Septicaemia/delirium in 95 yo GM... anyone know anything about this??

[Kewchoc]

Hi,

Not sure I'm in the right place so apologies if this should be in a different topic.

My Grandma is currently in hospital with a severe urine infection and septicaemia. This has also caused delirium and she has absolutely no idea what's going on. We spoke to the doctor today who said they save started giving her antibiotics and they seem to be working/clearing things up. Which is obviously good news, but my concern is that despite the antibiotics working her delirium has got significantly worse since yesterday. Surely if the infection is starting to clear up, the confusion should also be getting better? Prior to going into hospital she was completely 'with it'

I guess I'm just concerned that although the antibiotics are apparently working she still seems to be deteriorating. Does anyone happen to have any knowledge on why this could be or have been in a similar situation?

It takes a while for our olders to recover mentally even if the body is from my experience. Hopefully she will be fine in a day or two . I know it’s stressful x

Exh has been admitted at teatime today with the same, 62 with MS, temperature of 40.1, Sat's down to 88-92, on 100% oxygen, doesn't know what planet he is on, waited 5 hours for ambulance on floor as he had fallen. Only thing ds thinks is he had Covid booster & flu jab on Monday.

Thanks for both replies and sorry to hear about your exH.

Yes I guess it makes sense that it could take the elderly longer to recover mentally. But yes it's very stressful, feels like we're in complete limbo at the min as to whether she is going to recover or not

I’m a nurse. Delirium can vary a lot in time. Sometimes it can clear up with the infection, sometimes it can take days, other times it can take months. It was most likely caused by the infection but can be worsened by the hospital environment.

My dear GM used to get a lot of UTIs and accompanying delirium late in life. Only her doctors can really help explain, but I wanted to offer my virtual sympathy, because I know it is a very hard thing to watch someone go through. Be easy on yourself. All you can do is reassure her.

I have an older relative (80s) who is prone to infections because of other medical conditions and prone to this happening. It's a useful way of knowing that an infection is starting so action can be taken even though obviously we don't want them to have an infection but if they do. And the delirium it does actually get worse while the antibiotics are starting to work in that relative.

Sorry to hear that your grandma is so poorly. It can be very frightening to see the people we love disorientated and confused.

Delirium (passing confusion) comes as two sorts one that makes people very sleepy and low energy and confused (hypoactive) one that makes them high energy and confused (hyperactive).
They happen because in elderly people the brain and thought processess are fragile...just as their body is. Even a young person can become delirious but it would take a very severe infection, an older person carries more "frailty" in body and mind they can become delirious from even minor illnesses.

Unfortunately this frailty makes coming back from delirium difficult for them, and the unfamiliar environment, medication and people also stop them from easily re-orientating themselves.

For some people as soon as the physical infection improves their delirium does too...and they get better quickly, however they are likely to be at risk of having further bouts of delirium in the future

For other people the delirium takes time to resolve, this may take days, weeks or even, sometimes, months...which is very difficult as previously independent people require a lot more help.

I hope that your Grandma makes a quick recovery and can soon be back home and well.

My mother-in-law is going through this just now, she is in a care home and was transferred to a hospital for a chest infection was in for three weeks. She's back in the care home now for a fortnight so 5 weeks total and is still having spells of delirium. Whilst in hospital she phoned the police and told them she was being kidnapped, that someone was demanding money, she had heads coming out her wardrobe, someone on the tv was arranging her funeral and the fine at was waiting outside her room. Since being back in the home she's told us her buzzers not working in her room so she has to jump off her bed and land on a crash mat, climb the ladder to tell someone she needs them. That the hospital are trying to get back at her for not dying so they've put her on mashed foods. It's actually upsetting listening to her and I can only imagine how upsetting it must be in her head when she feels like this, my heart breaks for her. We are hopeful that it will get better!

Thank you for all of the helpful replies 😊

@Imperfect10 you seem very knowledgeable on the subject, do you happen to know much about septicaemia too? Of course I want her to recover but equally, the chances of a 95 year old with heart failure overcoming blood poisoning just seems unrealistic. I know that sounds awful but we're all really struggling with not knowing what to expect. We don't want to be too hopeful that she's going to make a full recovery if it's unlikely but also don't want to presume the worst if it's likely she will be fine afterwards

you are right. There is a huge difficulty with predicting how a 95 year old will respond to treatment for septicaemia. On one hand to get to 95 you have to be made of strong stuff!! on the other hand even a fit 95 year old has only a certain amount of "bounce back" we call this lack of resilience "frailty". Frailty impacts how well one responds to treatment and the likelihood of recovery as much as the bug causing the septicaemia.

There is no easy way to predict.

The will to survive and/or readiness to depart seems also to have an impact.

I hope that the staff looking after her are able to guide you through this difficult time and help your family to support her and each other.

@Imperfect10 Thank you for your reply. Well, she's still here and according to the doctor, the infection is clearing up and they're happy with how she's responding to the medication. However, she hasn't had a bowel movement in over a week and today was so weak that she couldn't even push herself to sit up in bed - a drastic deterioration from yesterday when she walked around the bed and considering that she could easily walk prior to this. She's also started shaking uncontrollably which the doctor said is probably just because she's cold (even though my grandmother was sat there saying she's not cold)

I would love to say the staff are really looking after her but unfortunately that doesn't seem to be the case at all 😞 they are talking about discharging her to go for respite in a care home as she's "medically fit" even though she quite clearly is not. I get the feeling they're just trying to free up the bed space and think it's pointless keeping her in now

So sorry you are going through this. Reassure her that she is safe and that nobody is trying to hurt her, tell her she will get better. I had sepsis, pneumonia and multiple organ failure four years ago, the hallucinations were terrible and I thought everyone was trying to kill me, it could have been the drugs or the temperature, I had been in an induced coma for two weeks. These are the words I wished had been said to me. I recall the hallucinations now, indeed they are more like memories. Hope she comes through this ordeal.