Delirium or dementia

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Hello.
Long post warning - trying to include all relevant information,
Having a tough time with DM and would really appreciate any experience or wisdom!
DM diagnosed with vascular dementia about a year ago. Honestly, we saw no sign of it and she was fully independent/full capacity - running her home, socialising, helping with reading in a school, etc. I saw her frequently to check in and make sure she was ok, but she needed no real support and no additional care.
She has an old back injury that flares up from time to time. This happened late in December and - long story short, led to a hospital admission via A and E for an x Ray, pain meds etc.
Unfortunately , the care was poor (I hate saying this but in this case it was true). It took them 5 days to do the corrrect x Ray then another few days to report back that there was nothing of concern and nothing they could do/no treatment indicated.
The ward she was on was chaos (no one’s fault) and during her admission she became delirious - not orientated in time and place, very confused, paranoid. This is not normal for her at all. All the staff saw “dementia” on her notes and just assumed it was that, no one listened that this was new for her, and sudden onset during her hospital stay.
Her infection markers were checked - there was no infection. No new meds given.
She was discharged to a care home, temporarily, on the 22nd as the confusion was still acute. I’ve heard friends describe similar experiences with their parents - delirious in hospital then eventually settle off the ward. I was hoping this may happen with mum. Initially in the care home she became much more orientated - was starting to make sense of what had been happening, what had been happening with her mind etc, but has become confused and paranoid again over the past few days.
I don’t know what to do? Ask for her infection markers to be checked again? Accept she may not adjust fully till she’s back home - or possibly, ever?
Social care are assessing hopefully next week with a view to going home with care in place/adaptations - which is scary but I’m feeling we need to try her at home to see if the confusion reduces any more.

I guess my question is - do I try and get a doctor to see her (she is temporarily registered with one near the care home) to understand the delirium/confusion is new, and possibly check for infection again, or just accept that she may not settle till she’s home/ever.
She did see a doctor yesterday they are trying new pain meds as her back is still painful, but no one communicated that the delirium is new. Because no one knows her they think this is normal, although I’ve repeated myself about this it feels like hundreds of times in the past few weeks!
Sorry for the long post. Thanks for reading this far!

I tried to communicate not just verbally but also in writing, setting out his activities on the day before he was taken ill (getting a bus by himself to his chiropodist and on his way home visiting his bank and doing a supermarket shop). He was 96 at the time so I understood why they had assumed the confusion was his normal. Having it in writing with specific dates and activities was the key to getting attention paid

Thank you @MereDintofPandiculation - good tip! I’ll try that.

I would definitely make sure that she is reviewed by the doctor specifically regarding the increased delirium. It could be an infection, changes to medications, dehydration or constipation.

Thank you, @Findmeaplant343 . She tested negative for infection. The delirium does seem to be on its way out now, thank goodness!! I do think delirium in the elderly during hospital stays needs to be acknowledged more - everyone just assumed it was the dementia. Anyway. Thank you for your suggestions.

Def get the care home doc to consider infection (esp UTI) and whether the new pain meds could be worsening her confusion.

really glad she has been getting better. It’s early days and people do come out of delirium but it takes time. And is quite up and down

if you can get her home that would help.

I think being in hospital can bring out delirium in the elderly. Everyday is the same, you can't tell what day it is. Unless you have a window, you don't even know what time it is. It's not like those who are at work. Sometimes I confuse myself and I don't know what day it is and I'm not even in hospital. It's like groundhog day in hospital.

My father in law is in hospital and I visit regularly. I tell him what day it is to keep him updated and bring him newspapers. I've paid for a tv package for him so he can keep busy watching tv and the news. Plus he knows when it's the weekend cos the sports is on.

Hope your mum gets better.