May is 89 years old and suffers from sudden confusion and dementia. While her story is sad and even tragic, it really demonstrates how the combination of extreme life stressors and the smaller brain can lead to equally extreme confusion. Until recently May was functioning on a very high level for someone her age. In fact she was providing some of the care for her aged husband.

Then due to the care she was providing she required back surgery. May suffered from excruciating pain prior to her surgery as well as following the procedure. This required her to be on narcotics, something that was certainly an assault to her brain. And one of those things known to cause elderly brains to shrink.

While recovering from her surgery, her husband of so many years died. Before May could adjust to the loss of her husband she received the news that her granddaughter had suddenly and tragically died as well. May then began to mentally spiral down, with the combination of grief, pain and narcotic medications, she could no longer cope.

May became delirious causing her to now be medicated with high powered psychotropic medications. She was physically restrained in a hospital bed, confused, agitated, delirious  and manic to the point of chewing on her fingers. Resulting in chewing off 1/3 rd of one of her fingers, in her extreme mental distress.

While the story of May demonstrates how extremes can result in sudden confusion, dementia and delirium. Her life tragedies could not have been for-seen nor avoided. The loss of her husband was expected but not the loss of a much loved granddaughter. Her back problems were possibly predictable depending on how much physical support she was providing for her ailing husband. However, that she would need back surgery and be on narcotics for the pain was not predictable.

But what we don’t know about May is how good of a job she had done taking  care of her brain during those 89 years. Our assumption is that she was doing a good job taking care of her health and her brain, due to the fact that at her advanced age she could participate in her husbands care.

So for May as well as many other elderly, sudden confusion and delirium are not all that unexpected or sudden when the tragedies of life arrive.

Virginia Garberding RN

Certified in Gerontology and Restorative Nursing