Delirium or Dementia?

Pigeon11

Registered User
Jul 19, 2012
351
0
Hello

It's some time since I posted on here. My Dad died in 2014 after suffering dementia for a number of years, but now I find myself worried about my mum-in-law and thought I'd re-visit to see if anyone has had a similar experience and perhaps some advice to offer.

She is 85 and we noticed her short-term memory was getting bad around a year/18 months ago. She also started to avoid our offers to take her on trips out or spend time with us at home. She found it hard to follow conversation and so would just sit without joining in. At this time, she was coping ok with most things at home, except shopping as her mobility is impaired due to osteoarthritis. In October last year, I took her to see her GP as she had suddenly become even more confused and forgetful and was feeling unwell. The GP was brilliant and arranged emergency home-care immediately while she was assessed. However this only lasted a few days as she had a fall and had to be admitted to hospital.

It turned out that she had a kidney infection and this was followed by hospital acquired pneumonia. Although she recovered physically, she became more confused whilst there. We were told this was delirium as a result of the infections and that she would improve in time. She stayed in hospital for 10 weeks while the infections were sorted before being admitted to a rehabilitation centre.

Four and a half months later she is now (just) home again with care in place to support her and twice-daily visits from us. Her confusion and memory problems are just as bad as ever (maybe a bit worse) even though the infections are gone. She is constantly asking the same questions over and over again - just day-to day things like "How is the family" or "What have you been doing today". We have had to leave notices all over the house as she can't remember that carers are coming, or that she shouldn't leave the key in the door, but she doesn't notice the notices. Sometimes she tries to prepare her own food, even though we have explained the carers will do it. She manages sometimes but put a microwave meal in the oven the other day and made a terrible mess. She doesn't seem able to follow simple instructions or use once-familiar household appliances (TV remote etc)

She is obsessed with the idea that she is going somewhere and most days when we visit we find she has emptied the content of her wardrobes in to shopping bags in readiness for the trip. Sometimes she think she is on holiday and gets very upset saying she shouldn't have come. Other times she knows she is at home but thinks she can't stay and has to move on somewhere else. She does accept she is at home when it's pointed out but within minutes it will all start again. She doesn't know the day/month/year or season but can remember her close family and friends. She struggles a little with less familiar names, eg our pets or more distant relatives.

This morning she called me to say that people had visited her the previous evening (it was the carers) and she was worried they would get access to her bank account. She was in a very tearful and anxious state, saying she had been unable to sleep with all the worry and it was hard to console her.

I'm not sure that all this is down to delirium. She was confused before and I think there is something underlying. We couldn't get the hospital staff to take this seriously - they were focused on her physical health but a brain scan showed no sign of a stroke (or I presume any obvious dementia symptoms) so this was discounted at the time.

I have been looking on-line at the differences between delirium and dementia and her symptoms seem more in line with the latter- ie she isn't generally agitated or lethargic as in delirium and the symptoms are pretty consistent from day-to-day, as in dementia.

We are waiting to hear from her GP about a more thorough assessment of her memory etc but I wondered in the meantime if anyone had experienced anything similar? I suppose my main question is does anyone know if delirium can continue long after an infection is resolved?

Any help appreciated and thanks for reading.
 

marionq

Registered User
Apr 24, 2013
6,449
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Scotland
These are all very recognisable symptoms to me I'm afraid of dementia. The constant packing and preparing to go somewhere usually results in wandering but if she is physically unable to do this it will be another source of distress.

I would start looking at suitable places for her to have 24 hour care.
 

Pigeon11

Registered User
Jul 19, 2012
351
0
These are all very recognisable symptoms to me I'm afraid of dementia. The constant packing and preparing to go somewhere usually results in wandering but if she is physically unable to do this it will be another source of distress.

I would start looking at suitable places for her to have 24 hour care.

Thanks for your reply Marionq

The packing etc started after we told her she would be going home from the rehab centre so we thought it was just that she had become obsessed with that. She does seem to understand and remember that she shouldn't go outside - she's quite scared of falling so we are hoping that this prevents her trying.

I think you're right about the full-time care though. Whether she has dementia or not, I can't see that she will recover from all this confusion and memory loss so whatever the diagnosis I can't see her carrying on with the present arrangements. It will be good to get a proper diagnosis though so at least we will know what we're dealing with and what to expect.
 

canary

Registered User
Feb 25, 2014
25,018
0
South coast
This certainly sounds typical of dementia and it sounds like she had it before the infections. Infections (of any sort) are renowned for advancing the progression of dementia.
Unfortunately it does sound to me as though this is what has happened.
 

Pigeon11

Registered User
Jul 19, 2012
351
0
This certainly sounds typical of dementia and it sounds like she had it before the infections. Infections (of any sort) are renowned for advancing the progression of dementia.
Unfortunately it does sound to me as though this is what has happened.
Thanks Canary. I suspect this is the case but you hope that it's something which is reversible. We'll wait to see what happens when we've had the full assessment
 

philamillan

Registered User
Feb 26, 2015
96
0
Delirium should represent a limited period of confusion and agitation, sometimes associated with an infection.

The difficulty is that in PWD the delirium can sometimes not resolve and become a significant deterioration in the dementia.

Delirium may take up to 6 weeks to resolve and so you have to give some time.

The unpredictability of the resolution of delirium makes it more difficult for Social Services to work out how much care will be needed.

I wish there was a more straightforward answer but just take it one day at a time.
 

Pigeon11

Registered User
Jul 19, 2012
351
0
Thanks Br_ana - we're awaiting blood test result as we speak and her GP did a memory test and referred her to memory clinic for further investigation the other day.

Philamillan I don't know what PWD stands for I'm afraid?


In terms of the delirium, I'm not sure this is what is presenting at the moment. There's certainly no agitation/lethargy as I've heard described as symptomatic of this on some sites - just confusion which has been pretty consistent after increasing dramatically when the infections started. It's certainly more than six weeks since the infections were resolved. Looking back, I'm inclined to think that she had a mild form of dementia before and the infections have made things worse and escalated progression.

But I'm no expert so will wait and see. Thanks for your replies - very much appreciated