Delirium - it's a thing? Who knew?

andrew250

I have posted how my 90-year old mother is now hospitalized. She was diagnosed with vascular dementia August 2020.  Starting on Christmas day, she got super agitated at MC. Lots of daily delusions going on, culminating in full-on hallucinations about a train wreck she could see out the window. On Jan 1 when she was sent to the ER for evaluation, basically because the MC staff were worried for their safety and hers. The common medical issues (UTI, etc) are all ruled out now. She changed from hyperactive to hypoactive - meaning she's lethargic, not eating or drinking well, not able to communicate.

One of the doctors referred to her "delirium." I thought "delirium"was the kind of thing you read about it Gothic novels, like "having the vapors" or whatever the opera heroine dies from. It turns out it's a real medical diagnosis, and it's good she's in the hospital being treated. They are looking to send her to geri-psych but beds are not readily available.

This disease is teaching me all kinds of new things.

Quilting brings calm

Andrew 

I’m glad that the medical professionals ruled  out things like a UTI, etc before they diagnosed delirium. However, please make sure they keep testing  her and do cultures, not just a dipstick test. My mothers 2019 doctors kept saying she did not have a UTI, and called it delirium. They declined to put her in the hospital and the ER kept sending her home.  She just got worse and worse. We moved her back to our home state and took her straight to the ER when we got into town.  She was admitted because she tried to open the car door at speed in the interstate. Within an hour they had diagnosed a UTI, which turned out to be urosepsis.  

We know now she does have dementia, and probably had MCI back then. However 14 months later,  it is nothing like what she had those last couple weeks out of state.  Everyone around her  in that other state thought she needed a nursing home and yet no one was helping us get there.  Not that we would have  placed her  halfway across the country from us. 

I hope your Mom does have delirium and that she improves.  

Milady1122

went through delusions with my mom about a year ago...

she thought she can read peoples minds and get messages from people. (usually to backup something she didn't want to do like take her pills.)  "the dr said i don't need this many pills anymore" or to tell me someone was going to be late coming over, etc.

the worst was when she was "talking" to people in the middle of the night.  A nurse "called" her (in her head) to tell her to get to the ER immediately because the meds she took would kill her by morning.  nothing i said helped until i told her to let ME talk to the nurse... and my conversation with the nurse was that she wasn't on the medication they were worried about.  she calmed down and went to bed.  her dr changed her meds at that time and until recently we only had these extreme issues when she had a UTI.

if you're dealing with it yourself, try to take her reality problem and resolve it for her... and hopefully they can find the right meds.  good luck

star26

Your poor Mom. Delirium is awful and to be taken seriously, as her doctors are. The hypoactive and hyperactive descriptors refer to the type of delirium. I'm just wondering if your Mom was newly placed in the MC or if there was some kind of change in the facility, or if she had been suffering with another illness, or not eating and drinking well and was possibly dehydrated, etc. ? It's often triggered by being in an unfamiliar environment or being unwell physically (even a seemingly small change is a big deal in a 90 year old). 

LaurenB

It's important to remember that delirium is a diagnosis of a serious disturbance in mental abilities that results in confused thinking and reduced awareness of the environment.  It can be brought on by many different causes including brain deterioration, drug toxicity, UTI's etc.  The important thing is to try to find the cause, and address it if possible.

andrew250

Thanks, everyone. Mom is doing better today. She's communicative at least rather than lethargic and out of it. She asked for a hamburger even. I was able to speak with her over FaceTime. She wants me to sell her boat (note, there is no boat). Also interesting, she seems aware she was not in her right mind for a while saying she had a "bad turn."

They tested her for all kinds of bacteria and viruses. X-rays, CT scans. The UTI was ruled out a few times by more than a stick test, so that's good. I didn't even know they had panels for so many virus tests too. There were multiple Covid tests.

She's weak from lying in bed for so long, but we hope with rehab she will be back to her regular level of dementia. Can't say for sure yet, but at least the news is better.

I doubt we will ever know for sure what caused this. We know that leading up to Christmas she was having delusions all related to being separated from her family. The hospital docs says she may have developed hospital delirium from the change from MC.

GothicGremlin

My mom-in-law had this a few years ago.  It was really, really scary.  It turned out that it was caused by a decrease in her electrolytes, which I think was triggered by low sodium.  This happened because there had been a change in her medications.

The good news was that she fully recovered.

zauberflote

My mother experienced "hospital delirium" several times. The first time, she lived 600 miles from me, had been taken to the ER from AL for what turned out to be simple dehydration, but they "saw a couple of things" in her labs and admitted her for observation. By the next morning, she couldn't walk. She'd gotten dehydrated from walking in the sun around her little campus, and then sitting outside. I didn't get there until the third day, and by then we were off to the races. She did not so much have delusions as massive confusion and disorientation, and the continued inability to walk-- she grew very weak very quickly. 

Apparently anybody over 60 or so is more prone to hospital delirium than those younger.