My dad has late stage dementia but now has C.Diff too....help, advice needed please

[sal68silurian]

Hi again everybody

Not posted for ages but now could seriously do with some advice. Will try to briefly explain. My dad who is 80 and who has vascular dementia had a fall in early Feb and was put in to a ward in hospital. As he was a dementia sufferer in the medium stage he did try to escape a few times so he was eventually moved to a specialist dementia ward. The care here was fantastic and the nurses sympathetic and kind......however he had a bad fall while on the ward, the nurses believed he had just injured his arm but after a few days when he did not want to get out of bed they x rayed his leg and found a fractured femur.

Dad was operated on the next day and spent several days in a semi conscious state...must say the care was not overly impressive at this stage so I was very glad when dad was moved back to the dementia ward after 2 weeks

At this stage no one had attempted to get him to try to put weight on the leg and on the dementia ward we were told he would probably not walk again...one of the nurses told us that his knee was the main reason for this...not his hip.....we never managed to get to the bottom of the knee before the next hurdle!

Two or three days later dad developed pneumonia and was put on to a course of antibiotics...miraculously he recoverd from this and started to come around and be capable of a coherent conversation. However only a few days later he suddenly started to build up urine and he was eventually catherterised...then in only a matter of hours he appeared to lose his swallowing mechanism....he was struggling to eat or drink.

Mum and I left the ward very upset and decided we would return later to see dad again as things seemed to be happening so quickly; not really like I had read in all the info on the disease. When we returned we were put in to a room and asked to wait while some investigations were completed...as you can imagine our minds were running riot. Finally a Dr and nurse came in and said dad had now got C. Diff and was needing to be moved to another ward so that he could be given intravenous antibiotics. The move finally happened at 9.30 at night...everyone was exhausted.

He is now in the CDU unit of the hospital and in a very bad way....the care appears quite minimalist; almost as if everyone has given up on him. The first 2 days we visited we were not told it was contagious, today we were told to wear gloves and gowns while in the room...so what had changed??

So please can anyone advise? Is the swallowing etc to do with the C Diff or is it the dementia? Is there likely to be any chance of a recovery from here or should we expect the worst...my poor dad looks to be really suffering; today his lips were stuck together and no one is trying to look after his oral hygiene other than us. Should I try to get him moved off the CDU ward where frankly it appears no better than A and E...should I try to involve PALS? At my wits end and live 250 miles away.

Any advice would be gratefully received....thank you all so much for reading this great diatribe!

Kind regards

Sally

[Jackcat]

Hi, I don't have much advice to offer, am sure others with experience will come along with that, but I think if I was you I would call PALS and ask them for advice, maybe the hospital has a dementia champion that could take your Dad's case on? Let us know how you get on x

[LadyA]

I don't have much to offer either, but I know this much about C.Diff - gowns & gloves will not make up for lack of rigorous handwashing. Nor will anti-bacterial wipes, sprays etc. C.Diff is spread usually from contact with contaminated faeces - in other words, people (or care-givers, nursing home staff, hospital staff etc.) not washing their hands properly, and then things like door handles etc. become contaminated and it spreads. Good old hot soapy water and a thorough cleaning routine will control C.Diff in any environment. I did see a program one time about some hospital (can't remember where!) that had a specialist isolation ward for stopping the spread of C.Diff - and they did! They insisted on gloves & gowns on all visitors which were disposed of before leaving the ward, and handwashing on entering and leaving and were rigorous in cleaning to the point of obsession.

[Nebiroth]

The symptoms of dementia can be amplified by stays in hospital (due to the abrupt changes in place and routine), by physical trauma, general anaesthetics and infections. Your dad is labouring under the effects of all of these so your dad's abrupt decline doesnt surprise me. The intial concern by the hospital may have been that they suspected some other cause for your dad's decline, such as a stroke caused by a blood-clot.

The majority of C Diff infections are actually caused by antibiotics. C Diff is naturally present in the gut of a small minority of adults (and the majority of children's). It usually causes no problems. However, antibiotic treatments can kill off other bacteria that are also naturally present which act as a check to C Diff. This then begins to multiply which causes problems as it produces toxins.

Most C Diff infections are mild, and the usual procedure is to stop antibiotic treatment. This allows the natural bacterial balance in the gut to restablish. In some cases, the infection is severe, and different antibiotic treatment is needed.

I suspect that the precautions advised when visiting are as much to protect your dad as they are you, from further infections. Healthy persons are often carrying bugs which are harmless to them but can cause problematic infections in those who are already ill, have weak immune systems or surgical wounds. The most obvious of these is MRSA.

[LadyA]

The symptoms of dementia can be amplified by stays in hospital (due to the abrupt changes in place and routine), by physical trauma, general anaesthetics and infections. Your dad is labouring under the effects of all of these so your dad's abrupt decline doesnt surprise me. The intial concern by the hospital may have been that they suspected some other cause for your dad's decline, such as a stroke caused by a blood-clot.

The majority of C Diff infections are actually caused by antibiotics. C Diff is naturally present in the gut of a small minority of adults (and the majority of children's). It usually causes no problems. However, antibiotic treatments can kill off other bacteria that are also naturally present which act as a check to C Diff. This then begins to multiply which causes problems as it produces toxins.

Most C Diff infections are mild, and the usual procedure is to stop antibiotic treatment. This allows the natural bacterial balance in the gut to restablish. In some cases, the infection is severe, and different antibiotic treatment is needed.

I suspect that the precautions advised when visiting are as much to protect your dad as they are you, from further infections. Healthy persons are often carrying bugs which are harmless to them but can cause problematic infections in those who are already ill, have weak immune systems or surgical wounds. The most obvious of these is MRSA.

And that's one of the reasons hospitals don't want visitors sitting on the patients's beds! They aren't just being awkward. Visitors' clothing has been in contact with possibly bus seats, car seats, brushing against people in crowded places - and MRSA can be transmitted on clothing. So we were taught anyway - so a way of controlling these bugs is a rigorous cleaning system including damp-dusting and vacuuming soft-furnishings including curtains daily. As we all see being done in all hospital wards.

[sal68silurian]

Hi again

A new consultant came on to the ward today and said that he did not think such a massive decline could be dementia or C Diff related....8 weeks ago dad was walking on the moor and doing the washing up and preparing vegetables. He thinks it more likely that when he had his fall he perhaps sustained a head injury, this would fit with his sudden loss of speech and loss of mobility in his leg...he has asked for a neurologist to do an MRI scan to look for other damage from the falls sustained.

My sister who has flown from the USA is quite traumatised by poor dad....his eyes follow you when he wakes up and they almost seem to be pleading for you to do something....the worst thing is the feeling of total helplessness that we all feel.

Does anyone out there know if the hospital might be willing to move dad on to a proper ward? Perhaps they would not accept a patient with C Diff?

Anyway thank you so much to those people who replied to my post...sometimes it just helps to write it all down....its also great to know that people genuinely help each other.

Take care everyone

With Love
Sally

[jeany123]

I can't help but just to let you know I am thinking of you and your family and hope things get better for you



Jeany x

[LadyA]

Hi again

A new consultant came on to the ward today and said that he did not think such a massive decline could be dementia or C Diff related....8 weeks ago dad was walking on the moor and doing the washing up and preparing vegetables. He thinks it more likely that when he had his fall he perhaps sustained a head injury, this would fit with his sudden loss of speech and loss of mobility in his leg...he has asked for a neurologist to do an MRI scan to look for other damage from the falls sustained.

My sister who has flown from the USA is quite traumatised by poor dad....his eyes follow you when he wakes up and they almost seem to be pleading for you to do something....the worst thing is the feeling of total helplessness that we all feel.

Does anyone out there know if the hospital might be willing to move dad on to a proper ward? Perhaps they would not accept a patient with C Diff?

Anyway thank you so much to those people who replied to my post...sometimes it just helps to write it all down....its also great to know that people genuinely help each other.

Take care everyone

With Love
Sally

That sounds positive - and even if the MRI doesn't show anything, at least you will know that that avenue was explored.