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Elderly parents
Original poster

what is wrong with my Mum?

60 replies

hellymelly · 20/01/2013 15:19

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?

OP posts:
PigletJohn · 29/01/2013 00:53

does she have any pets at home?

toastedteacake · 29/01/2013 00:42

Sorry if my post sounded bossy Blush was in a rush to get out of the house but didn't want to read and run.

I thought thyroid as DH's DGM sadly didn't receive her medication when admitted to a care home after a fall. Her family forgot she took it and it turned out that she hadn't been filling her prescriptions for a while (she lived a very independent life previously). By all accounts she was a lovely lady, very warm and smiley, but within a few months she had deteriorated into a delirious state.

One thing, has anyone noticed if she has a swollen tongue? The hospital may be interpreting this as dehydration, but as you know it's also a sign of hypothyroidism. I am also hypo and for me personally it is one of the first signs that something is not quite right and my medication needs a review.

I hope your mum begins to feel more like her old self very soon.

x

Original poster
hellymelly · 28/01/2013 23:12

She does seem under medicated to me, as regards her thyroid. (In that her home is very hot and she still feels icy to touch.) She wasn't quite so chilly yesterday though. I live two and half hours drive away, I don't drive so we can only go to visit when DH is free, and usually have the dds with us (5 and 8) so we only see her once every couple of weeks at the moment. My brother is closer, half an hour away on a good day (treble that in thick traffic) He is also a single parent of a 13 year old, so can't go every day- he goes three or four times a week.
she is prone to chest infections, and was coughing a bit yesterday, but is so chilly that she doesn't throw a high temp easily. I am going to talk to the ward sister about that. They are working up to a discharge, she's having lots of physio and this week her home is being assessed, she will need her bed moved downstairs and she was very upset about that, as she will then be in the room that was Dad's when he got too ill to climb the stairs.
She has a clot on her leg but it is shrinking well and she is walking with a zimmer but still needs help to dress/go to the loo etc. She can't come here sadly as my house has very steep stairs and db and I both feel its too much of a risk.
I'm also on thyroxine, so I'm fairly well informed, but I will go and google as suggested toastedteacake, as I didn't know it could cause delusional type behaviour.
Thanks for all the kind posts. It is very bleak seeing her so sad and small in the ward. I think she likes the staff, she knows some of them well from their care of my Dad, she is grieving though, and its not the best place for someone recently bereaved.

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toastedteacake · 28/01/2013 18:35

Are the hospital aware that she is hypothyroid and on meds? Are they making sure she is taking it? Anaesthetics can play havoc with the levels, she may now need more thyroxine.
Very low thyroid levels could account for her change in behaviour and confusion. Hypothyroidism before treatment became available was known as myxeodema madness.
Maybe you could do a bit of googling and see if this may fit?

gingeroots · 28/01/2013 09:52

I agree with everything said ,although not perhaps with the idea that it's simple to solve the dehydration problem Smile

My mum was beside herself while in hospital ,telling the doctors to "sling your hook " ,convinced that a film was being made ( it was some machine opposite her ) .

She was on IV diueritics but no monitoring as to fluids in ,no drip .

I had to discharge her myself and take her home .
She was better at home .

The only other thing you can do is to spend as much time as you can in hospital with her looking after her as the staff honestly don't have the time .

You may have to ignore visiting hours .I've found being very quiet and helpful works ,usually they let you stay .

But of course if you've young children it's not always an option .

BeckAndCall · 28/01/2013 07:36

It also sounds to me like delusions brought on by infection - not necessarily UTI. My MIL has had two horrid bouts of delusion which were really graphic and scary - both from a low level respiratory infection. But presumably they are checking her temp on a regular basis so would spot that?

Doctors go on special courses for spotting delusion symptoms - maybe ask for a second opinion within the hospital of someone who can at least rule it out?

throckenholt · 28/01/2013 07:36

re-reading this thrread - it is worrying that so many people seem to suffer from dehydration but little is done about it :(

I remember hearing a program on the radio about dehydration on old people's home leading to lots of falls - it really is a big problem and seemingly fairly simply dealt with - albeit you need to take the time to make sure someone drinks enough. And time is what seems to be lacking with a lot of care homes and hospital situations.

throckenholt · 28/01/2013 07:32

My mum was very confused when she was in hospital being treated for cancer complications - dehydration and repeated infections. We thought it was the onset of alzheimers. But after she went home she went back to normal - she was desparate to go home and we thought she would only manage a few weeks because of the confusion - she managed a good 6 months before the cancer took hold again.

I think dehydration is a lot to do with it. I think also that only people who know them notice the confusion - because most of it sounds so sensible. The one that really struck me was when mum said my brother hadn't been to visit for a week or more, and I knew he had been there the day before because he had phoned me and I spoke to them both. She had no memory of it. And much of what she siad that was wrong only I would know that - not the people looking after her day to day.

greenhill · 28/01/2013 07:15

It does look as if a care plan has to be thought through ready for your mother to go back to her own home. She sounds unhappy and if she isn't feeling brightened up by the bustle of people around her in the ward, she probably needs to be back in familiar surroundings. If that is feasible.

I know many people are very suspicious of hospital staff/ doctors if a loved one died or deteriorated at the same place they end up in. This may explain your mother's feeling of lowness.

My DH's GM, a sensible and calm woman, had dreamt that she had died and been taken down to the morgue etc. she was absolutely convinced of it, but it was a side effect of the GA and painkillers. She was convinced of it and couldn't wait to be back in her own home. My GM thought the staff were saying unkind things about her, on one stay in hospital. It is disorientation and unfamiliar surroundings.

I still think your mum is dehydrated, though.

I hope you were able to sleep and feel a bit more positive today x

PigletJohn · 27/01/2013 23:49

My opinion might be wrong, but I'd try to get her back to her own home, the quicker the better. Care will be required.

If you watch the level of squash in the glass, you might be surprised it doesn't go down.

Original poster
hellymelly · 27/01/2013 23:10

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 Sad ) 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.

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gingeroots · 27/01/2013 09:20

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 ?

Original poster
hellymelly · 26/01/2013 16:49

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 .

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IDontKnowWhereMyMedalsAre · 26/01/2013 11:58

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.

PigletJohn · 25/01/2013 23:54

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

Original poster
hellymelly · 25/01/2013 23:30

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?

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PigletJohn · 25/01/2013 16:38

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

Original poster
hellymelly · 25/01/2013 14:39

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

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Original poster
hellymelly · 25/01/2013 14:38

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.

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Rosy · 24/01/2013 21:39

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.

Original poster
hellymelly · 23/01/2013 18:01

no, they are checking her regularly for UTIs.

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recall · 21/01/2013 22:53

UTI ?

Original poster
hellymelly · 21/01/2013 22:51

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.

OP posts:
Original poster
hellymelly · 21/01/2013 22:48

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.

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CMOTDibbler · 21/01/2013 15:07

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

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