Mum in hospital, deep sleep and doctors puzzled

[holly_wood]

Hi
My mum has been in a CH for 6 months and has seemed to decline rapidly over the last couple of months. She has had what initially was thought to be just a cold for about 3 weeks. Since then she has been slumped over a lot, had a temperature and not been eating and drinking much. The GP decided it was a viral infection but 2 lots of antibiotics have not shifted it. She was taken to A&E on Tues night as the GP was concerned about her sodium levels.

After being on a drip for a day she started to eat a little (being fed) on Wednesday. However, on Thursday she seems to have fallen into a deep sleep and can't be woken up properly. She has had blood pressure checked etc and also a catheter fitted whilst in this state. She apparently got a bit aggressive whilst the catheter was fitted and she has been making noises as though disturbed when being moved etc but never completely wakes up.

I have spoken to some of the doctors and nurses and they seem baffled. However, I have looked on here today and immediately found a thread about deep sleep and it seems quite common in dementia patients. In my mind it seems that she has been ill, dehydrated and weak and now that she has got some nutrients from the drip and a little food her body has put her into rest mode to fight off the illness. Does that ring true with anyone else?

They were going to do a CT scan later yesterday (if they could) as she has also had a cyst on her brain 10 yrs plus ago and a stent fitted so they are checking that is all ok.

Its all quite worrying and the docs have now asked me back ground questions twice, my brother once, and also my sister in law and the care home. She was in the Acute Medical Unit yesterday but they did mention moving her to Frailty as they deal with dementia more. My mum is only 67 and until recently I wouldn't have described her as frail but think this may be a good move as the doctors she is under at the moment don't seem to have a clue.

Sorry this is so long!

 

[marionq]

On one of the days John was in hospital he did exactly that. Nurses could not waken him or get him out of bed. Doctors were puzzled as he seemed to be on the mend from the infection. They had planned to send him home but kept him in for another five days to see how things went. The following day he brightened up. I do see however that now he is home there is a marked downturn from where he was a few weeks ago.

 

[Moggymad]

Last year during that hot weather my mum spent 2 weeks in bed barely awake not eating & not drinking much. The doc was totally puzzled but continued to treat her for what may have been an infection running from her big toe across her foot & ankle. It was all a complete mystery & at one point I asked the care home manager if she thought mum was end of life. She wasn't sure but said possibly if there is no improvement. Gradually mum came round & eventually was herself again except that she can no longer walk or weight bare. I & the carers believe dehydration played a significant part in all of this as once she started to take fluid she rallied.
I think you are probably correct in your thinking.

 

[holly_wood]

Thanks for your replies.

She has now been moved onto another ward where they seem to be more familiar with dementia and have said she is probably having hypoactive delirium.

https://www.alzheimers.org.uk/get-s...ySUyQfaW2WHhEGFKMS3xQXzpGOUXqy_dEXKT4kZDw2340

She has come around on and off a few times now and we've managed to feed her a bit more food.

 

[Moggymad]

Thanks for your replies.

She has now been moved onto another ward where they seem to be more familiar with dementia and have said she is probably having hypoactive delirium.

https://www.alzheimers.org.uk/get-s...ySUyQfaW2WHhEGFKMS3xQXzpGOUXqy_dEXKT4kZDw2340

She has come around on and off a few times now and we've managed to feed her a bit more food.

I'm glad your mum has shown some improvement & hope it continues. I recently became aware of this condition & suspect this has affected my mum too.

 

[holly_wood]

So my mum is back in the care home again now and at first she seemed to have really improved. Then gradually over the last few days she has started to slump in her chair again so much so that they have left her in bed a couple of times as she looks more comfortable. The slump is making it difficult to get her to eat and drink again. Concerned that she will end up dehydrated again if continues to slump. Anyone got any ideas on how to help with her posture? It seems that she can't keep her head up for long periods and also seems to slide down in her chair. We were thinking of getting a neck brace to support her head but not sure if this will help.

 

[Linbrusco]

I would look at the medications & doses she’s on, even if she’s been on them for a while.
At various times my Mums had a pronounced lean when walking or slumped to one side when sitting.
One time it was put down to sleep deprivation, another with reduced eating her med doses had to be adjusted down, another time it was a reaction to a pain patch.
I have read constipation can also cause this.
Several times now Mum has been tested for signs of a stroke.

Mum has declined massively since September last year, moreso since Christmas, and then after a chest infection.
She was moved from Dementia level care to Hospital level as she has lost all mobility, barely eating but still drinking Fortasip.
Also sleeps 23+ hrs a day. Cannot wake her at all. Sometimes awake but eyes shut. Even if she opens her eyes, she cannot focus, and then eyes shut again.
10am seems to be her only awake time. 30mns at most before eyes shut again. Somewhat semi responsive, but 2 or 3 words at most.
She’s on minimal medication.
Otherwise calm, and no signs of pain.
It’s a truly awful stage.

 

[Jessbow]

A neck brace seems almost unkind. If she is seated on the bed to receive food and drink, can she not be propped with the head end raised and pillows at her side while she is fed?

 

[charlie10]

would a neck pillow like you use for travelling help support her head.....maybe the memory foam type rather than the beads. I don't exactly know what a neck brace is like, but imagine it to be pretty rigid like hard plastic....is there a danger that might damage her skin? Hope you can find a solution....

 

[holly_wood]

So they are sending her back to hospital tonight as she has a temperature again, probably due to not eating and drinking enough. See what happens this time and try to discuss her posture with the hospital see if they can offer any advice.

 

[holly_wood]

Since mums second visit to hospital, the care home have managed to get her a reclining chair. The difference this has made to her posture is amazing. She is now always sat with her head up and eating/drinking much better. As a result her dehydrating has been sorted. There are now other issues as she has a catheter fitted which is not always working as it should and she threw up blood a week or so a go so not great but just wanted to post about the chair in case anyone else has same issues. The chair is a second hand one that doesn't even work but just having a slight tilt to her sitting position was all that was needed.

 

[Karen22]

Since mums second visit to hospital, the care home have managed to get her a reclining chair. The difference this has made to her posture is amazing. She is now always sat with her head up and eating/drinking much better. As a result her dehydrating has been sorted. There are now other issues as she has a catheter fitted which is not always working as it should and she threw up blood a week or so a go so not great but just wanted to post about the chair in case anyone else has same issues. The chair is a second hand one that doesn't even work but just having a slight tilt to her sitting position was all that was needed.

I wonder if this would help my dad who has similar episodes and often slumps in his wheelchair, especially later in the day when very tired. I queried getting another wheelchair with the nursing home nurse but she thought he was okay as he was. I'm not so sure. Unfortunately, dad is now in hospital being treated for an infection and today seemed to be in pain and crying out which was distressing. I'd much rather he be asleep than as he is. He was better than this last week when first in hospital. Such a worry and so distressing.