Dad deteriorated quickly

[fishloop]

My 79 yr old dad has had lots of falls recently. He went to rehab and improved. On his last day there he fell. He had to wait on the floor for over 2 hours for paramedics. In that time he wet himself. A consequence of the fall was internal bleeding (blood thinners) it seemed to settle. He's been in hospital for 3 days now and is getting worse each day. He's been moved a lot and now they think he has dementia. He was a completely different person 3 days ago. Can dementia show so bad suddenly? He now can't walk or stand, feed himself, coordinate his drink. He's in bed with padded cot sides in a state of confusion and discomfort. Doesn't know where he is etc. Apparently he became violent last night. He isn't himself at all. He's very deaf which hasn't helped. He's been due a brain scan for the last 2 days. He was due a chest CT this week because an X-ray a month ago showed a shadow. I've been told they did it yesterday. I was told by a nurse that the dr wants to speak to me tomorrow (today Monday) about the chest CT. I know they have suspicion that it is pulmonary metastasis because a nurse accidentally read that out to me on the phone. I'm preparing for the worst. I'm shocked by his sudden change. I just hope it doesn't go on to long, I don't want him to suffer.

I’m so sorry
Has he been checked for UTI which can cause confusion

Also, could it be the situation?

A a few years ago my mum had a fall, hit her head, ended up with subdural haemotoma (sp) and recovered.

I do also know the feeling of not wanting them to suffer...sadly my late father did suffer.

I hope this doesn’t seem too jumbled but I just wanted to say that I know the state you are in and how hard it is. I’ll check back on this thread tomorrow. Would you like an unmumsnetty hug in the meantime, if so, sending big hugs

I would be asking about a UTI also. My Dad was extremely confused and also grabbed the arm of an x-ray tech, which landed him with a sign above his bed that said he was violent. This was completely out of character. They treated him for a UTI and two days later he was sitting in his chair reading. The infection can really cause a rapid deterioration. Dementia is a slower process usually.

Sounds like an infection to me. Surely they are screening him?? Push for it if not. It sounds like "Delerium"
en.m.wikipedia.org/wiki/Delirium

Hi,

I just wanted to add that I know how hard what you are going through with your Dad is. My Dad being sick and frustrated was one of the hardest things I have been through. You feel so helpless watching this strong, loving man who has always been there for you struggle. I found myself constantly trying to make sure the nurses etc. knew who he was as a person, that he had a professional job etc etc. It felt like the real person became invisible and just another sick old person replaced him. I know the nurses tried, but a case load of elderly sick people can be draining I am sure.

I think my worst moment was when the doctor took me in a room and tried to convince me all treatment should stop and that I had to get him out of the hospital. She said he had had an accident on the floor, and, I kid you not "we can't have that here." This was in an acute care hospital, where he had been infected with the C. Diff that caused the accident. I am not at all sure where I was supposed to take him. By this point he was alert and oriented and had told me in no uncertain terms he wanted all the treatment. He lived for over a year after that.

It is important you advocate for your Dad, but also take care of yourself. This sounds like a cliche, but you can't help him much if you are sleep deprived, hungry, or sick.

I hope things work out for you. Gentle hugs.

I agree with previous posters. A UTI can cause quite bad symptoms of disorientation etc . To the extent my FIL had actually had a stroke and they thought it was a UTI infection. It had been a stroke ( not to say that is what your father has suffered)

In the end he had both and also fell over in hospital and broke his hip and his femur. He was such a laid back man but the combination of being disoriented and in pain meant he was uncharacteristically angry at some times.

I am not a doctor @fishloop so I do not know , obviously, what your father has , but just to say - we have had a similar situation by the sounds of it so I very very very much wish you all the best.

Basilisk

Thanks for the replies everyone. They say he doesn't have an infection at the moment. The Dr came to speak to me about the chest CT. It definitely shows something and he couldn't confirm cancer or not. He's sent the images to a panel of doctors who will all have a meeting on Thursday to see what they think. The Dr mentioned DNR and how they think it wouldn't be a good idea to resuscitate if the need arises. I agreed completely. The heamatoma on his side has spread out to his arm pitt all the way down to his thigh. It's completely black. The Dr said he was surprised at how big it's got. They can't operate because he wouldn't survive. He was slightly less confused today but nothing like himself before the fall. The CT of his brain was clear so there isn't a bleed there thankfully causing the change. The Dr thinks it's been brought on by the trauma of the fall. I don't know what the future will be like.

They are concerned that the skin on the heamatoma might break down and he could get an infection. He's covered in skin tears and purple bruises. He is being moved every 2hrs and has a blow up mattress to try and prevent sores.

I feel for you and your dad OP

How is he mentally today? Are you able to communicate with him?

I hope you have real life support but do keep posting here if it helps.

I was so relieved when DNR was actually suggested for my dad. That feels like the kind thing you can’t say in real life.

I hate to say this but do you know the causes of the falls. My gran had vascular dementia and the first symptom was unexplained falls, and now my mother-in-law is going the same way.

My dad had a sudden (over about 3 days) decline in both mobility and cognition. He's since improved, but not to the position he was before.

I found the hospital assumed his mental state was normal for him. Once I had put in writing the suddenness of his decline, with examples of his activities in the week before hospital admission, they carried out more tests and treated him as a man with unexplained delirium rather than a man with dementia who happened to have mobility problems.

I dont have any advice but wanted to send you hugs.

There is very little change in my Dads condition. It is now 9 days since the fall. He's reluctant to eat as can only drink and eat with help. Still confused. He doesn't seem to be swallowing correctly. He chews and chews but it's like he forget to swallow. He eats jelly and ice cream well but still has to be fed.

A meeting took place about the shadow on his lungs. I don't actually know the exact results yet, I have to speak to the Dr on Monday. The nurse said he needs another CT in 3 months, is this a good sign?

What do the doctors say about his mental state now? I know the hospital environment can contribute to delirium.

Re the CT, I don’t know but obviously you will find out more on Monday.

Did they mention any treatment?

Are you the main contact for him? They don’t sound as if they are telling you much, even they don’t yet have a diagnosis, they should tell you that at least.

I’m also wondering what medication they have for him and if that could be affecting him in some way.

Maybe put together a list of questions to ask the doctors on Monday, it can be too much to keep in your head, I find.

How are you holding up?

I have just read your thread and sending you hugs.

I am in a similar position with my DM since Thursday. I won't go into the details but I am scared for her and she is very poorly. With her it's delirium not dementia and the assumptions it's is dementia.