what is wrong with my Mum?

[hellymelly]

she's in hospital at the mo, with a broken leg. She had a stroke a few years ago. She is 81. Anyway, she's been getting more confused for want of a better word. She is convinced that she has been on a day trip with all the other people on the ward, other things like that. However, the doc said she's been assessed and she did really well on the memory test, he said better than some of the nurses would, so he was baffled and surprised when db told him about the confused patches. We are worried as my Dad died in September and she is alone at home now, and it would be good to know what might be going on. Anyone experienced anything similar?

[jackstini]

What is she like for long term memory?
If that is good and she can remember lots of details from years ago and it is just recent things that are confused, it could be the beginning of Alzheimers, did they check for that?

[Jas]

If the confusion is a recent occurrence, I would want to rule out any kind of infection as the cause. It can be a common symptom of infection in the elderly.

[greenhill]

Is she dehydrated? Sometimes if you are unable to reach your own drink, a nurse may not think of offering you a fresh drink, if you are leaving one untouched.

[CMOTDibbler]

UTIs often cause confusion in the elderly, so hopefully they will be checking for that

[hellymelly]

She has been checked for a UTI, as I knew about that. She is eating and drinking well, short and long term memory are good, no memory lapses or problems generally-its just the delisions, or possibly hallucinations? Maybe she is dreaming and can't separate it from reality? She asked me how dd was getting on at nursing college, because in her mind dd had told her that was what she was doing. DD is 5...When I pointd that out, she said "yes, I thought that was strange". This has been going on for a while but is worse since she's been in hospital. After the surgery she was all over the place but the surgeon said that was normal, she then improved a lot but still the flights of fancy.
I don't know about altzheimers, how do they test for that?

[EmbarassingBodies]

It may just be because of the operation if she had general anaesthetic or maybe being in hospital has highlighted a problem not so noticeable at home? The other thing worth checking is thyroid as low thyroid can lead to memory problems.

[hellymelly]

She is hypothyroid, but her memory isn't the problem as such. We were aware if it before this most recent fall, and then after the general anaesthetic she was really not aware of where she was or anything, ( that was when we asked the docs who said norm for after a GA) but although she has improved vastly since the post-surgery week (she's been in for weeks now) she is still having these delusions.

[pippop1]

Could she have had some kind of mild stroke (a TIA) during the operation or just after perhaps? Was she on some blood thinning drugs before the op and are they still being given? Just a thought.

[PigletJohn]

Broken leg? Might be the painkillers. I used to ramble when I was.

Also stuck in hospital, probably dozing and half dreaming. Being out of her own home, daily life and activities will not do her any good.

If she cannot easily get to loo she may be avoiding fluids.

[hellymelly]

I did sort of put it down to painkillers, but she is only on paracetamol now. Also the bit that is worrying us, is that this was happening prior to her being in hospital, although it is more noticable now. It is strange as her memory is fine, so that rules out dementia doesn't it? Does anyone know? She has other things going on, she's fallen victim to various financial scams, she seems far too trusting, but then that has always been the case to some degree, which is at odds with her general character (she is very bright). she will go into some detail about these delusional happenings, and can't be convinced that they didn't happen.

[CMOTDibbler]

Not all forms of dementia present with memory loss at first - my mum lost her language long before you noticed her memory. But the only person who can tell is by getting her a referral to the appropriate team - and while she is in hospital is a good time to press for that

[hellymelly]

We have raised our concerns with the Doc in charge of her care, and I think maybe we need a family meeting with him. Some of her flights of fancy would not be noticed by a stranger as they would take them at face value (although not the one about the trip with the whole ward, obviously). She sometimes struggles for a word but that is lingering aphasia from the stroke and is worse when she is tired. Really the main symptoms of something not right are the delusions that she has done things or had conversations which haven't actually happened, an increased tendency towards gullability (maybe that is just being 81 though), and oddly, she is somewhat less grudge bearing and less touchy about things, I don't know why that is.

[hellymelly]

pigletjohn, I do wonder if she is dozing and her dreams seem very real now as she is drifting in and out of sleep and perhaps sleeping more in the day. She is quite frail compared with even a year ago, and has had a big shock losing my Dad after over 50 years together.

[recall]

UTI ?

[hellymelly]

no, they are checking her regularly for UTIs.

[Rosy]

Hi Helly - my mum went to the Memory Clinic a couple of months ago and they diagnosed mild Alzheimers. They did a really thorough assessment, talking all through her life and doing memory & calculation tests. The word they used on the summary was "confabulation", which had been going on for more than a year in hindsight, saying things like the doctors having closed so she didn't have a doctor (we were caught out when the post office did actually close!) Her delusions have now got more crazy, telling my sister she'd gone up to London to meet my husband and "the girls" (my nieces). I spoke to her GP a year ago and told her about my mum's poor memory, but she was useless. Then a few months ago we actually asked for a referral to the memory clinic. Once we'd got that, it made it alot easier to get SW etc. involved with her care, as she's physically fit, so not really coming to the attention of medics.

It may be that being with your Dad meant her confusion wasn't as noticeable, or that being on her own has accelerated her confusion. It may be helpful to get a Memory Clinic referral for your mum too.

HTH.

[hellymelly]

thanks Rosy, that is very helpful, I'm sorry about your Mum. I will ask at the hospital about the memory clinic. I did look online at an Altzheimers website, and she didn't seem to have any of the ten key symptoms, her memory assessment in hospital was 24 out of 30, which was very good apparently. However it does seem to my db and I that there might be some sort of dementia starting, or possibly that the damage from her stroke is causing problems. The ward nurses have also noticed that she is sometimes confused.

[hellymelly]

Oh and Dad had been in hospital for nearly a year, so she isn't suddenly alone at home, but she is devastated.

[PigletJohn]

have you verified that she is drinking enough water, squash etc?

[hellymelly]

Well, its hard to judge how much she drinks when alone. I live a long way away and see her every few weeks, my db goes about three/four times a week as he is closer. When we are there she drinks, she has a cup of tea, or drinks the juice that they bring round. She also has water. I will ask the nurses if she drinks well when we aren't with her. Could that cause the confusion do you think piglet?

[PigletJohn]

I don't know, but DM had a stroke and could not get to loo so refused to drink.

[IDontKnowWhereMyMedalsAre]

Sounds like confabulations mentioned earlier. DM lived on her own for the last 35 years and we live 3000 miles away. she has always been fit and healty and travelled a lot. We visited 2 or 3 times a year (have only been abroad for 6 years) and before that 5 or 6 days a week. Over the years the stories had got more and more "unusual". when staying with us last year she went for a walk (it took us 5 hours to find her) but she adamantly maintained she had walked past the zoo, unlikely given its more than 15k away and she is sure she didnt get in car. In my opinion it was because the zoo had been on the front of the newspaper that morning. It was the true begining of her descent into alzheimers. I could list 100 other stories of things she really believes had happened. I could go on with everything else except she kept her condition from everyone for a number of years because a) that is exactly what conflabulations are, little stories sounding reasonable and b) she wouldnt accept any help and could keep it together long enough to distract anyone.

Its heartbreakingly sad. She is now in a lovely care home (yes that was very difficult and required her to be sectioned for her own safety) but she thinks she knows one of the orderlies from being at school, doubtful as she is 25 years older than him and he has never left the county he lives in!

Good luck. Take all the help you can get and watch out (IMHO) for her using the wrong but similar words. Mother insisted in calling all the mosques here temples. Likewise she calls her bedroom in the home a cabin. all sorts. The talking point on the alzheimers website is fantastic.

[hellymelly]

thankyou, IDon'tKnow. She does mix words up, but that happened with the post-stroke aphasia and although it improved hugely, when she is tired she will struggle for a word. Did your Mother have the delusions without any memory issues?
We had to go through all the heartbreak of checking out nursing homes for my Dad, who in the end died while waiting for a suitable place. I have braced myself for doing the same for my mum. Although she is adamant that she will never go into a home, and has a real fear of it. She even refused to consider going to one with my Dad, although she adored him and visited him in hospital every day. So it will be dreadful I think. At the moment hospital teams are working up to her discharge and we are worrying about how she will cope at home .

[gingeroots]

I think the drinking ( with or without dementia ) makes a huge difference .
And it's likely that she's drinking less while in hospital .

How one manages to persuade someone to drink more is another matter .

My mum is confabulates a lot and imagines all sorts of things - yesterday it was that BT had interfered with her phone so that she couldn't make outgoing calls .
There's usually a rational explanation for her confusion ,sometimes it's hard to discover it .

But that said she continues to live alone with my support ,so although confused she's not wandering or anything life threatening .

Your mum might improve back in her home and in familar surroundings .
Maybe with carers she could stay there ?

[hellymelly]

Saw Mum today and feel very sad now, she was really down and weepy, missing Dad terribly. She is in the hospital he was in most of last year which doesn't help. She had orange squash out, and when I suggested she had a drink she said that one of the nurses had checked her tongue and told her she needs to drink more, so clearly she isn't taking enough in. She sipped some while we were there and I said it was important for her to keep drinking. She was very low though , saying she wished she had died in the fall ( my two dds heard that and were very upset ) So she may well just be having the odd cup of tea but not taking in enough. She was about the same in terms of confusion, she still thinks that the ward went on a trip to the place we were house-sitting for the past few weeks, she said she heard someone mention they'd seen the horse. She looked anxious when I said that no, only db and his son had been to see us. The mere fact that she can't see that it would be bizarre for all the ward staff to come to West Wales is very worrying. She was quite insistent. Other than that, the odd name slip up, but then I called her my dds name at one point ! (tired and stressed). She uses "thingummyjig" a lot when she can't find a word right away. She looked more frail and less rosy cheeked than when I last saw her, thinner and more frail. And her chin is suddenly hairy which made me cry in the car as she looked less cared for somehow. She's more loving and less prickly than of old too.
I am very tearful myself now so will go to bed, thanks for all the advice so far.