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?

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.

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

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.

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.

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?

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

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 .

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?

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.

Sorry if my post sounded bossy 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

does she have any pets at home?

Hi

Right, the memory tests that the doctors (or others) do in this situation (mini mental state examinations or MMSE for short) are to get a rough idea of where someone is at memory wise. Yes 24 out of 30 is a 'good' score but someone with a good education/ well looked after can often score highly when actually they are having significant problems. These tests are a gage rather than a finite answer. My own opinion is that used incorrectly they are actually quite dangerous and don't take into account the different backgrounds of the people taking them.

The 30 questions range from what is your name, how old are you, what day is it, what year is it, who is the prime minister... to....

spell 'apple' backwards now, copy this pattern, remember a word I told you 15 minutes ago.

I would not be overly concerned if people were getting the last few questions wrong, I would be quite concerned if they were getting the first few questions wrong. The score means nothing, how which questions were answered is more important.

Some older people develop fantastic coping strategies that can mask just how confused they are. For example you have already picked up on the fact that she is saying thingymajig a lot, i.e. actively contributing to a conversation but not quite being able to manage it. Its often worth checking back to a conversation held a few minutes earlier to see what they have retained or not and how much they were really contributing or just 'nodding along' to.

Piglet- no pets at home, no.
Teacake- swollen tongue? Interesting, as I had no idea about that. Very helpful to know.Thanks for that and no you didn't sound bossy! I am really grateful.
hatgirl- that is also really helpful. She does seem to keep up with conversations, she remembered all the details of where we were going to stay when house-sitting, and wasn't confused about that, its the imagined stuff that is strange, although it may well have its roots in half-overheard converstions. The imagined ward trip to see us is worrying, but more disturbing to me is that she repeats that to db and I without being able to see that it would be impossible. And she looked so worried herself when I gently said that no, it hadn't happened. Only db and son had come.

hatgirl are there any tests we should be asking them to do that would give a clearer picture, like the memory clinic suggested earlier?

There are other types of dementia other than Alzheimer's. Vascular dementia can cause hallucinations and delusions as can Lewy Bodies dementia.

It is common for elderly patients to become very confused in a hospital setting too.

I'm sorry you are going through this. It is horrible. My mum has Lewy bodies dementia and is nownin a nursing home. She has regular delusions. Some are funny but it is all very sad. She told everyone that she and I were not talking as I was having an affair with some guy in the IRA. She thought my sister was in prison for shoplifting shoes. And she was convinced that my dad was having an affair with the man accross the road. She was still living at home then and made my dads life hell with that one as it was in the early stages and wentnon for ages and we didn't know what was happening.

An elderly friend had the same thing and ended up being admitted to hospital as she was severely dehydrated. She had not been drinking enough for months as she was worried about not getting to the loo in time :(

She also had a B12 deficiency, has your mum been checked for this? Apparently it is quite common in elderly patients and the symptoms can look like dementia, but if caught early enough the damage can be reversible. It's not routinely checked though, so might be worth asking.

All the best to you and your mum :)

will ask for a B12 check.
Cider, does your Mum have Parkinsons then? My Dad also had Lewy Body dementia,( with Parkinsons) he had horrible nightmares and paranoid delusions, very distressing. I have wondered about vascular dementia with Mum as she has had two strokes we think (when she had the main one, they found signs of an earlier stroke). I should google though as I don't know much about it.

Hi helly - she does seem to have Parkinson's symptoms. We had no diagnosis for ages and researched ourselves and reckoned it was Lewy bodies. At one point when she was in hospital a few years ago I mentioned the Lewy bodies and was told it didn't matter what type of dementia she had! Except that one symptom of Lewy bodies is that they can't take the normal drugs prescribed for dementia. She had a really bad reaction first time they gave them. Next time she was admitted I told them not to give them so they gave something similar. Again the bad reaction. When she was discharged home at that point there was a care package and the carer and district health nurse were told she had Parkinson's. We weren't told. When she was moved to the nursing home they were told it was Lewy bodies.

Cider, as far as I know, you can get Lewy body along with Parkinsons, as my Dad did, but Lewy Body dementia can itself produce Parkinsons like symptoms, the movement issues etc. I am so sorry for your Mum, it is hideous.
I made a mistake earlier, after talking to db, he said Mum's score on the mini-mental was 29 out of 30, not 24 as I thought. So we are at a bit of a loss as to what is going on.. There was a crisis in the night, the hospital called me at 7a.m., Mum had wandered into the corridor and fallen/was sitting on the floor. She said she was "looking for the post box" .
The Ward sister said that she is much more confused at night-time, and that she constantly needs to wee at night, so they've sent off for a urine culture, but she felt the confusion was more fundamental than a UTI and that Mum would not be able to go home. (the unspoken word "ever" was hanging in the ether). She didn't say "care home" outright, but that was clearly what she was getting at, so I feel horrible upset today. Not helped by me picking up the call and thinking she might have died, as we got an early morning call when Dad died. the ward sister is arranging a meeting which db and I will go along to if we both can, to work out where we go now. .

sending strength vibes

I don't understand why she is getting almost a 100% score on the mini mental test and then is so confused at night-time that she doesn't know where she is. Also the needing to wee a lot at night is strange isn't it? I think it is likely she has a UTI-( a couple of years ago she was sent home from hospital, really not right and confused, after I had repeatedly asked for her to be tested for a UTI . DH was with her and he called out her GP- sure enough, UTI, and after meds she was ,masses better and back to her normal self. ) I just don't know if this could all be down to that, certainly the sister thought not. Am very worried. Also worried that she was able to get out of her bed, out of the ward and into a corridor without anyone seeing (she has a broken leg and is only walking with a zimmer and help by day, so whether she was using the zimmer or not she would have been very slow.)

Thinking of you and hoping that by bumping the thread, that someone comes along to reassure you very soon x

Thanks Greenhill.

I'm quite surprised that nobody has mentioned post-stroke vascular dementia. This is what my Mum has and at first there was no real problem with memory as such - she would just think that she was somewhere else, or think that she had seen or spoken to people when she had not. Has this been mentioned at all?

Sorry I cross-posted - I see that you have considered vascular dementia.

How are things?