Delirium caused by Covid

[Looseleaf]

Has any research been done on the lasting effects of Covid on Alzheimers?
My husband who is at a moderate stage of Alzheimers tested positive on Tuesday. By Thursday morning, after speaking to 111, an ambulance was called as he had lost the thought process needed to get back in the bed. He ended up sitting on the floor unable to move anywhere.

The delirium caused by Covid made him incontinent, very restless, trying to get out of bed and unable to follow the simplest instruction. I was with him for 2 days in A&E until a bed was found and accompanied him to the ward. Then next morning unsurprisingly I tested positive.

Today, from what I have gathered speaking to the doctor on the phone, he is showing signs of improvement . It is very difficult seperated to be able to gauge how much improvement and what the next steps now need to be. Will he return home in the next few days at the same stage he was say a fortnight ago? Will extra care provision, so far I have been the sole provider, need to be found? Do others have experience of a similar scenario?

 

[Palerider]

Has any research been done on the lasting effects of Covid on Alzheimers?
My husband who is at a moderate stage of Alzheimers tested positive on Tuesday. By Thursday morning, after speaking to 111, an ambulance was called as he had lost the thought process needed to get back in the bed. He ended up sitting on the floor unable to move anywhere.

The delirium caused by Covid made him incontinent, very restless, trying to get out of bed and unable to follow the simplest instruction. I was with him for 2 days in A&E until a bed was found and accompanied him to the ward. Then next morning unsurprisingly I tested positive.

Today, from what I have gathered speaking to the doctor on the phone, he is showing signs of improvement . It is very difficult seperated to be able to gauge how much improvement and what the next steps now need to be. Will he return home in the next few days at the same stage he was say a fortnight ago? Will extra care provision, so far I have been the sole provider, need to be found? Do others have experience of a similar scenario?

I am not sure where your husband is but he has got visiting rights under the Covid rules. If your husband has dementia or even suspected dementia you are allowed to be his visitor and that is universal across NHS England so you mjust press this straight away.

I would ask this doctor if they have excluded other causes of delirium as well as Covid and draw you to a nationally accepted quick assessment for delirium the 4AT and also the SIGN bundle on investigation for delirium and also respective treatments. Delirium on dementia is much harder to determine because it is either delirium or a progression of the disease and that requires more clear and concise investigation while in hospital.

The 4AT which is now the most common assessment tool for delirium can be found at:

https://www.the4at.com/

And the SIGN guidance on assessing and treatment for delirium can be found at:

Risk reduction and management of delirium

Scottish Guideline on risk reduction and management of delirium

www.sign.ac.uk

 

[Looseleaf]

Thank you Palerider -very interesting. I realise now that a nurse was doing 4AT in A&E and my husband definitely scored high, although he came up with his birthdate -something he is always pleased to recite!
The hospital are considering other causes like UTI which I was told will have been treated with the same antibiotic as the one for the chest infection.
I am now not allowed in as I have Covid. They did say he was not allowed another visitor either.

 

[Palerider]

Thank you Palerider -very interesting. I realise now that a nurse was doing 4AT in A&E and my husband definitely scored high, although he came up with his birthdate -something he is always pleased to recite!
The hospital are considering other causes like UTI which I was told will have been treated with the same antibiotic as the one for the chest infection.
I am now not allowed in as I have Covid. They did say he was not allowed another visitor either.

Thats true if you are Covid positive you can't visit, but when your tests come clear you can visit! Just to say now the media has switched to other world events there is a new spike in Covid cases in hospitals. However once you get a clear swab you can visit and that is very clear in the national guidance.

I hope you and your hubby get to the bottom of things

 

[canary]

Infections, of any sort, do horrible things to people with dementia. UTIs and chest infections are the worst, but any form of infection can trigger delirium.

My OH got UTIs and delirium causing incontinence and loss of mobility, but fortunately, it resolved by the time he came home. It doesnt always, though. Literature says that it can take up to 6 months for delirium to resolve, it may have rapidly progressed the dementia and sometimes it does not appear to resolve at all.

I think you will have to wait and see.
xx

 

[Looseleaf]

Thank you Canary.
I have been patiently waiting to see but I am now in shock!

My husband's delirium is improving, I can tell when the nurse passes the phone to him. I spoke with the doctor on Monday and she said there would be physio and occupational therapists assigned to him and consulting with me about discharge. I know there is then a re-enablement team that will be involved with the return home.

However just ringing to see how he is today the ward's clerical assistant reading his notes said he was improving etc and looking to be discharged to a care home!! I have asked for a doctor to ring me but just reeling in shock!

 

[Lynmax]

It might be that he is being discharged to a care home to assess his care needs. My mums care home had built an extension which was due to open just as Covid hit the country and has been empty ever since.

Then last month it opened in partnership with our local hospital to free up the beds there, patients are transferred from hospital once they no longer need medical treatment and spend a couple of weeks in the care home while assessments are done or a care plan to return home is sorted out.

Hopefully you will be able to find out if this is why a care home was mentioned or if a mistake has been made. When my mum was in hospital recently, we struggled to speak to a senior nurse and were told very different things by whoever picked up the phone.

 

[Looseleaf]

Thank you lynmax -that sounds a bit more reassuring. Hopefully a Dr will ring or if not I will speak to a nurse on the ward later today.

 

[canary]

Yes, I too thought it was D2A (discharge to access) bed - a sort of modern equivalent to a convalescent hospital - where they are discharged to a care home so that they can be assessed to see what help will be needed. Im glad the delirium is improving - they probably want to see whether he will get back to his pre-covid self.

 

[Looseleaf]

Thank you -I will know when that term is mentioned not to worry. They are moving him to a Green ward tomorrow but I am not allowed in until Tuesday (10 days after I tested positive) so I hope he can at least not be moved again until I have seen him. I am afraid he is keeping them busy as continually wandering.!

 

[Looseleaf]

What a continuing nightmare! The move to a non covid ward happened on Sunday. I rang today and was told that I still can't visit as the new ward had previously had a covid outbreak and is now closed to visitors. I am told my husband is continually wandering and agitated.

My mind us made up he definitely needs to transfer to a Care Home (D2A) as soon as possible. At last the discharge OT contacts me. She says there are no beds locally and it will probably mean a Care Home 30+ miles away and still a wait of even up to weeks.

My mind is made up to move him to a private Care home for convalescence and pay. At least hopefully he will then be nearer and I can visit (even if Covid only allows it to be in a tent in the garden). This will give us time to sort out whether he is back to how he was before Covid (managing at home and with me as his sole carer) and give us time to put in place support at home.

Huh! But not so easy though to find a Care Home to take him. The hospital says he needs 1:1 constant care (not helped by isolation and 3 moves within the hospital!). My son and I are now exhausted from the search for a Care Home. We think we have found a suitable Care home and then comes the disappointment after the admission officer has spoken to the hospital OT and they haven't got the suitable care.

Everyone we have spoken to has tried to be helpful and understanding but we are still no further forward . I just hope tonight my husband who has had so little sleep in the last 48hours is finally exhausted and has settled to sleep!