Struggling with disabled parent - the saga continues..

[Duchess379]

Those of you who've read my previous post will know that my mum, 67 has suffered several strokes which resulted in a triple heart bypass in 2017. Her mobility ever since has declined.
Last week, she was complaining of feeling unwell, she complained of chest pains & was very shaky, she couldn't hold her coffee properly. I rang for an ambulance, paramedics were absolutely fabulous & realised straight away that something was amiss. She was more vague than usual & couldn't remember how to take her insulin. As a result she ended up going to hospital.

For the first few days, all was well. Dr's diagnosed a UTI & prescribed strong antibiotics. They were also alarmed at her very high blood sugar readings (diabetic, blood sugars were 20+..) so her insulin was changed & the dose upped. By the 4th day, all hell broke loose. She was verbally abusive to the nurses in the night shift, wouldn't allow them to administer her antibiotics or insulin & accused them of drugging her. I was phoned at about 10pm asking to assist, so I had to drive to the hospital which is only 10 mins away to help where I can.

It was like my mum was possessed! Absolute mad ramblings & accusations made against the nurses, I was really alarmed!
I went to see her the next day & she was a lot more calm but still not herself.
Last night, just gone midnight, I get the mother of all calls from staff saying mum has physically attacked them. I ended up being in the hospital until 0330 trying at calm her down. She was full of conspiracy theories, claiming staff were killing patients & storing them in the basement. Nurses had tried to give her the insulin & she physically kicked one in the chest & one in the face! When I got their, she wasn't even contrite. Almost like she's had a psychotic break! Dr's are trying to figure it out and I'm left thinking 'wtf', whilst trying to sort out our move to a bungalow, which we've done to assist her!
I'm at an absolute loss & don't know what is best. Do I bring her home & hope it's the hospital environment that's driven her doo-lally or do I leave her there, seething & believing it's a conspiracy to kill her off.. 🥺🤦🏼‍♀️

Please do not bring her home OP. She needs assessing to see if there is a medical or psychological reason for her behaviour. If the medical staff, who are trained, are really struggling I can't imagine how you would cope alone with her.

I am bit shocked the hospital called you instead of calling for psychiatric crisis team to attend. Your DM is certainly mentally unwell.

I agree with Plan. If they call you tonight I'd be tempted to say now abs suggest they call then instead.

This sounds like my dad, he started having psychotic episodes in hospital. Was convinced they were killing him, he was also aggressive which was very out of character. He did go back home, but he was medicated for the psychosis and was not himself. You have my sympathy, they really are worried for their safety when they don't need to be.

How awful for you and your mother. Delirium is common in older people in hospital, can be caused by infection, certain drugs, sleep deprivation etc. It usually does resolve, if this is what it is. I presume they've taken bloods and checked her electrolyte etc. Do not take her home yet, she does not sound well. Hopefully she improves soon .

@PlanDeRaccordement

I am bit shocked the hospital called you instead of calling for psychiatric crisis team to attend. Your DM is certainly mentally unwell.

I'm a bit shocked they rang anyone, when my mother went delirious in hospital, they didn't bat an eyelid and just left her to it, saying it was 'normal'.

It's probably a mix of the medical issues, infection, and the hospital environment. Don't worry about bringing her home until they've got her medically fit, then if she's still acting odd you can consider if she'll be better once she's home, and if you can cope with her until she settles. Insist on getting her as thoroughly assessed by all the relevant teams before they discharge though, be that psych, or geriatric team etc. You could also ask them to consider prescribing something to calm her, they don't always like to because the more drugs someone's on it can cause more delirium, but if it reduces her upset in the short term it should be an option.

Thank you for all your replies, lord knows I need some guidance right now.
I've consoled myself with a bottle of wine so I'm certainly not going out to the hospital tonight. My thoughts are that she hasn't been sleeping well - is this like a state of delerium. Almost like an over tired toddler. Or is she harbouring an an unknown infection, which the antibiotics haven't dealt with? Could it be vascular dementia?! I have no medical experience, so I'm literally paddling in deep water. She rang my dad about an hour ago & almost sounded lucid & normal. But how long will that last? She went absolute batshit at me last night, accusing me of selling the house to steal the money. I'm buying a bungalow for her benefit. If I had my way, we'd stay put! I just don't know what the answer is or how to proceed. I've got no siblings to support me, I've spoken to her sister who is fairly local & her best friend who absolutely support me right now.
Thanks for listening 🍸👍🏼

@Puppymania

This sounds like my dad, he started having psychotic episodes in hospital. Was convinced they were killing him, he was also aggressive which was very out of character. He did go back home, but he was medicated for the psychosis and was not himself. You have my sympathy, they really are worried for their safety when they don't need to be.

Can I ask what your dad was diagnosed with and how it all started? I'm so overwhelmed & trying to make sense of it all I truly hope your dad is in a good place now 💕

Sometimes the patients in my area (I'm a nurse) become more confused at night time, it is very common where I work. Hopefully once everything settles down with the infection, blood glucose stabilises etc, she will improve.
If there was anymore deterioration, they could maybe do another brain scan at some point in the future, I presume she had one when she had the strokes. Hopefully this will be short term. Hope you get to relax a bit tonight.

Could it be vascular dementia?!

In my mum's case, she had no previous history of dementia or strokes, but immediately became delirious on 2 hospitalisations. They said they wouldn't diagnose anything whilst she was in, as they can't tell the difference between delirium and dementia symptoms. After she passed away though the coroner suggested some level of vascular dementia was likely.

However, plenty of people absolutely lose it in hospital then very quickly recover when they're home, the hard bit is not knowing in the meantime. Keep asking the hospital to do all they can to investigate whilst she's in. If she's had strokes then they could do CT scans to look for further deterioration, & they should have people who can help plan for her discharge - ask the ward who you can speak to, hospital social worker, or a dementia matron. Does she live with you normally?

@ToCutALongStoryShort

Sometimes the patients in my area (I'm a nurse) become more confused at night time, it is very common where I work. Hopefully once everything settles down with the infection, blood glucose stabilises etc, she will improve. If there was anymore deterioration, they could maybe do another brain scan at some point in the future, I presume she had one when she had the strokes. Hopefully this will be short term. Hope you get to relax a bit tonight.

I've had a bottle of wine, so feeling much better! This was my train of thought - she's overtired because she hadn't been sleeping well, her sugar levels are off the chart & she hasn't been for a no 2 properly whilst in hospital. So could have possibly resulted in some sort of toxicity in her system. I don't know, I'm not medically trained, I'm just grasping right now... 🥺

Also, she's had MRI & CT scans & nothing is amiss. Apparently...😶

@Duchess379 am so sorry you're going through this, it can be really scary for you to see your mum like this, sending .

But @Puppymania what did you mean by this You have my sympathy, they really are worried for their safety when they don't need to be. the staff don't need to be worried for their safety or the patient doesn't?

@Duchess379 I seem to remember that basically anything and everything can contribute to delirium - infection, strange environment, not getting their usual medication, getting strange medication, lack of sleep, noise etc etc etc. So there's every reason to just assume this is common temporary confusion and no point in assuming worse right now. You can't even think about taking her home until she's medically stable so try not to get too upset whilst she's under the hospital's care. I know this is much easier said than done though, so hard to see a parent so not themselves

@Lellochip

Could it be vascular dementia?!

In my mum's case, she had no previous history of dementia or strokes, but immediately became delirious on 2 hospitalisations. They said they wouldn't diagnose anything whilst she was in, as they can't tell the difference between delirium and dementia symptoms. After she passed away though the coroner suggested some level of vascular dementia was likely.

However, plenty of people absolutely lose it in hospital then very quickly recover when they're home, the hard bit is not knowing in the meantime. Keep asking the hospital to do all they can to investigate whilst she's in. If she's had strokes then they could do CT scans to look for further deterioration, & they should have people who can help plan for her discharge - ask the ward who you can speak to, hospital social worker, or a dementia matron. Does she live with you normally?

Yeah, we live together. She's had CT scans & MRI & nothing appears amiss. But this behaviour is totally out of left field 😶

Is she sleeping? My mum got delirious in hospital when she was unable to sleep properly due to noise.

Utis can cause this has hers cleared?

Seasonchange & DinosaurBlues No, mum's sleeping is awful. She's become nocturnal & only sleeping a few hours at a time. When she was home, she'd be asleep in her chair on in bed. In a hospital, with a lot going on, she's not getting that sleep. She's been treated for UTI all week but I've had no update whether it has cleared..

I'd perhaps mention the sleep to them today and ask if she's responding to the antibiotics.

I don't know whether it's appropriate to suggest a sleeping tablet but you could perhaps bring it up when you talk to them.

Psychosis with UTI is very very common - she needs to be assessed by an AMHP.

I’m sorry this is happening - it’s incredibly stressful.

Sounds like Delerium. Very common in older people taken into hospital, I'm surprised they called you in for it actually

My sweet, mild mannered Grandma had it on one of her admissions and became semi-feral...hitting and biting and telling the staff to fuck off (from a lady who never said anything stronger than bugger!) and making all manner of outlandish claims, it was like she was possessed but it did pass

Have you spoken to the ward yet @Duchess379? Have they given any clearer information on why she has delirium and such high blood sugar?

It might be worth speaking to the discharge team as well and saying that you're not prepared to have her home unless things have improved.

@PanicBuyingSprouts

Have you spoken to the ward yet *@Duchess379*? Have they given any clearer information on why she has delirium and such high blood sugar?

It might be worth speaking to the discharge team as well and saying that you're not prepared to have her home unless things have improved.

Funnily enough, they rang me an hour ago & this is exactly what I said! Physio team are worried that she will be unsafe at home because she struggles with her mobility, so much so that they haven't done any physio with her 'in case she falls over'. I got very grumpy & exasperated at this stage! Give her physio, get her legs strong enough to support her, then she can come home & have the freedom to move about the house, especially to go to toilet. That's a basic right. Discharge nurse wholly agreed & has gone off to make some enquiries. Meantime, my mum who sounds a lot better in herself has said there is no mention of a scan, that a Dr required last Friday. Wtf are they doing? I'm not impressed tbh..

Meantime, my mum who sounds a lot better in herself has said there is no mention of a scan, that a Dr required last Friday. Wtf are they doing? I'm not impressed tbh.

If you're not impressed you can always call the ward and ask things like when is she likely to get the scan. They won't mind answering calls like that, well not in my experience anyway

This sounds exactly like how my late husband's illness began. Going on my own experience, this is what they should be/will be looking at:

1. Vit B deficiency
2. UTI
3. Lewy body dementia

Maybe all three. The manifestation of the psychosis you describe is horribly familiar. Everything about it. If they haven't tested for the vit B, get them to do so. Probably they've checked for UTI. Lewy Body Dementia is a bastard to live with, experience and diagnose... but in the end that was what it was. Sorry.