Stroke in eye, acute delirium/rapid onset dementia

[KOKOagainandagain]

Mum is 84 and has underlying relevant history (since January she has been hospitalised following a stroke, discharged home alone, rehospitalised following fall, discharged to my brother's to recuperate)

She has been rehospitalised due to sudden loss of vision in one eye and confusion, distress, delusional thinking, hallucinations etc.

She has now been transferred to the dementia ward.

My DB wants her to return to his house. He thinks she is only distressed because she wants to go home and that being in hospital is killing her. He works f/t in a senior position and DSIL is a sahm to a 2 year old and 7 week old baby.

Any advice would be appreciated. He seems to think that continence is the only consideration. She has been on 1:1 in hospital and given medication for anxiety and anti-psychotics. DB seems to think that mum could be locked in a safe room whilst DSIL took the toddler to nursery

Btw I live 300 miles away, have 2 DC with disabilities and am a f/t phd researcher in the middle of writing up my thesis. I am limited in what I can provide to mum by my caring responsibilities for my DC.

I'm sorry to hear about your mum. Getting old sticks doesn't it.

I think your brother is being unrealistic. How does your SIL feel about it? She already has her hands full. If your mum needs one to one care right now the best place for her is in hospital. Your SIL won't be able to do that, and what about nights?

The relationship between DB and SIL is relatively new - he is the biological parent of the baby but not the toddler. They are unmarried and she does not have nationality. I don't think she is able to disagree with DB's wishes even if they are unrealistic.

Would medical staff have discharge criteria? How can we maximise her entitlement to resources that could provide support if she were to go back to DB's? Would she qualify for community psych services?

Sorry for all the questions. TIA

He's nuts. If she's unstable and on anti psychotics hospital is the best place for her.

I'm so sorry op. My Mum had Lewey Body dementia and it was awful seeing her like that.

Lean on her consultant and check the Alzheimer's society website.

And look after yourself x

I am sorry op. Very sudden dementia type symptoms can be caused by stroke damage but they are also very common with an infection. (My mum is 82, and is convinced that she was somewhere else all last week, as she has a chest infection that has made her confused). So do insist the hospital checks for UTI and chest infections. They don't always bother, my Mum was sent home from hospital confused and with a raging UTI a few years back.
As to her situation, the confusion may improve, depending on the cause, but if not it sounds a lot to manage at home. My own mother has had to go into a care home, as we couldn't manage her needs here, she really isn't safe to ever be alone as she has a big fall risk. I think that it needs a lot more thought about what is best for everybody before making choices, it is a huge undertaking managing someone with dementia along with young children in particular.

My aged aunt has dementia-like needs, but they are caused by TIA damage. She is now in a nursing home, and requires care suitable for people with advanced dementia, even though her symptomology is slightly different.

He really shouldn't be even considering where she should live until she is as stable as possible and her likely needs (and prognosis) have been properly assessed.

The hospital have done lots of tests including for UTI and we are now waiting for an MRI.

Mum is adamant and always has been that she does not want to go into a home and DB (understandably) is selecting part of what she says (I want to go home) whilst ignoring the obvious delusions which can be delivered in a quite 'matter of fact' manner. Apparently, the woman in the bed opposite used to work at Bletchley Park and is in the film that they are currently making (the ward is transformed when the visitors go) for the Hillsborough memorial.

DB thinks that she is less likely to become stable because being in hospital is causing the problem and wants the prognosis yesterday.

What kind of relationship do you have with your brother? You don't paint a very nice picture of him, especially in your third post.

Is there any way you can tactfully point out to him that your mother won't get the kind of care she needs if she goes to live with him. I assume that he is not a hands on father, because if he was he would understand how difficult it would be for your SIL.

My Mum has just those sort of delusions. The hospital she was in thought she might have the onset of Lewy Body, but once she went into a care home the delusions stopped for a while. Now they are only occasional, or when she has an infection, so we aren't sure what is going on. My mum also really wants to be in her own home, this makes me sad and guilty but luckily my db is very pragmatic and so we do what we can to keep her comfortable, and try to let go of the stuff we can't help.

Bun - DB are on good terms even if we disagree. Brevity due to phone . Another view is new love and new baby bliss/hard work.

SIL is rather lacking in confidence. Both her parents visited for 3 months whilst she was pregnant, her mother returned for 2 months just before the baby was born and is planning to come back in 1/2 months depending on getting a visitors visa. Totally take over all aspects of child care - DB and DSIL defer. I know it would be too much for most women and I think she needs to focus on herself and her own DC atm. And she is my mum too. How do I help DSIL to help DB to be more realistic? I don't want my mum to be a victim of predictable failure. Would the NHS discharge without stipulating care requirements?

To go against her wishes to go home, she would need to have a capacity assessment. If she is assessed as having capacity to choose then she would be sent home with a care package. If she is assessed as not having capacity then you can make decisions for her, I would think they would advise on her needs. Does she have a social worker? Finances are something to think of too, you and your DB need to apply for power of attorney, if you don't already have it. This is a much easier process if someone has capacity and gives permission, than it is if someone does not. So get some advice, as you will need to manage your mother's finances, possibly sell her property to pay for care etc.