Could this be dementia?

[Sterlingtimes]

I emailed my GP, but the receptionist refused to pass it on. I will hopefully get to my GP soon. I imagine that if I sent a letter, the receptionist would tear it up.

For now, I am worried. My mother is a few weeks short of 94. She had a fall five weeks ago and fractured her hip. Before the fall, she was completely self-sufficient in all respect and could even play a very good game of scrabble. Now out of the hospital, she has evidently suffered severe cognitive impairment.

Each morning, she cannot stay awake for more than a few minutes at a time. During the afternoon, she becomes more lucid but suffers severe anxiety. She has lost her perspective of time. At 4 PM, she will ask her carer whether she has come to put her to bed. At 7 PM, she will 'phone me to tell me that her carer has not arrived to put her to bed. The carer will arrive at 8.30 PM, and she will tell me that her carer did not arrive until mid-night. She has forgotten numbers such as her PIN. She has frightened her friends by talking of suicide. She has no concentration and has lost interest in everything.

Can dementia come on within a few weeks? Can the effects of dementia vary over 24 hours?

 

[Grannie G]

Welcome @Sterlingtimes

Taking your mother's age into consideration and the fact she has suffered a fracture, there is a possibility the trauma could have triggered this degree of confusion. Trauma and even the mildest infection can have significant effect on dementia or the mildest form of cognitive impairment.

I would visit your mother's GP. I did this when I was concerned about my mother.

Without a power of attorney, the GP will not discuss your mother with you but they will listen to your concerns and decide on the best way forward.

If you do have power of attorney your mother's health can be discussed freely.

The receptionist sounds very unhelpful and I would not communicate with them again other than to ask for a face to face appointment.

Please post an update It will be interesting to hear what the doctor says.

 

[Sterlingtimes]

Dear Sylvia

Thank you. This is valuable advice. I think that the power of attorney only covers financial matters.

I believe that the GP will talk to me in due course. I am just rather shocked by the speed of the impairment.

I will post an update when I know a little more.

Kind regards, Stephen

 

[MaNaAk]

Dear @Sterlingtimes,

Do you have Power Of Attorney? I made an appointment to discuss my concerns about dad's memory before I was made Power Of Attorney and the GP was very helpful. It could be trauma but either way it needs to be investigated. Once you have the help from the doctor I think you should say something about the receptionist!

MaNaAk

 

[DreamsAreReal]

It's not necessarily dementia. It could be delirium and/or an infection (quite easy to pick up an infection in hospital!). Google delirium and see what you think.

If your Mum was playing decent a decent Scrabble until the hospital visit then delirium seems more likely to me (just my opinion, I'm not a medic). I hope for both your sakes it's not dementia. One other thing - if mum lives alone and you don't get to visit her often, it's not unusual for a person with dementia (pwd) to tell you they're fine, doing all their own cooking, cleaning, playing scrabble etc. They don't want anyone to know they're impaired. Just a thought.

edit: this might help:

Delirium - symptoms, diagnosis and treatment

Delirium is a common, serious but often treatable condition that starts suddenly in someone who is unwell. It’s much more common in older people, especially those with dementia.

www.alzheimers.org.uk

 

[Jaded'n'faded]

I emailed my GP, but the receptionist refused to pass it on. I will hopefully get to my GP soon. I imagine that if I sent a letter, the receptionist would tear it up.

For now, I am worried. My mother is a few weeks short of 94. She had a fall five weeks ago and fractured her hip. Before the fall, she was completely self-sufficient in all respect and could even play a very good game of scrabble. Now out of the hospital, she has evidently suffered severe cognitive impairment.

Each morning, she cannot stay awake for more than a few minutes at a time. During the afternoon, she becomes more lucid but suffers severe anxiety. She has lost her perspective of time. At 4 PM, she will ask her carer whether she has come to put her to bed. At 7 PM, she will 'phone me to tell me that her carer has not arrived to put her to bed. The carer will arrive at 8.30 PM, and she will tell me that her carer did not arrive until mid-night. She has forgotten numbers such as her PIN. She has frightened her friends by talking of suicide. She has no concentration and has lost interest in everything.

Can dementia come on within a few weeks? Can the effects of dementia vary over 24 hours?

Are you sure the receptionist refused to pass on your email? That seems way beyond the remit of a receptionist! You must write a letter and take it to the surgery, ask to speak to the practice manager, mention about your previous email and say: 'This letter contains vital info about my mother's health and the doctor must see it.' They cannot refuse. Make sure you detail all the behaviours you have seen.

Only the medics can say if your mum has dementia but yes, it can come on very quickly. (And yes, it can vary a lot at different times of the day.) My mum had a fall, ended up in hospital and had to be moved straight to a carehome. Before that she was living alone (undiagnosed) and managing fine, although she was starting to show memory problems and some other issues. The fall caused a bleed on the brain which meant mum's condition took a complete nose-dive.

 

[SherwoodSue]

my mum was in hospital six weeks with pneumonia . She suffered from delirium during this time It is very common for elderly people to lose condition in hospital. Physical changes within the body, loss of sleep, being moved around departments, and General anaesthesia all take their toll. Even young patients in ITU get ITU psychosis sometimes

I was recorded on mums GPs as designated carer ( she agreed and fully asked for this) so they will deal with me on appointments results of test etc. Separate to LPA which we also did.
you do need family doctors involved.
mum recovered quite a lot in her own environment.
However each admission seems to reduce her ability I have noticed
there is a link between delirium in hospital and ongoing cognitive impairment I believe

 

[Sterlingtimes]

Dear @Sterlingtimes,

Do you have Power Of Attorney? I made an appointment to discuss my concerns about dad's memory before I was made Power Of Attorney and the GP was very helpful. It could be trauma but either way it needs to be investigated. Once you have the help from the doctor I think you should say something about the receptionist!

MaNaAk

Thank you, MaNaAk, for your kind reply,

I have a financial power of attorney but not a medical one. I will look into getting one set up. The GP did give me thirty minutes of his time on the 'phone, and he thought that dementia coming on so suddenly was unlikely. He has since telephoned my mother and must have caught her in a lucid moment.

It appears that the receptions are trained not to pass on emails that raise clinical questions. Instead, "carers" are urged to arrange appointments.

Kind regards, Stephen

 

[Sterlingtimes]

It's not necessarily dementia. It could be delirium and/or an infection (quite easy to pick up an infection in hospital!). Google delirium and see what you think.

If your Mum was playing decent a decent Scrabble until the hospital visit then delirium seems more likely to me (just my opinion, I'm not a medic). I hope for both your sakes it's not dementia. One other thing - if mum lives alone and you don't get to visit her often, it's not unusual for a person with dementia (pwd) to tell you they're fine, doing all their own cooking, cleaning, playing scrabble etc. They don't want anyone to know they're impaired. Just a thought.

This is helpful, DreamsAreReal, thank you.

Your link is helpful. My main problem now is a constant stream of telephone calls from my mother telling me that her carer has not arrived. I have arranged for a paid carer to attend morning and evening. I attend the daytime shift.

During her time in the hospital, she became used to pressing the button for assistance. Now that she is back home, she does not understand that her carers aim to attend during a specific 30 minutes slot but maybe a little earlier or a little later. I keep driving out to see her only to find that the carer has attended and there is no issue.

Perhaps, I ought to tolerate this for a few weeks and see how things work out.

Regards Stephen

 

[Sterlingtimes]

my mum was in hospital six weeks with pneumonia . She suffered from delirium during this time It is very common for elderly people to lose condition in hospital. Physical changes within the body, loss of sleep, being moved around departments, and General anaesthesia all take their toll. Even young patients in ITU get ITU psychosis sometimes

I was recorded on mums GPs as designated carer ( she agreed and fully asked for this) so they will deal with me on appointments results of test etc. Separate to LPA which we also did.
you do need family doctors involved.
mum recovered quite a lot in her own environment.
However each admission seems to reduce her ability I have noticed
there is a link between delirium in hospital and ongoing cognitive impairment I believe

Thank you, SherwoodSue.

This is the sort of help I needed. I am starting to get very frustrated myself and I am spending a great many hours dealing with my mother and her affairs. There is no let-up. I am going to take your advice and try to formalise my position as a carer.

Best wishes, Stephen

 

[Sterlingtimes]

It is now nearly 12 weeks since my mother had her fall. She is far more wakeful than she was, and she can conduct a conversation. Oddly, she can play a game of Scrabble and win.

On the negative side, she is forgetful and can be oblivious to conversations I have had with her the day before. When I meet with her daily, I feel like Cinderella in the old song, "Go up and do the attic and go down and do the cellar! You can do them both together, Cinderella!" She can become angry quite quickly and become obsessed with a particular daily issue. She has great difficulty talking over the telephone.

Could these signs be consistent with dementia?

 

[Violet Jane]

Delirium can take a while to go away. An episode of delirium can also 'unmask' dementia in that a person who was previously thought to be cognitively fine starts showing symptoms of dementia. Really, you need to get a GP to see your mother and take it from there. Confusion and forgetfulness can be symptoms of dementia but as well as delirium there are other things that can cause these types of symptoms.

 

[canary]

It is now nearly 12 weeks since my mother had her fall. She is far more wakeful than she was, and she can conduct a conversation. Oddly, she can play a game of Scrabble and win.

On the negative side, she is forgetful and can be oblivious to conversations I have had with her the day before. When I meet with her daily, I feel like Cinderella in the old song, "Go up and do the attic and go down and do the cellar! You can do them both together, Cinderella!" She can become angry quite quickly and become obsessed with a particular daily issue. She has great difficulty talking over the telephone.

Could these signs be consistent with dementia?

People with dementia dont decline in all areas at the same time. It is more like removing bits from a completed jig-saw puzzle - some areas remain intact for while, although other areas may be almost gone. My mum could do word searches until quite late into her dementia and there is a member on here whose husband can still play bridge.

But, as @Violet Jane says, there may be other causes for the forgetfulness and obsessions.

 

[Karl funk DJ]

It might not be dementia it could be hospital acquired trauma or hospital acquired confusion delirium etc due to change in environment & people. I think my mother has one of those as she was in hospital for 8 weeks then recently hospital and respite for 5 months. My friend’s father had a fall, was in hospital for only a couple of weeks and didn’t recognise one of his sons when he came out. I hope they find a way to avoid this hospital acquired trauma/confusion in future or some treatment.

 

[SherwoodSue]

i think it may be helpful to think of hospital trauma as delirium to truly appreciate what is going in here. Of course it’s 100% psychologically traumatic to be removed from one’s home and family and go into a strange noisy hospital environment. However there are physical changes happening to the person too. Blood salts such as sodium and potassium are often out of whack. This causes acute confusion and poor balance etc. to give just one example. Infection and fever another. Research does show there IS a link to delirium in hospital and subsequent development of dementia.
I do recognise the obsessions you describe. We think of it like this. We have full lives with so much going on. Your mum has less to divert her perhaps other than the chores she wants to ask you to do before you go. Imagine thinking of a small chore needing doing the second you had gone! So stressing away , I mustn’t forget I must ask for these to be done…… hence the Cinderella scene.
I think in time you might be asking GP for mental assessment.
wishing you well