Urgent advice needed-mum is delirious

[flygirl767]

My mum has been gong down hill rapidly, suffering from extreme anxiety and thinking there are people in the house/she's not in her own home. This has been sporadic and the GP could find nothing wrong initially. Over the last few days she has been particularly bad and today she is talking no sense at all. She usually comes round mid morning and is relatively ok but she is talking about being able to see a room full of people, saying she wants to go home etc.

I spoke to the GP this morning, he as already put in an urgent referral to the elderly care team with a view to getting her assessed and scanned but we are unsure how long that would take right now. He said the only other way of getting her assessed is to have her admitted to hospital which she would hate and probably make her even more confused.

I'm going over there now but can't stay over as I have my son at home (she is 30 mins away). Really not sure what to do? She sounds really bad and I wonder if any one has any advice? She is completely delirious at the moment but the GP says if she is a danger to herself I must call an ambulance. Seems extreme but not sure if she is ok on her own?

The practical aspects are 1) she has continuity for next period so the nursing team will get to know her better, 2) it’s near to you and you can see her albeit with distancing 3) staff ratios are higher than a care home which means more peace of mind 4) thankfully you were not the person who had to tell her 5) what PP said about it not costing and using her savings
Now going back to you, please be kind to yourself. You are very important and need this time to recharge and relax.
I have been there with my mum. Indeed my DF had an accident and died while DM was sectioned all without POA so we had a crash course in learning the whole of the social work system
It is hugely stressful having your DM sectioned but the reality is that something major had to happen to arrest the downward spiral and chain of events . The ‘change’ event has happened and she is safe. Take a few days away from her and recharge your own batteries and spend time with your immediate family and try to pick up the threads of your own stuff again. Bake or go running or take the dog out or whatever is your escape. Be really selfish as this period is also about you.

@Rinsefirst

The practical aspects are 1) she has continuity for next period so the nursing team will get to know her better, 2) it’s near to you and you can see her albeit with distancing 3) staff ratios are higher than a care home which means more peace of mind 4) thankfully you were not the person who had to tell her 5) what PP said about it not costing and using her savings Now going back to you, please be kind to yourself. You are very important and need this time to recharge and relax. I have been there with my mum. Indeed my DF had an accident and died while DM was sectioned all without POA so we had a crash course in learning the whole of the social work system It is hugely stressful having your DM sectioned but the reality is that something major had to happen to arrest the downward spiral and chain of events . The ‘change’ event has happened and she is safe. Take a few days away from her and recharge your own batteries and spend time with your immediate family and try to pick up the threads of your own stuff again. Bake or go running or take the dog out or whatever is your escape. Be really selfish as this period is also about you.

Thank you for your kind words. It is so stressful, especially doing it on my own (we lost my DSis last year) but having you all telling me what I really already know deep down, that she is in the right place, is such a help.

My DH has booked a nice hotel in the New Forest at the weekend for us with our son so I am really looking forward to that. We had to postpone our trip to Center Parcs for next week so at least we will have a couple of days away to switch off.

Good those are really nice things to have in place. Without your DSis must make it so much harder and without wanting to tread too clumsily, all this mum business will make you feel your sister’s loss even more.. Sending you hugs and encouragement and bucket loads of strength. It is OK to feel really bruised and crumpled. You have been through so much.

And please know that you are allowed to 'switch off' she will be looked after well and you need to self care as well x

How are you doing @flygirl767 ? I love the New Forest, spent many happy summers camping in and around there!

Hope I'm not derailing from you but our situations sound very similar (without any diagnosis as yet for my DM)
The NH has just called me to say DM is becoming increasingly delirious, confused and distressed. She is threatening all sorts and they found her on the floor this morning with a bandage round her neck

They believe she may have a severe UTI which I understand may be contributing to her state of mind but I think there are other underlying factors. They are sending her back into hospital as she clearly needs a full assessment and I am praying whilst she is there (after UTI treatment) they do a full capacity screening.
Reading between the lines I think this is more than the NH can handle

Oh heck @DorsetCamping what a nightmare! She clearly needs to be somewhere more secure where she is monitored regularly. That is truly awful, I do hope they find somewhere suitable for her as it is such a worry when you do not know if they will be safe. The diagnosis does seem to take an age with MH, I think a lot of it is ruling out/confirming infections and then observing over time if there are other issues.

We had the (Sykpe) meeting with the consultant, Dr and nurses today and it went well. The consultant is so lovely I cannot tell you, so kind and caring. She is sticking with the preliminary diagnosis of Delirium caused by the urine retention and also mild dementia but until they do another test (Addenbrooks I think she said?) we do not know what type. She is confident mum can be discharged in a few weeks if social services get their finger out and allocate her a social worker who will in turn hopefully find her a bed in a suitable home for respite care. I'm feeling a lot more positive now and although I realise we still have a lot to contend with, I am so happy that it is not looking like months in the hospital although I cannot fault the care she is receiving.

I have been granted 2 hour leave slots so I will be able to take her out for a coffee rather than lurk in the grounds. She can also have her hair done next week which will be a major boost to her!

Addenbrooks is the standard initial screening test. It seems so simple, I hadn't thought of it as distinguishing between different types of dementia, but of course it can - do you remember Terry Pratchett saying he fell down completely on the clock face drawing - could only draw half a clock face?

www.ncbi.nlm.nih.gov/pmc/articles/PMC6387595/

So pleased things are getting sorted for you @flygirl767

DM is back in hospital with severe constipation and suspected UTI, which may explain some of the confusion. But the NH matron says DM's behaviour is like nothing she's seen before in people with the usual infections. Perfectly rational one minute then threatening to kill herself or other
people the next. Constantly attempting self-harm. Another example is that DM will be asked to do/not do something which she'll go along with then completely do the opposite.
It's so wierd and out of character.

I was really hoping someone from the MH team could assess her whilst she's still in hospital but I've been told the referral process for the elderly is notoriously slow

@DorsetCamping

So pleased things are getting sorted for you *@flygirl767*

DM is back in hospital with severe constipation and suspected UTI, which may explain some of the confusion. But the NH matron says DM's behaviour is like nothing she's seen before in people with the usual infections. Perfectly rational one minute then threatening to kill herself or other
people the next. Constantly attempting self-harm. Another example is that DM will be asked to do/not do something which she'll go along with then completely do the opposite.
It's so wierd and out of character.

I was really hoping someone from the MH team could assess her whilst she's still in hospital but I've been told the referral process for the elderly is notoriously slow

What a worry Dorset! What type of ward is she on, a general geriatric ward? I am surprised they can cope with her there. Mum was lucky being sent to a MH ward despite having the constipation and urine retention as they can assess her properly, albeit slowly. As long as we get a diagnosis and she is safe, I am okay with that.

Update here-still no diagnosis! We do however have a social worker which is progress. I happened to be visiting today when she arrived to do the care assessment so I ended up talking with for for an hour.

She too is frustrated by the lack of progress and is amazed my mum has not had an MRI yet. She is going to push for a diagnosis so we can arrange what kind of respite car home she will need. This will be for 4 weeks initially and then they will see if she is up to going home with the full care package (4 visits a day).

Frankly, the way mum has been this last week I can't see her going home. Her confusion is worse than ever on a daily basis. Not sure if it is because she is on hospital though as when I took her to the hairdressers last week, she kind of came back to life. The social worker agrees with me that she needs to go somewhere before going home so with the right care, she could well improve in the care home. Downside is she is quarantined for the first 2 weeks so I cannot visit. However, the SW said it will likely be a minimum of 4 weeks before she can move and that is if they can find a place to suit her. She said that as mum will be discharged with a section 117, she will be funded but if we want to upgrade we can as the maximum provided is around £650 a week which is nothing compared to the prices I've been looking at!

@flygirl767

Update here-still no diagnosis! We do however have a social worker which is progress. I happened to be visiting today when she arrived to do the care assessment so I ended up talking with for for an hour.

She too is frustrated by the lack of progress and is amazed my mum has not had an MRI yet. She is going to push for a diagnosis so we can arrange what kind of respite car home she will need. This will be for 4 weeks initially and then they will see if she is up to going home with the full care package (4 visits a day).

Frankly, the way mum has been this last week I can't see her going home. Her confusion is worse than ever on a daily basis. Not sure if it is because she is on hospital though as when I took her to the hairdressers last week, she kind of came back to life. The social worker agrees with me that she needs to go somewhere before going home so with the right care, she could well improve in the care home. Downside is she is quarantined for the first 2 weeks so I cannot visit. However, the SW said it will likely be a minimum of 4 weeks before she can move and that is if they can find a place to suit her. She said that as mum will be discharged with a section 117, she will be funded but if we want to upgrade we can as the maximum provided is around £650 a week which is nothing compared to the prices I've been looking at!

Hi @flygirl767 - we seem to be having a dual conversation going between our threads

Sorry to hear you're not much further forward. I guess this can be a really long process and what you're going through is (although understandably frustrating for you) a really helpful guide for me. Feel like I'm on the same journey just a few steps behind!

I am surprised though you've only just had a SW allocated; a hospital one was appointed to do my DM's MCA last week and will be staying with her.

Crikey I thought if a person was discharged to care after a section 3, the fees were fully funded . The care home my DM was in for respite is
£1400 per week!

@DorsetCamping I know it's not much is it!! She was a bit unsure of the cost and I think that sounds very low. However, they are obliged to find her a place to suit her needs so if none of the low cost homes are available or suitable they have to pay for a more expensive one. She didn't tell me this, I have read up on it!

Yes we are on the same path aren't we?!. Mum was assessed initially by a social worker but as a bed could not be found in her trust, she was sent to a different area (which luckily for me is local to me) so I think the delay in allocating one may have been caused by this. Anyway, I like her, she seems very pro active so we have to wait and see what happens now. She was also concerned that mum has been left with the catheter in without finding out the cause of the urine retention (she has never suffered from this in the past). I guess there is a limit to what they can do on a MH ward and all medical issues have to be dealt with at the main hospital.

I hope your mum settles down now and they can get the bottom of what is going on.

Discharge meeting today but still no daignosis! The consultant and dr both agree that mum has gone down hill and is suffering from delirium again. She has also lost more weight (well under 7 stone now from 9.5) despite nurses sitting with her for meals and giving her build up drinks. They think the delirium has a physical cause but they cannot find it despite numerous tests. She has some mild dementia, cognitive assessment score was 20/30 so not too bad.

She is fine one minute, totally ok and understanding everything then a few hours later completely delirious. It is so frustrating! I have been told I can look at care homes but tricky without a diagnosis as I don't know if she needs one which specialises in dementia or not..the SW will let me know what places they have at the ones they buy rooms from but they looked pretty grim when I looked on line. She's applied for the funding today so should be able to go ahead next week and start the search for respite care initially. Mum did agree to it (reluctantly) which I was relieved about.

Sorry to hear you're not much further forward. I guess that's the nature of mental illness, but must be worrying that's she's losing weight.

Do you mind if I ask which area of the country you are in? A couple of things you've mentioned sound similar

I can't believe this but my mum is being attacked by a new patient. She was punched on the arm by her this morning, the nurse told me when I visited today as did mum. Just had a call from the charge nurse and this woman has gone for mum again and chucked water all over her. An 86 year old woman being targeted..I'm so upset. They are trying to move the new patient and have her on 24 hour surveillance but it's not good enough.. my mum must be terrified. Any idea who I who I should complain to if she is still there tomorrow? Typical it is the weekend when they have skeleton staff

Oh no @flygirl767 ! That's shocking and totally unacceptable in the very place she's been put to keep her safe.
Have you managed to find out what's been going on and has it now stopped?

@DorsetCamping it seems to have calmed down. I rang first thing after a pretty sleepless night and they said that they had put in an urgent transfer for this patient as she shouldn't be on mum's ward when she has violent tendencies. However, we both know how long it can take for a suitable bed to become available! I asked if it had been logged as a safeguarding issue and it has. We talked at length how they were going to manage the new patient and keep mum safe. They also have extra staff members on duty today.
I've just seen DM and she didn't even mention it. She was more concerned that her knickers had not come back from the laundry and she had run out!