unnecessary blood from her to sink the Titanic and of course forced her to have a urine tube, which ruptured a blood vessel in between three and five seconds. I finally started the IV myself. When I took her out to the park after getting out of the hospital she said "I'm so happy!", and aside from her difficulty in swallowing, continued to improve on a monthly basis since her stroke in her 90's.

She certainly didn't need a hospice. She had a very high quality of life from the time I became involved with her at age 99 until she was 103, went out with me every day, got flowers every day, learned to read and write again, and was beginning to walk again. Her sentience improved with every month.

She's 104, by the way, a very happy camper and looking forward to a birthday at 105.

The total incompetence of the physicians at the hospital would warrent a book, but to state none of them could walk and chew gum would be an understatement.

It is very difficult, and almost impossible to push things in the right direction these days, even when you see the hospital is treating a patient in a way you know will ensure their death.

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Avatar_n_tn
My father went though a similar experience and never recovered his mental health (he just turned 75).  Until his back-to-back surgeries in Dec., 2007, he exhibited only normal signs of aging and was communicative and alert.  He was admitted for a gaul bladder removal operation (small incision) and was alert and speaking normally.  My mother was in with him 7x24 and left him in the hospital just for 1 hour to return home and take a shower.  When she returned, he had fallen and was lying on the flow with a seriously bruised hip.  Several days later he fell again and fractured the hip and replacement surgery was performed.  She found him lying on the floor AGAIN and had to scream for the nurses... who were busy filing their nails and talking about their children's Little League games.  For about two months afterward, he was not good physically, but at least his mind was there.  Then suddenly, he began talking out of his head and has never been the same since... and requires in-home nursing care for about 12 hours a day.

Myself, I suffer from severe allergies to artificial food additives.  For example, if I ingest sodium nitrate, my throat closes, I begin gagging and within 30 minutes I lose control of my mental faculties...similar reactions to TBHQ, EDTA, colors, dyes, etc.  I've placed myself on a very restrictive diet (no thanks to rat-******* doctors, who are only trained to medicate and operate.. and could never "determine" the cause of the problem.. and never read the work of Dr. Feingold, a pediatric allergist who linked food additives to allergies and hyperactivity).  I've also removed wheat from my diet and no longer have chonic bronchitis and have lost 15 pounds of swelling and bloating... again no thanks to rat-******* doctors, who do not understand preventative care... it's bad for business!

Doctors do not care to address this issue of post-operative dementia.  It opens them to litigation and the sheeple, whom they lead to slaughter, would storm their offices like a congressman's town hall meeting.  Frankly speaking, if I met the doctors who did this to my father (separate operations, separate docs, different forms of anesthesia and no colloboration) in a dark alley... an "serious" conversation would ensue.
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Avatar_f_tn
Most aides and nurses have a work sheet they go by they do no more or no less than they have to especially for the elderly i have worked mental gen hosps most of my life, there are some who care deeply but they are few and far between, and most elderly are scared but do they get assurance the answer is no, not from what i have seen, and psychiatic help for the elderly is no good, the dr just do not care, but they will take your money, this is just from what i have seen, and is my personal opinion every nurse and aide or caretaker should ask to see the little movie they used to show in hosps the name  Mrs Reynolds needs a nurse, and they will understand more just what to do when an elderly pt comes in, when they are scared they get gripey and aides say boy i sure hate taking care of that ole biddy, but what they do not know is they are lonely scared and need some TLC  luck  jo
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Avatar_f_tn
Our mom was 80 years old. she was admitted to the hospital for heart failure on monday . she went in weighing 127 pounds within several days her weight was down to 112 pounds, with proper diet and medication she was back   on her feet. The doctors 's felt that she would benefit by putting a fibulator. The doctor's scheduled the surgery for friday. when friday came our mom was doing well , but the doctor's decided to reschedule her for monday. They stated they wanted an anesthetist team on board.  our mother was feeling wonderful eating, walking ,and talking. Our mother wanted to go home . she didn't understand why she was in the hospital due to her alzehimers.  It was the weekend of hell . during the night our mother started to halluciate due to the medication ativan that was given to her by the nurse. In the middle of the night a other nurse came in her room and startle our mother. she was frightend and scared very confused did not know what was going on. The nurse  try to take ;her vital signs. Our mother refused, and at that point the nurse seemed to be upset and made a phone call to the doctor. which he prescribed a medication called HALDOL..  Thats when everything went wrong. Our mother was put in a stupor, because of this medication call haldol. She was not responding. Several nurse's  on the unit had come into our mother room and put a light to her eye pupils. we did not know what they were looking for, but they already knew the damage had been done. Our mother was not eating ,and nolonger talking she could not even walk. The doctor's did the surgery as scheduled on that monday. During the surgery our mom stop breathing and we were not informed till the next day.  Our mother's brain was not functioning enough to tell her to breathe due to the HALDOL .When she stop breathing her body filled with CARBON DIOXIDE. Her levels were over 100 . The next day the doctor's were trying to bring down the levels. By the time the levels came down, the damage had been done to her kidneys and it lead to other complication. This medication should not be given to any one .  It is  very dangerous it puts people in a stupor then kills them. See people with heart failure can live a long time with proper diet ,and  medication. but our mother did not get that chance. Haldol shorten her life.. we thought that we were putting our mother in good hands. DOCTOR'S that knew best ??  To see our mother in good spirits and in good health one moment and then the next put in a stupor then die. HALDOL is a killer drug,  Now our mother is home with JESUS..             (THE VOICE OF OUR MOM)
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547368_tn?1332173665
I am so very sorry to hear about what happened to your Mom. My heart goes out to you and your family.

I am not an expert. In my experience with the elderly, haldol is a potent anti-psychotic drug. There are good uses for this medication but in your mother's case I beleive there should have been other, better choices. It is most effective in patients with schizophrenia. Sometimes it is used in end of life situations when a patient is extremely agitated and non-consolable. Haldol, is considered a chemical restraint and has a multitude of side effects in the elderly.

When you Mom responded poorly to the ativan this should have been a red flag. The possibility that she would respond more severely to higher doses of anxiety relieving or   anti-psychotic medications should have been a consideration.

My father also cannot tolerate even a tiny dose of ativan. Haldol I beleive would have the same or similar effect on him that it did in your mother. But again this is just my personal opinion.

Again I am so sorry that this happened to your mother. It is important to educate those ppl that have elderly loved ones on the use of medications. There are so many meds that may be effective in the general population but that can have a reverse effect on the elderly population. Gerontologists are the experts and should be involved whenever possible with the care of our elderly.

~Tuck
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Avatar_f_tn
THANK YOU , IF YOU KNOW ANY OTHER SITES THAT WE  CAN INFORM ANY ONE ELSE OF THIS MEDICATION . PLEASE LET ME KNOW.  ONCE AGAIN THANK YOU SO MUCH.... YOUR OPINION IS VERY IMPORTANT TO US..
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547368_tn?1332173665
It is ironic that this discussion came just days before my father's illness took a turn and he began actively dying. On the 11th he became horribly ill and passed on the 13th.

A Hospice Director wanted to give him haldol when he became so very restless. His own Hospice RN was not available at the moment and would not have suggested that drug due to the past responses to ativan and similar medications. I had a fight on my hands but stuck to my guns, NO haldol.

My father went in and out over those days. Ultimately it was time for him to go Home.
But when called upon he knew me and other loved ones, He knew his name and where he was and what was happening. He was able to express himself. I maintained his comfort with other medications and beleive had I given the haldol he would not have had any lucid moments.

Thank you for sharing. Your post aiding me in making my decision against the haldol and sticking to it.  

Your MOMSVOICE was heard.

Still Mel's Daughter,
~Tuck
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Avatar_f_tn
God has a purpose for us all, and we can not thank you enough in reminding us that although our mom should not have been given Haldol, her voice is being heard. And we can rejoice in the fact that one day you and I will see our love ones once again. "Absent from the body present with the Lord." God bless you, and continue to pass the word that Haldol is a deadly drug.

Your MOMSVOICE4
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Avatar_n_tn
Our mother is 97 years young. She has always helped people and been a very sweet person.  On the 1st of May she became very aggressive and combative.  Uncontrollable.  She was admitted to a geriatric psych unit and was administered HALDOL as a chemical restraint.  At my sister's insistance a UA was done and mother had a very sever urinary tract infection which was drug resistant.  After several days in the hospital Mother began to show some improvement.  We finally were able to take her out of the hospital but had to place her in dementia facility.  Before the Haldol mother knew all her children, grandchildren etc.  She was able to get around just fine with her walker.  Now she sleeps, most of the time, she has litterly no memory, and stays in a wheel chair most of the day.  I will always think that haldol was the culprit.  By the way there are no hospital notes showing the use of haldol, although the nurse repeatly told us that she had been giving mutiple dosages of haldol because of her aggressive behavior.  We no longer have our mother, just a shell!
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Avatar_m_tn
My mom was given haldol and adivan mixtures in ivs. I told them she could not have them because of a sensitivity and some high blood pressure/ heart issues.She also told them she did not want them but they attempted what I would call murder about 3 different times with these drugs. My mom was so strong that they were unable to kill her. However, it did damage her very badly and she did get serious health complications from the druggings. Before the druggings she had only been to the hospital a few times in her life. After the druggings she was in and out from so many complications from the drugs.They were able to label her because of her age as being in the last stages of dementia.When they do this it will often get them out of trouble for the overdosing and also give them an excuse to drug although any excuse is as good as the other for the medical staff. They can also label her as aggressive to make it easier to give more drugs.It did not matter that she never showed as much as an aggressive hair, she was still labeled so it was easier to drug. I will continue to fight for human beings rights and do whatever I can. I get my story out as much as possible and am working with organizations to stop these druggings. I did not realize that it is against the law for them to force any drug on a patient who does not want it.Even though my mom told staff that she did not want the drugs they gave them to her anyways and  threatened and tricked to get her to use drugs. I would like to get out pamphlets etc of patient's right and where to go for help if being abused by the medical staff. My mom had always taken excellent care of herself so she would be able to enjoy her future great grandchildren.The medical staff ruined that for her. Everyone needs to fight for stronger and enforced laws to stop this from happening so bad medical staff cannot ruin or take anymore lives away from elders or anyone of any age.
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Avatar_m_tn
Our Dad was killed by haldol and risperidone!  Doctors, nurses and hospice are all liars!  They kept telling us that the drugs are not causing his unresponsiveness, but we found out too late, after he was already dead!  The psych hospital just drugged him and sent him back to the nursing home.  He did not even need the psych hospital.  He said the nurses and the aides were the devil and they were trying to kill him.  He was right! and I let them do it, because I trusted them all.  I thought for sure they would not do anything to harm my dad.  Well he is dead now!  Risperidone is not even approved for use in the elderly with dementia.  He was getting haldol on top of it!  I am disgusted with them all!
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Avatar_f_tn
My Dad was 87, he had the beginning of dymentia, on a Monday he caught his heel on a throw rug and bumped his head, because he was on Plavix we took him to ER just to be sure...he talked he knew where he was going he was Dad. The ER ran all kinds of tests..Brain scan, Mri, chest X ray hip x ray you name it. They said that he has a freacture in his left hand so they put a splint on it. They wanted to keep him overnight just to keep a eye on him and we could pick him up in the morning. I called at 3AM just to see if he was resting etc. When we went the next morning we found my Dad a vegatable laying in feces and urine, we did'nt know what was going on he was fine when we left him the previous evening at 9PM. We immediately went to the HOSPITALIST, who told us he neede to stay another day. We told him ABSOLUTELY NOT, we took him to a another hospital, one that we knew we could find out what hapened to my Dad overnight. This hospital ran toxicology, MRI's cat scans, they questioned us as to why my Dad was given Haladol and Ativan!!!WE HAD NO IDEA..they never told us they gave him that stuff, and on top of putting my Dad in a coma he did'nt even have a fractured hand. He ended up with infectious pnuemonia (pneumonia) and tachacardyia along with sepis, which caused him to have a fever. This GREAT hospital did all they could, my Dad NEVER woke up and we had to let him go. SHAME SHAME on anyone giving a elderly person with mild dymentia Haladol and Ativan, THEY KILLED MY DAD!!!
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