Help please - delirium vs dementia

[Picklock]

Really hoping for any advice or guidance.

To be brief, my grandmother who is in her 80s was admitted to hospital about a month ago with rather severe swelling and water retention, and with a minor infection. She had started become confused quite suddenly. I know it's fairly common for confusion to follow infection so we weren't overly worried initially.

Infection treated easily, physically she's much better, but the confusion has just become so severe. She's hallucinating, become very aggressive and forgetful.

What's most upsetting is that the doctors don't seem to care what's causing it. They won't say if they think it's permanent. They won't say if it's likely to be delirium or dementia. They just want to discharge her and send her home.

I've had a quick look online and at the NICE guidelines. Everything I'm seeing says that if delirium is suspected then investigations must take place because it can cause further, more permanent damage.

I don't want emotion to cloud my judgement, but I feel very upset and frustrated that my grandmother is being left to suffer with no one caring about why this is happening to her.

Does anyone have any similar experiences? What's the protocol meant to be in situations like this?

Bump

Hi Picklock. My DM (75) was in hospital recently after severe chest infection then heart attack. She had delirium: hallucinations, extremely confused. It was distressing to watch. It did fade after a few weeks but got dramatically better when we got home. We had organised a care package through the hospital and local authority to help her remember to take meds, get dressed and make food. She’d sacked them off within a week as she was so much better.

Hopefully the same will happen with your grandmother. Continue to voice your concerns to the senior nurse and docs about her being sent home in this condition. We had an occupational therapy referral which triggered getting the care package organised.

I don’t know if that’s of any help. Hope your grandmother recovers quickly x

Hi OP. So your grandmother is only still in hospital due to her mental health presentation?

A month is an awfully long time, she’s at risk of hospital acquired infection.

If she is deemed medically fit, have the ward completed a discharge to assess (D2A)? This notifies the hospital social work team that the patient is med for and needs their discharge planning.

This will include an assessment of need, discharge destination based on the outcome of the assessment. They will determine, with their family, the safest place for her with her presentation at the moment.

This can be done regardless of whether she has delirium or dementia.
If her symptoms continue your grandmother can be referred to the older people’s memory service for further investigation.

Unfortunately it can go either way. My mother never recovered from the delirium from a UTI which then became classed as dementia and she died about 6 months later. I have no idea if this was inevitable or poor care in the hospital. We did our best to advocate for her and then looked after her at home but it was a pretty horrible experience. I hope your grandmother does improve.

@Picklock you/your family must advocate for your grandmother.

Our elderly, especially in hospital, are hugely vulnerable and dare I say, forgotten.

Hospital acquired delirium is, sadly, not unusual but strong advocacy needs to be undertaken to ensure the right outcome for your grandmother.

Do not allow them to fob you off. Check on the board who Senior Staff is on duty and make sure you talk to them expressing your concerns. They can treat it!

Get her home, asap

Am sorry you are going through this. In my experience hospital care for the elderly was horrendous. DM was written off as soon as she went through the doors. They really don't care. Was told they weren't set up to deal with older, confused adults. But quite frankly that is no excuse. Poor care is poor care.

Delirium can get better on discharge, but the longer she stays in the less likely it will be.