Old person suddenly hyper

[AInightingale]

My mother is in hospital atm following a fall and a fracture. She has dementia and has been very tired, foggy, not really great health-wise all year, and not really up to conversation (she forgets everything within seconds, she just can't engage because of her condition). She is generally lucid though, no bizarre behaviour/speech or anything. Since being in hospital, she is chattering away in a very unselfconscious fashion to everyone (think a three year old child), wants the nurses to look at clouds and things through the window, and seems more generally upbeat than she has been for years. In a way it's really nice to see, obviously, but I am also thinking wtf is going on? She's not on any drugs except codeine, which she has been on before without any strange side effects, they did test for a UTI, there was a trace of protein but nothing severe. What could be causing this, has anyone ever experienced it?

Do the hospital staff not have an opinion on the cause of her sudden chattiness?

They don't know what she's normally like, the only thing they could suggest was a UTI (though she's been given something to treat). I will go to see her later and see if there's been any change.

She could be experiencing 'mania' which can be associated with Dementia but also UTI's

What time does it stsrt or seem to be at its most active? It could be sundowning if around 5pmish onwards

I have never heard of mania as a dementia symptom but it seems a disease that affects everyone differently. Does seem strange that it has come on so suddenly but she is in hospital and out of her normal environs.

It could be another form of infection too, have they taken bloods as well to look at the infection markers rather than just dipping urine? My grandad was immobile under his own steam for the last few years of his life however when he had an infection ( chest or urine infection in particular) he would be trying to get out of bed to go to the toilet and would physically bend fingers back if you were holding his hand to try comfort him in his efforts to get out of bed. He was often sedated and catheterised because of it to let himself rest (and to make it easier on the staff too...)

Do you think she's enjoying the attention? Does she normally spend a lot of time alone?

My Grandma had moments like this when she was in hospital. She also recalled having very vivid dreams which she found hard to differentiate from reality (for example she genuinely thought my DH had died in a car accident). I remember talking to her on the phone (we couldn't visit as it was back in covid times) and she sounded similar to what you have described...almost like someone when they are tipsy.

As soon as she came out of hospital this stopped, I still don't know what caused it. I do remember she had a UTI at one point though and the doctor mentioned it could cause that change in behaviour.

very common side effect of a uti in the elderly and utis are common for the elderly in hospital

No, she lives in an assisted care village where she has plenty of company and activities daily. She's by nature a reserved person which makes it very odd, almost as if she's drunk / high, as pp mentioned above! May be infection although her temp. and appetite are normal and she's not complaining of any discomfort or pain, surely utis are excruciating.

surely utis are excruciating

Not in my experience of caring for an elderly parent. They didn’t complain of any discomfort - just turned suddenly completely doolally and had to be admitted to hospital for a while. It was frightening (for their offspring) at the time, but thankfully treatable.

Has she been on IV fluids? Might it be that she's fully hydrated?

Eating and drinking fine, no IVs. Her bloods are described as okay.

My Dad was admitted to hospital after a fall/generally not looking after himself (was a few years ago now). He was behaving very oddly but as they didn’t know him they weren’t bothered. I had to speak up a lot to say that this wasn’t normal for him. It turned out in his case that he had bowel cancer and needed an urgent operation. He’d hidden symptoms for months.

Im not suggesting that’s the case here, but don’t worry about speaking up if you think the behaviour isn’t normal.

Sorry to hear that @Tulipvase. My mother has been sick, lacklustre and tired on and off for a year but they can't seem to identify anything. Which makes this behaviour quite surprising!

The anaesthetic can make people act differently, change of environment, maybe she was a bit dehydrated before she went in, she would have had iv fluids, hope she's on the mend.

No surgery, just in for rehab/physio - it's a pelvic fracture. I really am not hopeful that it will heal properly at her age but I don't think they do surgery on those bones in an older person.

Is she better hydrated in hospital (is she on a drip?)

She may have worsening renal function ( her kidneys not working so well) so she's might have higher doses than usual of codeine in her system?

I would discuss with her team and make sure they are aware this is not normal for her.

Sounds like it could potentially be delirium

It sounds like delirium - which is a symptom, not a diagnosis. It has many potential causes - one of which is UTI but it can also be caused by pain / constipation / recent surgery / simply being in hospital.

Hi. Ask about Hyperactive delerium. My mum went the opposite way Hypoactive delerium I’d never heard of it.

HAD - hospital acquired delirium. Very common.

Often it stops just as suddenly as it starts but sometimes it doesn't.

Does codeine build up in the body like that? Her kfts have been a bit iffy (GP said they showed a bit of deterioration but not unusual in a person late 80s) & she has had a yellowish hue for a while, I thought. I will try to get talking to a doctor at afternoon visits. She is sleeping now and has gone the opposite way, kind of zonked.