Urgent-dilerium (again)

[flygirl767]

Hi need some advice, DM has Alzheimers, diagnosed last year after suffering from delirium and being admitted to an acute ward for 10 weeks. She's been coping at home alone since with carers 4 x a day.

Last 2 weeks she has totally changed, can't bear to be alone, confusion and barely eating. I called GP, antibiotics prescribed which made no difference. Since found she had leukocytes in urine but no infection. Last night she was totally confused, hysterical, shouting at me, which she never has in my life. I wasn't able to so called out an emergency carer. During the night she has called the police, she has no idea where she is. I spoke to her twice, calmed her and said I would be over first thing.

Spoke to GP again yesterday who was a locum and a bit useless, mum didn't seem to bad then so we just left it that they would re-test urine. I have contact details for lead nurse at OPMH but there must be a cause for the delirium, the Alzheimers can't have progressed so suddenly can it? Feel like I am back to square 1 where we were last summer! Does she need to go to hospital? Really don't want to go down that route right now but I need to do something.

Call the person who deals with her MH. I imagine that the first thing they will ask is whether she's had a urine test and whether it was dipped or cultured, they see this all of the time. They have the experience that you don't and they will be able to support you in this.

GP came out, he's asked for her to be checked at hospital so that is where she is now. They are checking everything, GP thought it could be dileriulm cased by constipation.

Mum of course doesn't think there is anything the matter and remembers nothing of her night time rampage. The carer arrived to find the iron on this morning, I really don't think she can be left on her own at night anymore unless this has a physical cause which can be treated.

We had the same last year with DMIL. The hospital checked every possible cause, like UTI, dehydration etc but nothing ever came up. In the end the multi-disciplinary meeting decided that she couldn't go home so is now in a Care Home nearby.

Hers was a sudden dip too but she has Vascular rather than Alzheimer's.

@DuaLipaSuction

We had the same last year with DMIL. The hospital checked every possible cause, like UTI, dehydration etc but nothing ever came up. In the end the multi-disciplinary meeting decided that she couldn't go home so is now in a Care Home nearby.

Hers was a sudden dip too but she has Vascular rather than Alzheimer's.

Thank you for your reply. I don't think we are far off a care home to be honest but really wanted to try and keep her at home while the pandemic is on going. She was coping fine until a few weeks ago.

The hospital have called and she has severe constipation, one of the main causes of confusion etc in elderly particularly common with those with dementia. DM's diet leaves a lot to be desired these days! Not sure if she will be coming home at the moment as it may take a while for her to get back to normal and the care agency had concerns about her being alone.

Oh Flygirl, just seen this update. So sorry that things have escalated to this point. My DM also had severe constipation at the point her delirium started. Maybe there’s a trigger there?

Maybe now is the time to assert her need to go
Into a care home, especially given the toll it is taking on you. For all the other rubbish I’m sorting out with my DM I am so thankful she is at least in a safe place now and being cared for 24/7.
She tells me she hates it on a daily basis but i know it was the right decision.

Hang in there

I don't think we are far off a care home to be honest but really wanted to try and keep her at home while the pandemic is on going. They may decide that she is only discharged to a care home. If it's any consolation DMIL still is very confused but looks happier and a bit brighter now she's in a home and they seem to have a genuine affection for her.

Have you got POA and Attendance Allowance? I'm not sure what her financial circumstances are but it might be worth looking at Pension Credit too.

We also looked at some local care homes whilst DMIL was in hospital, just in case.

I know that you can't go to them but we read the Reports and reviews and had a look at the facilities online. I think it helped when we were told that she did need to go into a Care Home that we had already read some really quite good reviews. The one she is in looks a bit shabby but is always clean and it's small with a homely feel.

Well I have just had a call from the hospital-she has tested positive for Covid! I am really shocked, she must have either got it from me, the carers or the vaccination centre last week. No other symptoms as yet. Hopefully having the vaccine even though recently might mean she gets a milder form. I have to isolate now unless I get symptoms then I will get tested.

@DuaLipaSuction she is on a section 117 after her hospital stay last year so aftercare provided by Social Services (although only up to a certain limit, we can top up). I am already on the case and looking at Care homes on line. I think she may have to at least have respite care before she could even think about going home, it depends on her recovery I guess.

Oh so sorry she's got Covid, poor love, that can't be helping with how she's feeling at all.

I think respite sounds like a good idea

Oh what a shame about covid. I hope it isn't too serious for her.
Thinking of you

Covid, Just what you and your DM need on top of everything else
Really hoping she stays strong through it

flygirl don't despair. My father is in a very similar condition, including the severe constipation, delirium and positive Covid test. He had the Covid diagnosis two weeks ago and is doing fine in hospital. His doctor said the delirium could be partly due to the Covid - he has had no breathing problems and hasn't been in any danger, but there is apparently a link.

They are beginning to contemplate discharge and, like you, we find ourselves contemplating whether a care home would be the right next step, at least for the short term to see if he settles.

Fingers crossed your mum doesn't have it too bad and is able to get stablised.

@AChickenCalledDaal

flygirl don't despair. My father is in a very similar condition, including the severe constipation, delirium and positive Covid test. He had the Covid diagnosis two weeks ago and is doing fine in hospital. His doctor said the delirium could be partly due to the Covid - he has had no breathing problems and hasn't been in any danger, but there is apparently a link.

They are beginning to contemplate discharge and, like you, we find ourselves contemplating whether a care home would be the right next step, at least for the short term to see if he settles.

Fingers crossed your mum doesn't have it too bad and is able to get stablised.

@AChicken thank you that is helpful. I had no idea that delirium was a symptom of Covid in the elderly but the doctor confirmed that it can be.

I do hope your father continues to make good progress and you can get him discharged soon. Mum doesn't have breathing difficulties either and oxygen levels are good at the moment. Fingers crossed she doesn't get any worse.

Having been down this path with MIL, prepare for the fact that being in hospital is likely to make her more confused, as they are noisy places and you get woken up early. When she lived at home there was always a significant deterioration after a hospital admission and in the end she was placed in a care home by SS because she wasn’t safe and roamed at night. It is very hard going through this but you have to prioritise her safety and bear in mind the toll that the worry and mental load take on the family. My husband nearly had a breakdown and spent a lot of time at her house which meant caring for our children and a f/t job was mostly on me. It was an enormous relief to know she was safe and not leaving irons on, the front door open, frightened by TV programmes etc ...

How is your Mum doing @flygirl767 ?

@DorsetCamping

How is your Mum doing *@flygirl767* ?

Hi Dorset Well I've spoken briefly to her twice today and she was equally confused both times. Talking about being on a boat and dentists-nothing made sense. She knew me though and on speaking to her nurse, she said that DM was in reasonable spirits with no more symptoms of Covid so far.

They are taking her for a CT scan tomorrow to see if there is any change in her brain which might be causing the increased delirium.

Thanks for asking, hope your DM is okay, it much be such a relief knowing she is safe even if not too happy at the moment.

Glad she is being sent for a CT scan; hopefully that should bring some clarity.

I spoke to DM this morning and she is also so confused again. Asked me about the time she was givien too many drugs and was arrested for killing someone!
She is incapable of staying on topic and literally changes the subject with every sentence. 100% sure there is no way she could be at home now!

When she was in the MH unit I was told she'd had memory tests etc and no sign of dementia but to be honest I don't believe anything they've told me now. Am wondering if it's a possibility to get an assessment done privately.

@DorsetCamping

Glad she is being sent for a CT scan; hopefully that should bring some clarity.

I spoke to DM this morning and she is also so confused again. Asked me about the time she was givien too many drugs and was arrested for killing someone!
She is incapable of staying on topic and literally changes the subject with every sentence. 100% sure there is no way she could be at home now!

When she was in the MH unit I was told she'd had memory tests etc and no sign of dementia but to be honest I don't believe anything they've told me now. Am wondering if it's a possibility to get an assessment done privately.

@DorsetCamping surely she must have some kind of dementia, what do the staff in the CH say? Is she in a regular care home or one that specialises in dementia patients? I would certainly be looking to get in touch with your local older peoples mental health services and see if they can come to the CH and assess her. Worth a try, I guess you can go privately but you would still need a referral from her GP.

The ramblings are so strange aren't they, you do wonder where all these bizarre thoughts come from. Mum has no clue where she is again today and thinks it is me that is ill-this is exactly what she was like last summer..We seem to have gone full circle!

I have experienced caring for a relative with Vascular dementia for several years and several clients with dementia. I’m not saying that makes me an expert but just thought I’d share something.

It was explained to me that someone with dementia might, for example get very agitated for no apparent reason. It could be something like a box of tissues they can see out of the corner of their eye but the brain isn’t processing the image properly and they think there’s a bird flapping about in the room.

The reason I’m mentioning this is because I think the human brain tries hard to make sense of muddled input and to make coherent narratives so if someone’s perceptions are confused they sort of create what seems like a plausible fiction around it. So the dentists and boat could be a way of explaining feeling a bit seasick if she’s feeling wobbly like labyrinthitis and maybe she’s had dental treatment where the dentist was wearing a mask and gloves.

I hope all goes well and you find a really good respite place.