DM about to dangerously discharge

[DorsetCamping]

Apologies for the continuing saga but am at wits end.

To be brief DM (74) has been in hospital 3 times over the last month due to various conditions and the last admission being for 10 days and near deaths door. All pointing to her continuing decline and inability to cope independently.

She reluctantly agreed to go to a rehab unit last week and seemed to be making reasonable progress, no doubt due to be constantly monitored and with the 24/7 care.
Tentative Plans were being discussed for her to go home with an enhanced daily care package.

However, yesterday she had a fall, whereby her walking frame tipped and she banged her head. Thankfully she is ok but naturally it raised deeper concerns about her safety and needs when she goes home.

Onto this morning, she said she is self-discharging and that if I don't go and get her tomorrow she will call a taxi . Said that there is no way she is staying, hates it and is exhausted.
I have spoken to The nursing staff who are adamant that it is not safe for her to go home, especially with yesterday's fall and that her care package needs a new review. More worryingly is that no carers will even be available in the immediate future given COVID and calls on resource.
They have told DM all of this but she it's falling on deaf ears.

I am so cross her with, it's like dealing with a toddler. She has no clue about the worry this is causing or the implications with lockdown. All she keeps saying to the staff is that either I, or her elderly neighbours will help if need be.
I mean, WTF?!
They did ask me about her mental health as she seemed so low today but ultimately it is her decision.

I am so exhausted with her. All she is being asked to do it sit and recover - you'd think she was in a prison cell the way she goes on. I can pretty much guarantee that if she goes home tomorrow she will just end up in hospital again and we'll be back in the same merry go round.

Thanks Rinse.

The hospital has just called to say DM is in extreme distress and they have put a call out to the psych team. I'm going in to visit her at 3 and can't lie, am dreading it. Haven't seen her for 10 days and no idea what awaits me.

Your DM sounds very similar to mine. It's so draining. Good luck this afternoon.

Dorset Hope it hasn’t been too traumatic. Your mum sounds increasingly unwell and it maybe that they will start to increase meds or do an about turn on whatever meds she has been put on. The hospital staff will have a huge volume of cases that they have seen before and can look objectively. It’s harder though as you are not detached. All days won’t be as bad as this one .

Hope the hospital can help her and you are coping as well as you can

Thinking of you🌺🌺

Thank you for your kind words

So I saw her yesterday and all I can say is that the woman I was with was not my DM.
Completely confused, paranoid and terrified. She recognised me but was talking nonsense.
Saying she wanted to die, everyone was trying to kill her, what had she done to deserve this, shouting, crying. Wouldn't believe a word I was saying to her.
She needs constant supervision by staff.

She is being sent for a liver scan today which I almost hopes shows something as the speed and severity of this delirium is staggering.
She is no longer constipated and there is no UTI to account for things.

Also praying she is seen by the psych team today.

Hugs and more

De-lurking to send you a very un-MN hug. You've really been through the wringer. I'm sorry things are so awful for you and your poor Mum.

Good luck for today - I feel for you x

Oh Dorset, it sounds like she has psychosis or something, surely they must have sent a psych team member to see her? Can they give her something to calm her down so that she at least gets some rest?

Poor you and her, it must be dreadful seeing her in this state. My mum was none too good either today, begging me to take her home, not knowing where she was again and talking nonsense. Just when you thinking you are getting somewhere then they take a turn for the worse again. It is painfully slow getting any diagnosis let alone any treatment. Keep us posted how things have gone today.

My DB who lives 3 hours away visited her today. She didn't recognise him and kept trying to send him away. Even more confused and manic than yesterday, wouldn't stop fiddlling with the bed controller and trying to pull drip out of her arm.
Again repeating she wanted to die and that all men were murderers!

I spoke to the doctor, they still hadn't done the liver scan but every other test she'd had done was clear. She last had a brain scan 30 May but her behaviour has been so extreme I'm going to insist they do another one. Dementia has been mooted but how can it be so dramatic and quick? This delerium/psychosis has literally gone from zero to off the charts in a matter of 2 weeks. There has to be something organic causing it

Ask the dr if they are going to do another brain scan, did she have one done after her fall. Bear in mind it will be difficult for her to have any scans done if she is so distressed and agitated and they need to consider her safety. How is her diabetes is it under control now.

@DorsetCamping

My DB who lives 3 hours away visited her today. She didn't recognise him and kept trying to send him away. Even more confused and manic than yesterday, wouldn't stop fiddlling with the bed controller and trying to pull drip out of her arm. Again repeating she wanted to die and that all men were murderers!

I spoke to the doctor, they still hadn't done the liver scan but every other test she'd had done was clear. She last had a brain scan 30 May but her behaviour has been so extreme I'm going to insist they do another one. Dementia has been mooted but how can it be so dramatic and quick? This delerium/psychosis has literally gone from zero to off the charts in a matter of 2 weeks. There has to be something organic causing it

Could she be constipated? My mum's delirium was caused by a mixture of that and urine retention (mixed in with a bit of dementia for good measure) Like you say, it is very sudden which was the same with my mum.

You poor thing OP, I’m so sorry.

@HappyHammy

Ask the dr if they are going to do another brain scan, did she have one done after her fall. Bear in mind it will be difficult for her to have any scans done if she is so distressed and agitated and they need to consider her safety. How is her diabetes is it under control now.

I did raise this with the doctor earlier as he seemed unclear on the timeline of events. He said her last brain scan was on 30/5 which was normal but I reiterated she has had several falls since then. Will press harder tomorrow for another scan

good luck with tomorrow, maybe the doctors can get to the bottom of her distress and tell you if it's something that has gradually happened.

I just don’t understand why your mother’s choice means your choice is not valid.
I mean, if she comes home but cannot care for herself safely then your choice has been taken away as you will have to pick up the pieces.
It’s becoming more common - I’m biased as my FiL rules our lives even though he seemingly asks for little.
It’s just not fair.

I hope you and your D M get the support you need.

@flygirl767, yes she was constipated when she was admitted but let's just say the whole ward were made very aware of when her bowels opened opened yesterday 😷
An abdominal scan she had earlier today not the liver one) confirmed that any fecal matter had been cleared

To add, thankfully her diabetes has been well controlled throughout

I went to see DM today and although she was a little calmer, still utterly confused and paranoid. Shouting all sorts of dreadful accusations at the poor male nurse and just talking nonsense at me. She seems to be worse on a daily basis, almost psychotic. Even a few days ago she could focus to some extent but now nothing, just ranting or rambling. She's not even really eating or drinking as thinks it's all poisoned.

Not had any further scans, but am sure a brain scan would show some sort of damage/trauma. I keep saying it but the speed of her decline has to have a physical element.

Have they checked for sepsis and delirium? My Dad was really awful when he had this, but the hospital were on the ball and had him diagnosed and treated.

She's had a psychotic break. Suggest they medicate it now. Vascular dementia does this - it worsens in steps, not bit by bit.

DM's acting normally for dementia, OP. This is the disease. Push for her to be sectioned and then she has to be treated.

The frustrating thing is that no one at the hospital seems unduly concerned or has a sense of urgency.

No doctors are ever around and all nurses are able to do is give general updates. I tell anyone I speak to that the woman laying off her face in that hospital bed is not my DM and utterly unrecognisable from even 1 week ago!

@Supersimkin2

She's had a psychotic break. Suggest they medicate it now. Vascular dementia does this - it worsens in steps, not bit by bit.

DM's acting normally for dementia, OP. This is the disease. Push for her to be sectioned and then she has to be treated.

Do you think this we are definatley dealing with dementia then @Supersimkin2 ? I had no idea it could come on so rapidly