1. Expert Q&A: Protecting a person with dementia from financial abuse - Weds 26 June, 3:30-4:30 pm

    Financial abuse can have serious consequences for a person with dementia. Find out how to protect a person with dementia from financial abuse.

    Sam, our Knowledge Officer (Legal and Welfare Rights) is our expert on this topic. She will be here to answer your questions on Wednesday 26 June between 3:30 - 4:30 pm.

    You can either post questions >here< or email them to us at talkingpoint@alzheimers.org.uk and we'll answer as many as we can on the day.

CONFUSED: Mother diagnosed with MCI, Depression and Delirium/Need help.

Discussion in 'I care for a person with dementia' started by JackieJames, Dec 20, 2015.

  1. JackieJames

    JackieJames Registered User

    Dec 31, 2014
    83
    USA
    #1 JackieJames, Dec 20, 2015
    Last edited: Dec 20, 2015
    Short Recap: Mother almost 90. Diagnosed several years ago with Mild Cognitive Impairment (MCI).Then a year ago diagnosed with depression. Also experiences delirium while in the hospital.
    She suffers from heart failure, advanced, so hospitalizations are frequent. Yet, to this day no diagnosis of dementia.
    In short, the doctors believe that she suffers depression and anxiety, (she is on medication for this), and delirium when she is in the hospital. I am really confused why they call it delirium as she seems to be having delusions: For example, she believed that a nurse was trying to drug her, when in fact, this person was trying to give her a blood clotting drug.

    I have just learned another thing now, after almost two years of wondering why she gets angry so often. As an example, we talk. She suddenly becomes very angry at me and attacks verbally something I have said. For the longest time, I could not make sense of how/why she would get angry. Then, the other day, I asked her a simple question when she again became angry: I said “what do you think I just said? . Her answer was nothing like what I had said at all or her answer would be “well what did you say?
    My question is: are they missing some of our words and filling in the gaps? Or what is it? What can I do to make this happen less? I also notice that in talks she moves from one unrelated subject o another and I am frequently lost.

    If anyone can relate to anything here or provide me with any information at all, I would be most grateful. Thank you all.
     
  2. Onlyme

    Onlyme Registered User

    Apr 5, 2010
    4,999
    UK
    I am not medically trained but from what you have said I would suspect vascular dementia and dehydration during hospitalisation making things worse.

    Mum was a terror with her hallucinations when she was dehydrated and her 'visions' of my sins reached monumental proportions. In a week I was dead, a murderer, the police were coming for me, had drowned the dog and my daughter, and moved her to a different country to spite her.

    Please jump up and down to get your mum's diagnosis checked.
     
  3. Amy in the US

    Amy in the US Registered User

    Feb 28, 2015
    4,624
    USA
    Jackie, hello and welcome to TP.

    I am short on time but will do my best for right now, and then will come back later tonight (Eastern time) to answer you more fully. I'm sorry for the short reply as I realise it may be frustrating for you. I am in the States as I see you are as well.

    Disclaimer: not a medical professional, so take everything I say not as medical advice.

    Mild cognitive impairment, or MCI, is, in layman's terms, sort of like "dementia light." The "mild" does not refer to the degree of impairment, but rather to the number of systems affected. I will try to find you a link to a proper description, later, when I have time (again, SO sorry for the rush).

    People diagnosed with MCI often go on to a diagnosis of one or more types of dementia, I am sorry to say. Given your mother's age and what you describe, I would be inclined to think it is quite possible she has full-blown dementia of some sort (vascular, Alzheimer's), or even mixed.

    You could consider getting a proper diagnosis so you know what you're dealing with and can get the proper help. You are not going to like my suggestion, so please brace yourself: if/when your mother is medically stable enough, and only the doctors can tell you this, insist she get worked up by neurology and/or geriatric medicine and/or the Senior Behavioral Health team (what used to called Geriatric Psychiatry in the bad old days but please don't let that stop you; I promise, they are on your side). She needs not just a consult from a psychiatric resident, but an assessment from a team used to dealing with this patient population. Depending on where you are and what's available, this may require transfer to another hospital. I would not permit her to be discharged from hospital until you know exactly what is going on.

    I realize that at your mother's age, and depending on how medically fragile she is, this may not be desirable or even possible. But if you can get some information, then you can stop second-guessing yourself about things like, oh, maybe she's not hearing me properly and that's why she gets angry (what you describe does happen with some types of dementia at some point; language processing gets affected).

    I haven't the skill to tell you the difference between what my mother's neurologist calls a delusion (a false, fixed belief) and what the hospital is calling delirium. I suggest you pin them down on this as well.

    I can tell you that a hospital stay in and of itself can disorientate even a patient without cognitive impairment/dementia. It is much worse for those with cognitive impairment/dementia. This can be incredibly exaggerated by physical problems such as, but not limited to: dehydration, infections (especially urinary tract and pulmonary infections), medication problems, blood pressure problems, vitamin deficiencies, et cetera. All the stimulus and "scary" bits of being in hospital seem to do a real number on our PWDs (persons with dementia). Delusions of poisoning/harm are, I am sorry to say, very common with dementia. DO NOT ARGUE with a delusion, it will get you nowhere. Just do your best to calm, reassure, and redirect (which may be impossible, I understand.)

    I'm so sorry but I must go and I know this may not be completely intelligible as I typed at great haste. I will come back tonight with more.

    In the meantime, call the US Alzheimer's Society at 1-800-272-3900, answered 24/7, and get the contact info for your local group and also your area agency on aging/senior services group. Tell them everything you've told us and see what they can tell you. It can't hurt and may help.

    Do you have a good relationship with her primary care/internist/GP? If yes, enlist their help as well.

    so sorry must dash,

    best regards,

    amy
     
  4. Amy in the US

    Amy in the US Registered User

    Feb 28, 2015
    4,624
    USA
    Jackie, I'm so sorry I didn't return last night to post more. I will be around on and off the rest of today if there is something I can clarify, or if you have questions.

    I will see if I can dig up some links to the Alzheimer's Association fact sheets, that might be helpful for you. I strongly urge you to get some support and help for yourself. Easy to say and hard to do, and Christmas doesn't make it easier.

    Best wishes to you.
     
  5. CeliaThePoet

    CeliaThePoet Registered User

    Dec 7, 2013
    614
    Buffalo, NY, USA

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