Dealing with delerium

[Raindancer11]

Hi all - just looking for some info and advice here. Mum had a fall at her care home last week and has fractured her arm. She remains in hospital as she is in so much pain but also has low sodium ( side effect of sertraline, I was told), constipation and has developed delirium.
I am ringing most days, as I am not allowed in to see her but I am so worried about the effect of being in hospital is having on her. They have done a brain scan, which was normal and have now referred her to elderly mental health team to seek advice on treating the delirium. They are telling me that she will be in hospital for quite a while, possible eventually being transferred to a rehabilitation ward. Has anyone has experience of this? I wonder if her dementia will deteriorate as a result of all this, I am so worried for her.

 

[karaokePete]

I haven't had to deal with delirium but I discovered that if you put that term into the 'search' field at the top of the page a great many threads, both old and recent, are found. Doing that may be worth a try.

 

[lemonbalm]

Hello @Raindancer11

I'm sorry to hear about your mum. My mum had very bad delirium after a fall and hip replacement a few years ago, and again during a hospital stay after a stroke. It can take anything from days to months to recover and some people do not get back to their previous state. Mum had 3 months in rehabilitation ward after her hip operation and she was pretty much ok after that, although her mobility was obviously reduced. After the second hospital stay, she had of course had a stroke, so that may have been the reason she deteriorated, her existing dementia becoming quite a bit worse.

It's such an individual thing, it's impossible to say how it will affect your mum but she is in good hands and it sounds as though everything is being done to help her. My experience of rehabilitation wards was quite a positive one. Mum was not an easy patient much of the time but the staff were extremely kind, the atmosphere calm, and it was a great improvement from the main hospital ward.

This link might be useful:

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.

alzheimers.org.uk

 

[Thomasina]

MMy

Hi all - just looking for some info and advice here. Mum had a fall at her care home last week and has fractured her arm. She remains in hospital as she is in so much pain but also has low sodium ( side effect of sertraline, I was told), constipation and has developed delirium.
I am ringing most days, as I am not allowed in to see her but I am so worried about the effect of being in hospital is having on her. They have done a brain scan, which was normal and have now referred her to elderly mental health team to seek advice on treating the delirium. They are telling me that she will be in hospital for quite a while, possible eventually being transferred to a rehabilitation ward. Has anyone has experience of this? I wonder if her dementia will deteriorate as a result of all this, I am so worried for her.

Husband was in hospital with delirium in Jan. Thankfully he doesn't remember anything about it.. It did advanc e is dementia and it was a terrible time not being able to reassure him. It took 4 maths to recover. I was told delirium can last days weeks or month's. Hopefully you will get to seeher.

 

[Pots and Pans]

I think it may depend very much on the hospital. My OH had delerium after a fracture... right at the beginning of lockdown last year! He went in with mild cognitive issues (developing Alzheimer's) and came out just 7 days later, home to me and one carer with post-op delerium and pretty severe Alzheimer's. I wasn't happy with the care he had had in the hospital... but a lot may have been due to staffing issues cos of Covid. It was appallingly difficult to deal with at home so if you do get a rehab ward, jump at it. It truly can take a long time for the delerium to come under control and my husband needed eyes-on both day and night for a few months. But if you are allowed to visit, do! Your mum would probably eat and drink better with your help, for instance. Do hope it works out well for you.

 

[lollyc]

Mum got delirium after a hip fracture, which ultimately led to her dementia. From what I have since read of how delirium should be managed i.e quiet, undisturbed sleep, orientation to time etc., I doubt a hospital is going to achieve that, even prior to covid.

 

[Andr3a]

I think it may depend very much on the hospital. My OH had delerium after a fracture... right at the beginning of lockdown last year! He went in with mild cognitive issues (developing Alzheimer's) and came out just 7 days later, home to me and one carer with post-op delerium and pretty severe Alzheimer's. I wasn't happy with the care he had had in the hospital... but a lot may have been due to staffing issues cos of Covid. It was appallingly difficult to deal with at home so if you do get a rehab ward, jump at it. It truly can take a long time for the delerium to come under control and my husband needed eyes-on both day and night for a few months. But if you are allowed to visit, do! Your mum would probably eat and drink better with your help, for instance. Do hope it works out well for you.

@Pots and Pans How have things been with your OH (and you of course) since this post? It sounds a lot like my Mum, went into hospital with delirium - possibly due to a problem with her liver which was and still is being investigated. Whilst in the Gastro ward they thought encephalitis but the EEG ruled that out and instead Delirium with underlying Alzheimer’s (PCA) we had no idea about the Alzheimer’s! The hospital psychiatrist said it could take months for the delirium but the Alzheimer’s would be worse by then - how worse? For my Mum to go from zero to severe (not recognising me) in weeks. Surely not.

 

[Andr3a]

Mum got delirium after a hip fracture, which ultimately led to her dementia. From what I have since read of how delirium should be managed i.e quiet, undisturbed sleep, orientation to time etc., I doubt a hospital

Mum got delirium after a hip fracture, which ultimately led to her dementia. From what I have since read of how delirium should be managed i.e quiet, undisturbed sleep, orientation to time etc., I doubt a hospital is going to achieve that, even prior to covid.

@lollyc Hi, you said that Delirium led to your Mum’s Dementia. Would you mind telling me about that? My Mum has developed Delirium and they’ve said underlying Alzheimer’s (that we didn’t know about) it could take months for Delirium and by that time the Alzheimer’s will be worse. The Dr and GP seem to think that would mean from discharge to care home but I just can’t believe it could happen so quickly, she is only 68.

 

[lollyc]

@lollyc Hi, you said that Delirium led to your Mum’s Dementia. Would you mind telling me about that? My Mum has developed Delirium and they’ve said underlying Alzheimer’s (that we didn’t know about) it could take months for Delirium and by that time the Alzheimer’s will be worse. The Dr and GP seem to think that would mean from discharge to care home but I just can’t believe it could happen so quickly, she is only 68.

Mum had apparently no symptoms prior to the hip fracture. She was running her home, caring for terminally ill Dad, and organising events in her community. Because of Dad's illness my sister and I saw her frequently in the lead up to the fall, and had no concerns about her memory. We haven't had any of her friends say, "Oh, with hindsight, she was doing....", so, if she had a dementia, it was well hidden!
4 weeks after hip fracture she had her first hospital admission - no delirium mentioned, although her neighbour thought her decidedly odd when she picked her up from hospital. 2 further admissions over the next few weeks - still no delirium mentioned. By this stage she was hearing / seeing things not there, and had become very paranoid. Due to be discharged for a 3rd time, and she thrw a fire extinguisher at staff, so was sectioned for 14 weeks. Only then was delirium mentioned. Told it could take a long time to resolve, but no mention of dementia. She was eventually discharged (probably only because Dad was dying), with a "resolving delirium", which didn't. She could not reliably use kettle, oven, microwave, phone, TV. Didn't know her address, how to put a key in a lock. I could go on... She certainly was and is incapable of living independently.
Just like you, I couldn't believe it. Everyone tells you dementia is a gradual process, but that's not our experience.
Sorry to not be more positive.
I really wish more was being done to research, diagnose and manage delirium, but it seems we're more concerned with whether heading a football 60years ago causes dementia.

 

[lollyc]

@lollyc Hi, you said that Delirium led to your Mum’s Dementia. Would you mind telling me about that? My Mum has developed Delirium and they’ve said underlying Alzheimer’s (that we didn’t know about) it could take months for Delirium and by that time the Alzheimer’s will be worse. The Dr and GP seem to think that would mean from discharge to care home but I just can’t believe it could happen so quickly, she is only 68.

You might be interested to read research done by Dr Daniel Davis. Google Dr Daniel Davis delirium.

 

[Jessy82]

Lollyc, I never really researched delirium till a few weeks ago, and I think this was the start of mums dementia. It was her second knee replacement about 12 years ago, first one was 2 years before that with no problems. Day 3 after her op when we visited she was rambling and hallucinating, could not get any sense out of her, I spoke to nurse and she said she lost a lot of blood in the op and they were going to do a transfusion, I asked why it wasn't done straight after the op? She said they thought they'd try tablets first, I thought what????
Shd did recover after the blood, but I think that was the start of her decline, and reading up recently think she had delirium. What I thought was strange that at her 6 week consultation after the op her consultant asked why she did not have a blood transfusion after the op, was it religious reasons, I said no she just wasn't given one.

 

[Andr3a]

You might be interested to read research done by Dr Daniel Davis. Google Dr Daniel Davis delirium.

@lollyc Thank you, I’ll take a look at that

 

[Pots and Pans]

@Pots and Pans How have things been with your OH (and you of course) since this post? It sounds a lot like my Mum, went into hospital with delirium - possibly due to a problem with her liver which was and still is being investigated. Whilst in the Gastro ward they thought encephalitis but the EEG ruled that out and instead Delirium with underlying Alzheimer’s (PCA) we had no idea about the Alzheimer’s! The hospital psychiatrist said it could take months for the delirium but the Alzheimer’s would be worse by then - how worse? For my Mum to go from zero to severe (not recognising me) in weeks. Surely not.

Sorry. Just seen this. Sadly, just been a struggle since then. Initial discharge was appalling as he was totally bedbound - couldn't even sit up and had to be spoonfed, in addition to hallucinating.... Thought we were being bombed by the Nazis! We had to have three months of full-on care ie: he couldn't be left unattended at all so we had a night carer until he got over the worst and then just me at night. Shared daily care with a live- in carer. Donepezil turned the lights back on ,- prescribed by consultant who came to the house and said Alzheimer's. Prior to accident there were definite memory,/ functional issues which we had checked out and been told NOT Alzheimer's only a month before. Hence doctors were just treating the delirium when he was home but nothing tried did more than make him worse. He certainly had no idea who I was for some weeks!
Definite improvement once diagnosed and started on medication and we stopped any carers last October but downhill recently so I have gone through a carer assessment and got some help (otherwise we paid for everything) and Alzheimer's group activities have been great. We've even managed to get away together for a holiday or two! Frankly now looking at probable care home soon. But big problem is that the hip injury causing pain and we have to have it checked as there may be bone growth that is restricting movement.... If so possible more surgery! Can't go through delirium again so hoping can be done with epidural if necessary. But the lack of movement means a LOT of bad temper. Sadly it seems as though Alzheimer's has stolen my lovely OH away most days.
Do do hope your mum is on medication and responding well. I think every situation is so different. In our case it was just a perfect storm ( and hospital made mistakes too, for which I have had apologies,. For instance they did a brain scan and said no Alzheimer's. Not what they thought when the consultant took a look a few months later and it was looked at again. So treatment delayed...) Hopefully your mum's diagnosis will get her on the right treatment plan swiftly. The delirium certainly does go, so it depends on the level of Alzheimer's then. For my husband the whole hospital op simply seemed to have accelerated what was already brewing. However when the consultant first saw him in July 2020 he felt I should maybe look at care homes... and we are now more than a year later still together at home with just one day a week help. So that's positive!