@cedarlake My dad had complications from a dental procedure that had him in surgery and then in ICU on a ventilator 24 hours later. He ended up with ICU delirium that lasted for weeks after they finally got the breathing tube out. It was the most terrifying thing to see my entirely independent father go through that.
ICU delirium is very common for patients on a ventilator, and even more common for older patients. Effects can linger or become permanent.
My dad had trouble with his motor skills due to the drugs, and he couldn’t write. We made an alphabet for him to spell things out but (he told me later) that his train of thought was very fragile and he had to think through every little step. If he got interrupted the whole train was lost and he’d have to start over. He couldn’t just point to T, then H, then E, but had to think that he wanted T, then think about where T was, then think about where his hand was and about physically moving it, and then think about me saying T, and then think about nodding, then think about the word and the next letter.
He is an engineer, and afterwards said it would have been helpful to see pictures of familiar things and be told what they were so he could find the connection in his brain again. Things like home, and people. Be careful about things like that because the nurses and doctors will want to ask him questions about what’s happening to him (do you know where you are? Do you know why you’re here? Etc) to judge cognitive clarity and memory. Once they’ve done that in the morning you should be okay.
The drugs caused a lot of brain fog and confusion, and took days to clear his system. I asked every nurse to remind my dad often that the ventilator tube was temporary, and would be taken out in a couple of days. It was over a week, but he couldn’t keep track of the days. It was more about reassuring him that it was temporary than giving him a timeline.
If go the alphabet route, my dad said having some things pre-written (like the, a, etc) would help. I will add ideas like nurse, toilet, sit up, lie down, pain relief, water, thank you. The regular events that happen each day.
One thing I had trouble with was that my dad’s ICU delirium symptoms varied in intensity through the day and the doctors weren’t seeing the same things I was. I was seeing him during his better times more often, and not seeing the more pronounced symptoms the doctor saw. This meant the doctor was getting a false impression of how severe the symptoms were. As my dad was 81, they were ready to see age related impairment and it took a while before I realized what was going on. His electrolyte levels were all over the place and had a huge impact on his cognitive clarity. You may not be able to judge because of not seeing him recently, but your relatives should be aware of this possibility. I was worried that they were accepting his cognitive lapses as “normal” and not looking for treatments that could help him get back to his actual normal.
I hope your father doesn’t have to go through ICU delirium, but if he does, please feel free to message me. It can help to talk to someone who’s been there.
