Hospital for confusion

[Crownlyn]

Hello, I’ve not been on here for a while as mum has been plodding along kind of okay with the usual memory loss and confusion.
However over the weekend I noticed she seemed to be more confused mainly over her medication which I have complete control of so she can’t overdose or forget to take.
Urine test dropped to GP on Tuesday showed no UTI and Tuesday afternoon at the memory clinic my passed all the questions with flying colours.
Yesterday she was so confused phoning me for reassurance about her tablets. When I got to her house she was in such a state of confusion I dialled 111 and they sent rapid response out (who were brilliant) and her water test showed a UTI.
I picked up the antibiotics prescribed and she can’t eat 2 hours before or 2 hours after which is a nightmare for a dementia patient with type 2 diabetes so she couldn’t start them last night.
I left her last night to come home (regretting now).
She called me this morning at 5am, I’m here now , I’m not sure she’s slept and she doesn’t know if it’s night or day.
Her call this morning said she had all her tablets laid out but wasn’t sure which to take as she muddled them up. I knew that couldn’t be the case as she didn’t have them but what I’ve walked into is all her diabetic lancets laid out in colour order thinking they were her tablets.
I just don’t know what to do, whether to wait for the GP to open and hopefully get through or take her to a+e.
I’d prefer a tablet for her UTI but could this be more serious.
I’m sorry for the long message but I just don’t know what to do. Her kidneys aren’t good either due to diabetes.
Would you go to a+e?
Thank you Lyn

 

[Grannie G]

Dial 111 @Crownlyn

Taking your mum to A&E might involve a long wait which is the last thing she needs right now.

 

[LynneMcV]

Hi @Crownlyn - very worrying for you. I agree with @Grannie G about contacting 111.

Has your mum been drinking enough, especially in this hot weather? If not, that could add to the confusion.

 

[canary]

UTIs do horrible, horrible things to people with dementia.
Get her started on the antibiotics and make sure she is well hydrated. She may well improve over the next couple of days. If she doesnt, I would contact 111.

Would you be able to stay with her for the next couple of days to make sure she takes her ABs and other drugs properly?

 

[LouiseW]

Hi, I hope you manage to get the attention of the GP and some help.

My Dad who lives alone randomly takes any medication he comes across - last time I went round to his house there were open packets of my late mums HRT, steroid medication AND codene on his bedside table

Every time I think that I have found all the drugs in the house he manages to find more !

In the early days of this I was really distressed but over the last year I have had to just take it in my stride because there is nothing I can do about it.

I managed to get him into respite care last week and am searching every nook and cranny at his house to remove all the meds.

Good luck xxxxxxxx

 

[Andrew_McP]

Nothing very useful to add, but agree that getting her hydrated is/was a very good start. The 2 hours either side thing sounds like the monuril drink, which I've had little luck with. It helps Mum, but not for long... though they've only ever given me one at a time (the dose for folk with simple UTIs and circumstances).

Anyway, it's no use me pretending I'm an expert on UTIs. After 6 year or so I feel I know less than when I started! But I do know for certain that the horrible sense of isolation we get as carers, not knowing what to do for the best with all the complications of dementia healthcare, and especially in the early hours when sleep & options are scarce, is brutal. And I get twitchy every Friday, knowing that options get even more limited at the weekend.

Good luck getting your Mum stable again.

 

[Crownlyn]

Thank you for all your replies, it’s made me cry, you’re all so helpful x
I don’t think she slept last night so I’ve given her breakfast and sent her to bed for a bit.
She ate at 8 so would be due her Monuril at 10am but I’m waiting for the gp to call back to see if I can give her MacroBID which I have some left over from the last time as that is much easier to use.
I have a dementia carer coming today for 4 hours for the first time ever so I’m hoping that will help both me and mum.
Andrew it is monuril, 1 sachet every 3 days,
Louise I’m pretty sure my mum wouldn’t have attempted to take the lancets but it freaked the life out of me at 5.30 this morning.
I work full time but I think I need to write this week off and stay with her.
Thank you all again, I feel much calmer xx

 

[silkiest]

Hi @Crownlyn,
I am shocked that medical staff gave a confused person medication that is time (and day ) dependant - maybe you can remind them next time she has a uti that this is impossible for you to deal with.
Does your mum test her own blood sugars? If not it may be safer to lock all the lancets away. The white bits are the ends for the purple lancets, so any without the white bit need throwing away. If its only other people are testing your mums blood sugars it would be safer just to use the purple ones and get rid of the other lancets and the pen device to use them with. Your mum wouldn't then be able to re use lancets and put herself at risk of infections in her fingers and carers are not then at risk of needle stick injuries either.
I would certainly be looking at either getting carers in to dispense all medications from a locked medicine box or getting one of the electronic medication dispensers - these are filled by the chemist and work in conjunction with the care phone system.
My mum and dad won't accept twice daily carers so we have to leave my dad in charge of mums pm meds - this has led to no end of problems with mum finding them and taking them early. We now keep the key for the lock box in the outside key safe so the carers have access to it.

 

[Duggies-girl]

I agree with @canary Stay with her for a few days if at all possible and supervise her medications and she may start to improve. In my experience a trip to hospital is the last thing you want to do as it is very likely to make things much worse.

 

[Jessbow]

I think I'd try giving her the Monuril last thing at night, so after her evening meal ( And/or an early supper)and let her sleep on it.

i'd agre, try and stay fr a few days , see if she improves

there must be easier oral antibiotics

 

[Crownlyn]

Thought I’d update you, mum mentioned she felt nauseous so I decided to take her to a+e, they tested her thoroughly and found no UTI but her sodium levels were very low. We eventually got on a ward and she’s on a drip for 8 hours! Apparently low sodium can cause worse confusion etc.
It’s now 1.40am and she’s sleeping (I’m obviously not). They asked me to stay with her because of the dementia and confusion. Absolutely shattered but in mums confusion she thinks she’s in a hotel room and said she enjoyed the break x

 

[LynneMcV]

Thank goodness your mum is getting the treatment she needs and that at least she is relaxed in as far as she is sleeping and believes she is in a hotel. It must be a huge weight off ypur shouders knowing that professional help is close by. Try to get some shut eye if you can - not easy at a hospital bedside I know, but even 20 mins can be an energy booster. Thinking of you and your mum.

 

[LouiseW]

Thinking of you xxxxxxxxx

 

[Crownlyn]

It’s been a while so I thought I’d update you. Mum
actually stayed in hospital for 2 weeks. It took awhile to get all her electrolytes sorted, then she caught an infection that happened to be HAP (only knew once I received the discharge papers) got delirious, became violent, paranoid, accusatory and abusive to me, was eventually sedated and discharged Wednesday with carers coming in 3 times a day. They have been as good as nothing. One carer tried to give my mum toast even though her sugar level was too high!
But I have been advised to keep them as you’ll never get offered any help in the future.
I had a private carer over the weekend which gave me some much needed rest.
Since mums been home she’s so anxious and frightened of everything. I’ve tried giving her half a lorazepam but it’s not working so I called the memory clinic today for advice.
And to top it all, she’s just tested positive for covid ?
Sorry for the rant ?

 

[Louise7]

So sorry to hear about your mum @Crownlyn and there's absolutely no need to apologise for the rant as you've got a lot on your plate. Hospitals are not the best places for those with dementia and it does sound as if your mum's needs have increased and she needs more help, even more so now that she has covid too. I saw your message in the 'How to decide when it's time for a care home' thread and it's common to feel guilty and think that you've failed but you'll be helping your mum to stay safe. She would have a team of people looking after her 24hrs and her diabetes/medication will be managed and you won't have the constant worry and stress and exhaustion that comes with trying to juggle care responsibilities whilst working full time. You need to look after yourself too.

 

[Crownlyn]

So sorry to hear about your mum @Crownlyn and there's absolutely no need to apologise for the rant as you've got a lot on your plate. Hospitals are not the best places for those with dementia and it does sound as if your mum's needs have increased and she needs more help, even more so now that she has covid too. I saw your message in the 'How to decide when it's time for a care home' thread and it's common to feel guilty and think that you've failed but you'll be helping your mum to stay safe. She would have a team of people looking after her 24hrs and her diabetes/medication will be managed and you won't have the constant worry and stress and exhaustion that comes with trying to juggle care responsibilities whilst working full time. You need to look after yourself too.

Thank you Louise7 I slept in the spare room last night due to the covid and mum was very unsettled, saying she wants to go home.
I keep thinking that all this confusion is due to an infection and once it’s treated she’ll be okay (well back to the start of her diagnosis which was only February) but I think I’m just kidding myself or hoping that will happen x

 

[Louise7]

@Crownlyn sometimes things get better once the infection is treated, but your mum has been through a lot with three infections one after the other. It's not good that the hospital didn't tell you about the HAP, I had a similar issue when mum went into hospital and acquired an infection whilst in there and no-one said anything Your mum may 'rally' a little in time but unfortunately there's no way of knowing and in the meantime she needs a lot of care. Perhaps a spell of respite might help in the meantime so that your mum stays safe and you would get a break too? There's a lot to think about, it's not easy.

 

[canary]

Im wondering whether your mum developed delirium from the infections. Delirium can improve, but they dont usually get back to the level they were at previously and it can take up to six months for it to resolve.

I agree with Louise7, perhaps a period of respite where they could also assess her needs will give both of you a bit of breathing space and allow you to plan for the future.

 

[Rachael66]

Reading this is like reading about my mum. My mum went downhill quickly last April and I did a urine test at home with the strips from age uk, gp prescribed antibiotics just on my word but she got worse so had to get an ambulance and they said she’d probably Be back by the evening - 10 days later they found a small chest infection, that was it. Original tests had shown liver issues and lots of stuff. Due to covid I wasn’t even allowed to visit, I passed her phone charger to someone at the door but they never helped her charge it, so she couldn’t contact me, she was a nightmare in hospital so they eventually let her use the nurse station phone anf had to have a HCA sit with her at all times. Hospitals are just not dementia friendly enough. BUT when they brought her home she’d not recognised me that well in a long time and the delirium did eventually ease