Any experiences of Delirium ?

sounds like a horrendously tough time. X

My relative had delirium after an operation. It was very difficult for everyone involved. I think he was dehydrated but suspicious of the drinks he was being given so wouldn't drink them. Refusing to take meds and kept pulling out the cannula so difficult to treat. Eventually everything sorted itself out he pretty much went back to normal after 10 days (ish).

One thing you might want to look up is Capgras syndrome - tips on how to cope with it. It doesn't sound exactly like what you have described, but your mum struggling with faces and not thinking it is you on the phone reminded me of it. Maybe there's some ideas on how to calm her worries.

Hope your mum is better soon

It's so hard to support someone through that, isn't it? I really feel for you. My mum had delirium about 18 months ago after a serious emergency open-heart surgery op, and she was unwell for many weeks, many of them delirious. There is something about hospital: the lack of natural light, constant noise, lack of sleep, strange faces you don't know which keep changing every shift, coupled with medical reasons like infection etc which seems to be the perfect storm for creating delirium in older patients. It must be so frightening for them. I spoke to my mum about it once she was recovered and she said it's hard to explain when you are in it, thoughts feel like facts. And she forgot a lot of the worst of it. She was refusing treatment, meds, attacking nurses who tried to intervene. It was very frightening to witness and kind of broke my heart. She thought I wasn't real and was a figment of her imagination planted there by demonic beings and tried to exorcise me. :(
It does get better, but brace yourself that it might take a month or so and her leaving hospital (whenever that is) will help a lot. In the meantime, photos of family, a clock for bedside so they know what time it is, familiar things from home and a steady calming presence (which you are already doing) will help a good deal. Let yourself cry if you need to, and if you have someone to give you a hug, take the hug. 💐

That's good.

Are they doing urine cultures, or just dip tests? UTIs don't always show up in the the latter.

Yes, my mum had it after surgery for cancer. It was very distressing for everyone involved.

After she was discharged from hospital we worked out from timings that it was either caused/made worse by one of the medications the hospital put her on. We cut out the medication and symptoms disappeared immediately.

Have there been any new medications introduced?

It’s a very common issue but for some reason it doesn’t seem to be something that family members are warned about. My DM got much better when she was home, unfortunately the things she believed during her delirium weren’t so far out there that they couldn’t possibly be true and three years on she still believes these hallucinations actually happened. It’s impossible to get her to believe otherwise as she knows that some things were implausible like the woman in the bed opposite turning into a cat. The rest could have happened but didn’t!

Very common side effect of UTI in the elderly, first time I saw my late mum going through it, was so heartbreaking and upsetting for her and me. She got over it once the infection was successfully treated.

Yes, it's very common. IME they came out of it and remembered nothing inc whether we visited them so don't feel bad and try to look after yourself too

Yes, when my FIL came home he was still slightly delerious and paced the floor for days moaning things had been moved. We had moved things to reduce clutter but he wanted them back.

My dad was delerious after a seizure and was awful when he came home. My opinion on the intermediate discharge team not good..... But he got there in the end.

Yes, with MIL after surgery and to a lesser extent, every time she had a UTI.

After the surgery it was for around 3 weeks before she went back to her severe dementia 'normal'.

After morphine it's very common indeed.

If she is in rehab in the hospital I'd ask them about 'discharge to assess' (called intermediate care in some areas). This would be either back home with a care package or, better in her situation as she presumably has limited movement of the break and is needing physio, an NHS funded stay in a care home with visiting physio. Usually for a month or 6 weeks.

Even though it will be a less familiar environment than her own home, a care home it will be much better than a hospital ward for helping the delirium resolve - natural light, better sleep, more activities to occupy her mind.

Patients on my ward sometimes get post op delirium; due to either: the anaesthetic, the meds eg opiate pain relief, underlying infections (utis, chest, wound); dementia (which can suddenly worsen to acute confusion & disorientation for a few days post op but then the person often - not always - returns to baseline.), or DTs (delirium tremens caused by being off alcohol for several days - sometimes patients don’t tell the drs how heavily they drink at home so they don’t get medically detoxed post op - then get DTs.); constipation can actually cause delirium (constipation is really common post op); also serious mental illness eg schizophrenia can worsen post op causing maybe an episode of psychosis.

It’s usually patients over 60 who are most prone to delirium and they can behave in extremely out of character ways. But.. my sister had a short episode of post surgery delirium at age 19 due to morphine.

Often they do recall what happened while they were delirious and obviously they can feel very embarrassed or even guilty for being confused or violent.
But luckily not everyone remembers.

The key thing post delirium is to reassure the patient as much as needed that they are safe and not in trouble if they have been aggressive.

Sometimes delirium can last a few months - it’s worth bearing this in mind before thinking an older individual has dementia.