• All threads and posts regarding Coronavirus COVID-19 can be found in our area specifically for Coronavirus COVID-19 discussion.

    You can directly access this area >here<.

Dad in hospital after a fall and has totally lost the plot! Dementia or painkillers?

HanSpan

Registered User
Aug 9, 2013
2
0
Last Saturday my lovely OH & I visited my father to help with lighbulbs & odd other DIY issues. Dad was forgetful (repeating the same stories) a bit bumbling and clearly has lost track of time. I understand this is due to his recently diagnosed dementia as well as probably partly because he lives alone and doesn't do much. But he knew where he was and who we were and had a clear grip on reality.

On Tuesday he called to say that the day before he had sat on a chair in the garden which had collapsed & he had called an ambulance and was in hospital with a fractured hip. He said they hadn't decided what to do yet and no - he didn't want me to make the trip to visit till things were clearer.

In an example of ultimate sods-law social services rang later that day to ask about planning a home assessment (I called a few weeks ago when I first posted here). I pointed out he'd fallen twice since I'd called & was now in hospital so they were a bit late! The OA (Occupational something?) lady was lovely though and explained he would be passed to the hospital OA if he was in for more than 48hrs but that she would call and discuss with the hospital. We had a long chat where I explained Dad hates being in hospital and will tell tales that appear terribly plausible to escape - including lying and saying I will be at home with him!
Wednesday I spoke to the nurse at the hospital (another lovely lady) who said the docs wanted to act conservatively and not operate but have him not weight bearing for 6 weeks. Later she rang to say the physio reported that was going to be difficult as Dad forgot the minute she stopped telling him not to put his foot down. The nurse told me the docs have changed their minds and he can bear weight as much as the pain allows and Dad had already been wandering around. She reported he was a bit confused but basically OK, compliant with taking meds, although he did ask whether I knew where he was (a bit worrying as we had spoken earlier).

So yesterday evening I went to see him at about 6 and he is utterly confused. He was convinced we were on holiday and he was being kept waiting to get on a plane or something. Complaining about the surly staff. Wanting to know when we were going to 'our house' (I don't live with him). Wanting to know why we were waiting.
Off I went to see a nurse and find out what the heck was going on. They wanted to put it all down to the dementia but I told them this was most certainly NOT what he'd been like less than a week ago. Dad had told me he had refused pain meds after the first one but he is actually taking Oxysomething (an opiate) 10mg twice a day. He ordinarily refuses to take anything but paracetamol so I explained he'd not be at all happy if he actually realised what they were giving him! (he's obsessed with his bowels and whether things will give him constipation). I then asked about the possibility of a bladder infection as that is what happened when he had the replacement hip 2 years ago when he really didn't have much (if any) sign of dementia normally but was totally out of it in the hospital and they agreed to do a test. When I then asked Dad about it and giving a urine sample he became really agitated and started saying they'd not let him in (when I asked where he said the country - so we were back to the plane) if he was 'contaminated'.

Throughout the hour and a half I stayed (I couldn't cope with any more and snuck off before the end of visiting) he kept returning to the 'contaminated' subject; whether we had booked into the hotel and endlessly going on about wanting a drink -gin or wine or whisky. He was sure he could find a bar one and would put some clothes on and go and look. He thought the man opposite had a glass of wine and kept rummaging through the bags of clothes and bits I'd brought convinced he'd find a miniature. I had to explain, about every 3 minutes, that he was in the hospital, not a hotel; that the bed next to him was his hospital bed; that the people were nurses not hotel staff. He also started asking about the fact that the curtains were moving up and there were posters that kept moving and the table was turning around. It seemed like he was hallucinating.
Before I left they had a nurse changeover and did agree that they'd get the docs to come review his meds and consider reducing or changing them, and would test for a urine infection.

So my question now is can dementia cause hallucinations? Can it get so much worse so much faster? Or is it more likely its the drugs and/or a urine infection?
Also how on earth do you deal with it when someone has so lost their grip on reality? I tried to play along but it was just impossible to go along with him thinking we were on holiday as he wanted to get up and walk to a bar, and was convinced he was coming with me. I was really worried he'd try and follow me out and had to make him understand he had to stay there and I had to leave.

I'm at Dad's house now, having stayed overnight, and OH has just turned up to help me sort some things & we will be going to visit later and I just don't know what to do. I want to just run away to be honest. Seeing my father like that is heartbreaking.

Sorry for rambling on again. I don't seem to be able to stop once I start;)
 

Izzy

Volunteer Moderator
Aug 31, 2003
67,168
0
71
Dundee
I'm so sorry to hear about your dad. It must be very hard for all of you.

My mum had vascular dementia and she went through a period of hallucinating. It turned out that she had a bad UTI and this stopped once she had gone through a course of antibiotics. My husband has Alzheimers and last week he had a UTI. During that he had a mild episode of hallucination. Mum's were much more scary.

I haven't enough experience to comment on the drugs aspect but someone else will probably be along soon. to help with than one.

I wondered if you have seen this thread about compassionate communication. I thought you might find it helpful.

http://forum.alzheimers.org.uk/showthread.php?61757-Are-we-dealing-with-this-the-right-way

I do hope you can get your dad settled soon. x
 

tropicbird

Registered User
Last Saturday my lovely OH & I visited my father to help with lighbulbs & odd other DIY issues. Dad was forgetful (repeating the same stories) a bit bumbling and clearly has lost track of time. I understand this is due to his recently diagnosed dementia as well as probably partly because he lives alone and doesn't do much. But he knew where he was and who we were and had a clear grip on reality.

On Tuesday he called to say that the day before he had sat on a chair in the garden which had collapsed & he had called an ambulance and was in hospital with a fractured hip. He said they hadn't decided what to do yet and no - he didn't want me to make the trip to visit till things were clearer.

In an example of ultimate sods-law social services rang later that day to ask about planning a home assessment (I called a few weeks ago when I first posted here). I pointed out he'd fallen twice since I'd called & was now in hospital so they were a bit late! The OA (Occupational something?) lady was lovely though and explained he would be passed to the hospital OA if he was in for more than 48hrs but that she would call and discuss with the hospital. We had a long chat where I explained Dad hates being in hospital and will tell tales that appear terribly plausible to escape - including lying and saying I will be at home with him!
Wednesday I spoke to the nurse at the hospital (another lovely lady) who said the docs wanted to act conservatively and not operate but have him not weight bearing for 6 weeks. Later she rang to say the physio reported that was going to be difficult as Dad forgot the minute she stopped telling him not to put his foot down. The nurse told me the docs have changed their minds and he can bear weight as much as the pain allows and Dad had already been wandering around. She reported he was a bit confused but basically OK, compliant with taking meds, although he did ask whether I knew where he was (a bit worrying as we had spoken earlier).

So yesterday evening I went to see him at about 6 and he is utterly confused. He was convinced we were on holiday and he was being kept waiting to get on a plane or something. Complaining about the surly staff. Wanting to know when we were going to 'our house' (I don't live with him). Wanting to know why we were waiting.
Off I went to see a nurse and find out what the heck was going on. They wanted to put it all down to the dementia but I told them this was most certainly NOT what he'd been like less than a week ago. Dad had told me he had refused pain meds after the first one but he is actually taking Oxysomething (an opiate) 10mg twice a day. He ordinarily refuses to take anything but paracetamol so I explained he'd not be at all happy if he actually realised what they were giving him! (he's obsessed with his bowels and whether things will give him constipation). I then asked about the possibility of a bladder infection as that is what happened when he had the replacement hip 2 years ago when he really didn't have much (if any) sign of dementia normally but was totally out of it in the hospital and they agreed to do a test. When I then asked Dad about it and giving a urine sample he became really agitated and started saying they'd not let him in (when I asked where he said the country - so we were back to the plane) if he was 'contaminated'.

Throughout the hour and a half I stayed (I couldn't cope with any more and snuck off before the end of visiting) he kept returning to the 'contaminated' subject; whether we had booked into the hotel and endlessly going on about wanting a drink -gin or wine or whisky. He was sure he could find a bar one and would put some clothes on and go and look. He thought the man opposite had a glass of wine and kept rummaging through the bags of clothes and bits I'd brought convinced he'd find a miniature. I had to explain, about every 3 minutes, that he was in the hospital, not a hotel; that the bed next to him was his hospital bed; that the people were nurses not hotel staff. He also started asking about the fact that the curtains were moving up and there were posters that kept moving and the table was turning around. It seemed like he was hallucinating.
Before I left they had a nurse changeover and did agree that they'd get the docs to come review his meds and consider reducing or changing them, and would test for a urine infection.

So my question now is can dementia cause hallucinations? Can it get so much worse so much faster? Or is it more likely its the drugs and/or a urine infection?
Also how on earth do you deal with it when someone has so lost their grip on reality? I tried to play along but it was just impossible to go along with him thinking we were on holiday as he wanted to get up and walk to a bar, and was convinced he was coming with me. I was really worried he'd try and follow me out and had to make him understand he had to stay there and I had to leave.

I'm at Dad's house now, having stayed overnight, and OH has just turned up to help me sort some things & we will be going to visit later and I just don't know what to do. I want to just run away to be honest. Seeing my father like that is heartbreaking.

Sorry for rambling on again. I don't seem to be able to stop once I start;)

So my question now is can dementia cause hallucinations? Can it get so much worse so much faster? Or is it more likely its the drugs and/or a urine infection?

Sadly this is true...everyone is unique in how fast it gets worse or better - every day is different for the patient. Could be that the new drugs are interfering with his brain. Ask the medical team. Read other entries on this excellent website for help in dealing with your father's behaviour and hallucinations. I have to enter my husband's 'world' and agree with him when it doesn't matter. He finds it difficult to understand what I am talking about if I try to disagree. He will clam up and get depressed. Try changing the subject , and take with you things to distract him - reading matter, an ipod of music, his favourite photos, other visitors, whatever you can think of.
Remember he was a truly useful person in his life, and is as frightened of these experiences as you are, except that your mind is whole. Try to love and reassure him. love and hugs to you...we are dealing with these things together - the researchers say there is no cure as yet.
 

Noorza

Registered User
Jun 8, 2012
6,542
0
Izzy has it covered just didn't want to read and run. It's awful for you but Dad's in the best place. It could be the medication but if he's broken his hip that's going to hurt and probably will need something stronger than paracetamol.

When my son broke his arm a few months ago they gave him something that really zonked him out until they could operate to refix it into place. Personally I was glad of them but I wasn't looking at my son being like that for weeks only a day until they could get a spot in theatre.

I could be an infection, could be the meds, who knows all you can do is explain to the nursing staff how very different he is from his normal self, and get them to arrange for the investigations. I am also wondering if it's chicken and egg, did he fall because his balance is getting worse only the nursing staff can find that out. The other thing is just going into hospital for a person with dementia can be distressing just by itself, without the broken bones and the drugs.

I just wanted you to know there are others who understand what you're going through even if we don't have the answers.
 

zicomar

Registered User
Jan 16, 2013
7
0
Leeds
My Father is currently in hospital for the third time in 6 months twice with Pneumonia, each time he has become increasingly confused and seems to exist in some fantasy land, but also thinks he is on holiday and keeps asking how much it is costing him. Yesterday he thought he was India where he was stationed during the war and the day before he thought he was in Gibraltar again from the war, he has forgotten where he lives and keeps asking if we the family have sold his house. The doctors told me last time that antibiotics can cause a dip in dementia and certainly this does seem to be the case because when he gets home he is noticeably less able than before he went in. We have had to increase his care package each time and fear we will have to do the same this time. the strange thing is when he comes out he immediately forgets he's been in. We found this distressing the first time but have learnt to live with it and rather than disagree with him just agree, he doesn't get so distressed then. Dad has had dementia for four years now and much of that time he has told stories that clearly haven't happened, we are told this is normal and dementia patients often make things up to fill in blanks in their memory.
 

HanSpan

Registered User
Aug 9, 2013
2
0
Thank you all so much for the support. Today I went with OH and Dad was still confused but I think more about what he'd said and believed happened than about right now. Seems he refused the long acting Oxy last night and this morning, then asked for painkillers so had Oxysomething else but not 10mg of the 12 hour ones so I think that was part of it.
They have decided to take him off the Oxy and give pain patches which a rather charming junior doc said are often better tolerated in patients like Dad.
They had apparently still not got urine from him - I find it hard to believe he hadn't gone for about 18 hours :eek: although he was desparate just before we left and peed over half a litre which they tested and said no UTI so I guess its not that.

I so wish I'd not buried my head in the sand and had sorted POA before all this happened. The GP says she will charge £250!!! I pointed out all she had to do was sign so she agreed maybe less but still - given Dad finds the idea of paying so outrageous - this isn't going to make it any easier and the house is filled with bits of paper with stuff about all unmptymillion bank accounts so I'm really worried if I don't manage to get something sorted it will all spiral out of control.

Also between the ambulance presumably locking up the house and where he is now his house key seems to have vanished which is another worry.

I have read the stuff about communicating kindly and am all for it in theory but I have aspergers traits myself and find it hard to tell deliberate lies so I just freeze trying to think of something and he watches me and knows something is up (I'm rarely lost for words) and starts questioning me!
We really are cut from the same cloth and straight talking has always been our way so I am finding it nigh on impossible. What exactly can I say when OH & I are about to leave, and I say we have to go and Dad says - 'oh but I'm not staying here am I'? Errrrr - "yes I'm afraid you're going to have to stay a little longer as you have broken your hip and the doctors ........." what on earth else can I say? I try to be calm and tell little fibs saying hopefully it won't be long and once they have sorted him out and.... but I'm not sure what else to do.
At the end he did then say "oh I realise I can't go home this time - I know I'm not OK to look after myself yet" so he's back to having quite lucid moments.
I actually think part of the confusion is the fact it seems he was passed round several departments (A&E, then somewhre else, then orthopedic, then the ward he is on) after arriving in the ambulance. I somehow can't help feeling that if I can explain to him exactly where he has been and what happened that it would help - I guess because it helps me to understand the detail of exactly what has gone on.

I think I need to get you all to write me scripts in response to his repetitive questions to practice;)
 

tarababe

Registered User
Sep 9, 2012
192
0
Durham
Hanspan my mum was exactly the same. When she was in hospital she though she was in Australia or on holiday too. She was very confused and would get very agitated when we visited begging us to take her home. Sometimes she had semi lucid moment's, but it seemed her short term memory had completely gone. I do wonder if going into hospital accelerates the illness.:(
 

HanSpan

Registered User
Aug 9, 2013
2
0
Unfortunately he's still in hospital, although they plan to send him home today. Its been a nightmare saga with the totally disjointed teams who are in the hospital, might be helping when he gets out and who send equipment home. OH & I spent Friday waiting for equipment that never turned up!
Anyway Dad is still rather confised but at least he's stopped halucinating and knows where he is most of the time, he certainly no longer thinks he is on holiday! I think the shock & the pain, the confusion of being moved around the hospital and the daft drugs they had him on all contributed, but I do think its probably pushed him further down the path. I can only hope he gets a little bit better again at home.

Yesterday I spoke to the psychologist at the memory clinic as I had to call & cancel Dad's appointment. He was a lovely man and we talked for a long time. He explained that the other doctor there hasn't prescrined anything for the Alzheimers as the drugs that might help arrest that (like aricept) would make the vascular dementia worse. So it looks like for not we just have to let it take its course & see what happens:(

Now I'm wondering whether to go there tonight or leave the care teams to it. I want to support him but I don't want them to think they can get away with leaving things to me as I cn only really visit once or twice a week. Decisions decisions.
 

lexie1968

Registered User
Nov 1, 2013
17
0
My father had an operation on his back in july. Prior to it he had a little memory loss for about a year. Whilst in hospital he started having hallucinations, imagining he was on holiday, thinking people were stealing his belongings, all sorts of weird things. We were seriousely worried, and to be honest, the hospital were of no use whatsoever. To cut a long story short, he discharged himself, and we seeked help from the gp. After visiting a memory clinic, we were told he had delerium. It eventually wore off, but left him with worse memory problems, which have now been diagnosed as mild cognitive impairment, although im still convinced its dememtia. He is vulnerable to delerium again if anthing stressful happens to him. I hope this helps a little.
 

HanSpan

Registered User
Aug 9, 2013
2
0
Thanks for that. I don't know whether I just hadn't noticed before or whether it has permenantly shaken Dad but he seems considerably worse than before he went in.

He has improved a fair bit but he's still distinctly more forgetful and confused, and although he accepts he was imagining some things he still remembers them as if they happened - not helped by some of the mad things that DID happen that I thought he was making up - like hospital transport not turning up and some old couple from age concern driving him home.

At least the power of attorney has now come through so when I ring banks I can tell them I have it and why, which makes getting them to do things marginally easier.