Any drs/nurses? Gran in hospital suddenly gone 'confused'

[MHQuestion]

I'm hoping someone can help. My Gran was taken into hospital last Sunday after being in a lot of pain in her arm. She's nearly totally blind, can only walk with a walker, lives in sheltered accommodation, is diabetic and has had several strokes. However, mentally she is totally fine, keeps up with the news, no problem at all.

Been visiting her all week, everything fine, having scans on the arm to find out what problem is.

My mum saw her last night and she had totally changed, she said all sorts of things mainly that she'd been at a party and everyone had left her alone, that the nurses had left a door open and cats and rats had got in and lots of other strange things. She thinks she's in her flat not in hospital. My mum told the nurses straight away. They checked for a water infection but she was clear.

I rang this morning they told me she was very confused. Got there this afternoon and she was convinced that she was at a club, that my dad had had a heart attack, that she'd been locked in a hairdressers all night, that someone had taken her bag etc etc and begged me to take her home.

I asked the nurses what was happening and they said they knew she wasn't normally like that and were investigating but didn't explain how or what might be going on. She has gone from totally mentally ok to utterly confused/agitated etc.

Does anyone have any idea what on earth is going on? I would say dementia but it has happened literally overnight. My parents are going back tonight and will let me know how she is but this is very distressing for us and must be horrendous for her.

I've posted in Chat too.

You may find this a helpful read...I hope they work out the why soon.

So sorry for you and yours MH very upsetting for everyone concerned. and awful that the medical staff have left you feeling in the dark.

I'm NOT a medical professional (social worker), but have some experience of working with people with dementia.

sometimes confusion is caused by an 'event' in the brain, e.g. like a little stroke that has damaged blood supply to the brain. it can happen very suddenly, sometimes with no outward symptoms. If it is this kind of dementia, people can have periods of confusion, followed by times when they seem quite lucid.

BUT, like I say, I'm not a doctor, and I'm sure it is being investigated.

Good luck, and I hope you get some answers soon.

No, it's very unlikely to be dementia, although the stress of being away from everything familiar and something obviously being wrong with her can cause confusion. So can aneamia.

Not sure this is the best place for responses though, similar posts in chat have had good responses, there's also general health but that's quite slow. I don't think it's a mental health issue.

Do you know if she is getting enough to eat and drink? Something very similar happened to my Grandad on hospital stays and rectified itself once my mum made sure he was properly fed and hydrated.

Not a medical professional but mother with dementia and experience with lots of elderly relatives. My first thought was chronic dehydration. You may be lucky and have a good ward sister who is checking that drinks given are actually drunk and not simply taken away by ordelies when left. If she is blind she may not be aware or be able to find the drinks they give her. You need to keep on and on as they don't know that this is not normal behaviour for her.

Urine infection

mumblechum that's already been ruled out

kandinsky good point

Dehydration sprang to mind for me too - is there any way you can make sure she has been eating and drinking

Sorry to hear this. The doctors will be looking for signs of infection anywhere in the body and will be investigating if the confusion is caused by dementia (eg. small strokes as another poster suggested); or is delirium and more temporary eg. caused by infection which could present differently in elderly people.

Also speak to the nurses about multi disciplinary meetings - with doctors, nurses, social workers/ occupational therapists to plan for her discharge with the care that she will need according to her diagnosis.

The doctors and nurses should be looking for signs of dehydration - fluid input and output, closely monitoring her blood sugars and the doctros will have probably taken blood looking for kidney function, signs of infection, anaemia.

I would second/third the suggestion of dehydration. I would also be wondering if her blood sugar levels are stable?

Would second upwardandonward's link to the information about delirium / acute confusional states. Lots of different causes, sometimes more than one thing going on, sometimes not always possible to identify the exact cause. Hopefully the medical team are doing all the routine investigations and will be able to find something they can easily treat. This is not dementia. I hope she gets better soon.

Thank you all, posted in chat too and had lots of good responses from all of you.

Could definitely be the dehydration, she doesn't like to drink in hospital because she feels that she's bothering the nurses by asking them to take her to the toilet. I tried to get her to drink earlier but she said 'Ill drink when they take me home' (she thinks she's at her monthly club).

Mumble - I thought that too straight away but they checked her last night and no infection

I hope to god its not a mini stroke as its desperately upsetting for my mum, and as I said god knows how horrible and frightening it must be for my gran.

Thank you all again, will update you when parents ring me if any news.

Only want to say big hugs! You are a credit to your Nan and family. X

Thank you ThatsNot x

Quick update - she was talking to imaginary children tonight when my mum was there. However, they spoke to a dr (my parents, not the imaginary children!!) and he thinks its constipation related (I still think that's weird!!) so they're putting her on lactulose.

We're visiting tomorrow afternoon so fingers crossed for her to be a bit better x

Thanks again, you've all been really helpful x

Did you find a cause yet? Firstly, could be a systemic infection.....I assume the ward doctor will have ordered blood tests? Urine testing alone is not enough.

Secondly, some drugs can cause delerium type symptoms especially cytotoxic drugs - though I assume she isn't on these.

Constipation can also cause confusion but haven't seen the delusional type symptoms that you describe.

Hope cause is found soon and that your gran regains her normal function.

Cross posted there! If it is constipation causing the confusional state, she is probably quite impacted and may need a more assertive treatment plan than lactulose........but lactulose is pretty gentle so I guess they want to try that first. She will need to drink plenty of liquids whilst on lactulose - so that may be a problem if she is struggling to drink enough already.

Oops - didn't cross post, I just missed your last post. Sorry - bit tired!

I was going to suggest some sort of infection (urine?) too. I have no medical knowledge whatsoever beyond coming from a family of nurses (except me, I run away from illness!).