Any advice?

Oespups

It's been a long while since I've posted, but I know that this is the place to find kind folks who have experience or guidance during this long, lonesome journey of caring for a spouse with dementia.

My wife has had a "mild" cognitive impairment for years, coupled with heavy wine drinking.  A couple of weeks ago, she had a very bad fall, she is covered with bruises.  A hematoma on her leg exploded in the ER, and she is left with a long, wide, shallow wound that will take some time to heal.

I am in a rural area, but I was blessed to find a wound care specialist nearby, who has arranged for home health services.  We've had a couple of visits from nurses, and hope to have some PT/OT in the future.

My problem?  After 2 days of not drinking, my wife started hallucinating.  A long night without sleep (strangers in the closet, people looking in our window, bugs on the ceiling, etc), followed by a day of stress with people in our bushes, also a horse, car, etc.  The doctor and I think that perhaps this was caused by alcoholic hallucinosis.

Today a new problem - my wife thinks that there were people in our house the last 2 nights, and that I gave them keys and invited them in.  Agitation in addition to hallucinations.  Maybe the beginning of paranoia.

Any guidance on how to handle this?  And the hallucinations as well?  

Wife is frightened, angry, I am distressed and handling as best as I can.  LOL, I thought I had my hands full with helping her with getting up and down, to the bathroom, off the toilet, changing dressing, getting her to eat...  Our doctor says that she can order medications to help with the alcohol withdrawal, but last night my wife was angry, agitated, demanding wine.  I did give in, I cannot handle her withdrawal on top of everything else, but I let her have 2 glasses only.

I am fearful that my wife will no longer trust me.  Last night she started to take off the dressing for her wound...

dayn2nite2

Were you absolutely honest about how much she was drinking prior to the fall or did you minimize?  Because I cannot imagine a physician recommending that a heavy drinker go cold turkey from alcohol like that.

An addiction specialist should have been brought in to make recommendations and unfortunately healing wounds and detox are not 2 things that should be done together.  She needs to be seen by someone in addiction medicine to get a plan going and if you are rural, this may end up being something you will have to travel for.

Oespups

Yes, perhaps we minimized the amount of drinking, but no - the physician did not recommend that my wife go cold turkey.  My wife was just in so much pain she did not drink or want a drink for 2 days, and then, this happened...

I agree that detox should be handled separately, my priority is to get my wife healed and hopefully able to be on her feet at least a little bit (she has severe arthritis and has had mobility issues for years), enough to get around the house, use the bathroom, etc.  

At this point, I cannot leave the house - and rely on the kindness of neighbors for grocery shopping, picking up the medications that I can't wait for mail order for...  I make sure that my wife has used the toilet before I walk the dog.  Thinking of getting a blackboard to leave messages for her if I have to walk the dog, take out garbage, step outside for a few minutes...Have already installed grab bars in the bathroom, and looking at walkers..

Ed1937

Osepups, Take a look at Goodwill or other places like that for walkers, wheelchairs, etc. You can typically pick up things like that for a fraction of the price of new. For example, I picked up a wheelchair for around $25.00. It was pretty much like new condition.

harshedbuzz

Oespups-

When you wife was diagnosed with dementia, did the neurologist do the testing to rule out alcohol-related dementias like Wernicke-Korsakoff's? 

My dad had mixed dementia-- Alzheimer's and WKS. He was diagnosed in the hospital as the result of a psychotic episode after drinking. We were told at the time the WKS was confirmed that continued drinking would hasten the progression of his cognitive deterioration as well as worsen his mobility and vision issues. If this is the case, prioritizing her wound healing and physical mobility while she's still drinking could be counter to making progress in those areas and around the hallucinations both. 

I know this is really hard. My dad could be a real monster if denied his Chardonnay and I didn't want my mom in the role of alcohol-police on top of all the other caregiving she needed to do. 

HB

MaryG123

I’m so sorry Oespups.  You’ve got some difficult decisions to make.  Maybe thinking about what you need going forward will help you plan.  I don’t think you’re going to be able to keep your wife happy, or maintain her trust in the face of the dementia.  Just keep you both safe.  So sad.

Gig Harbor

It does sound like your wife developed DT’s from suddenly stopping drinking. I worked in a new hospital in a town with a lot of retirees. When we would get people in who had fallen and fractured their hips we would ask about alcohol intake as part of their history. Well after quite a few ladies developing DT’s after they were admitted we revised our intake questions to ask very specifically how much they drank each day. Some were insulted but the unexpected DT’s slowed down. When you add dementia into the mix it can be hard to know exactly how much each is contributing to the hallucinations.

M1

Oespups:  Delerium tremens (DT's) can be fatal.  I would call the doctor now,  she may need hospitalization and treatment until they subside.  Or at least ER evaluation again.  Treatment of choice is benzodiazepines (valium), which can also be problematic in someone with dementia.

Oespups

Thank you all for the benefit of your knowledge and experience, and your kindness - greatly appreciated and more valuable than any guidance I could get elsewhere.

I have notified the doctor of course, about the drinking, hallucinations, and another problem related to blood pressure (my wife has heart, lung issues too and is on a lot of medications).   My wife has never been formally diagnosed, there is some testing scheduled for January.

The hallucinating has diminished considerably today, and for now, I'll take it!