Elderly mother in hospital now mentally confused

Armchair23

My Mother was in hospital earlier this year and the medical staff deemed she had a 'lack of capacity' to make certain choices.

I wasn't told exactly how they arrived at this decision, but it was clear that they were right and she was in no position to make any decisions whatsoever.

In my Mothers case this meant a cannula, IV meds and fluids and Gastro Nasal feeding. And believe me it's no easy task to do this when it's against someone's wishes.

It may be that the medical staff are trying to weigh up the lesser of two evils as enforced treatment when someone is conscious can be very distressing.

I do hope you manage to get the best possible outcome for your Mum.
It's a very upsetting and frustrating time for you all.

katsclaws

Mr_Toad wrote: »

It may be dementia.

My father was 84 and in the very early stages of dementia, if you didn't know him you would never have guessed. He was mildly forgetful but not as bad as some people half his age can be in normal life. He knew people but if he hadn't seen them for a while it would take him a moment to remember their name, that sort of thing.

I visited my parents one Tuesday, mum was out shopping so just me and Dad. He was absolutely fine, made us a drink and we chatted about all sorts of things. He was in his workshop servicing the ride on mower ready for a lawn cut session.

On Wednesday he started feeling poorly and by Thursday it was obvious that he had a nasty chest infection. His GP came and had him admitted to hospital. It took three weeks to clear up the infections, chest and urine but when they'd done that he was a different man. He didn't recognise any of his family, didn't know who he was or where he was.

It seems the infection triggered a massive advance of the dementia and he never came home. He was transferred from hospital into a care home and he never spoke to me or mum again.

That was almost exactly two years ago and he passed away peacefully in his sleep on Tuesday night.

Was your mum a little forgetful before she went in?

It can be hard to spot as people are very good at covering the early stages up because they are still generally fine and they know that they should know something but rather than say they can't remember they develop strategies for covering it up.

Dad was helped by Mum, she would be sure to say the persons name, rather than simply saying hello, haven't seen you for a while she would say hello Bob, haven't seen you for a while so that my Dad didn't have to struggle with the name.

As LondonDiva has already said, you need to request a mental capacity test and take things from there.

Good luck.

I am sorry to read about your dad. My sincere condolences.

carolinabirichina

Well, we went in to visit Mum this afternoon and found her in bed saying "I want you to tell me who I am!" over and over again to no-one in particular. Not a good start!

I took a letter in and gave it to the nursing staff to put in her notes and give to her doctor tomorrow morning asking for a full mental review following LondonDiva's advice - let's see what happens!

She hadn't had any tablets, or breakfast, or dinner or drink so whilst we were there I managed to get her up and out of bed, the nurses took her to the toilet and changed her bed and then they got her to sit in her chair and I fed her a weetabix with milk and managed to get her to take all her tablets including an absolutely massive antibiotic one.

She was constantly complaining and arguing and shouting whilst we were there and we had to leave her in that state so it was very upsetting.

My major worry is that this chest infection has caused irreversible damage to her mind because I don't know what we will do if that is the case.

Thanks for all your replies - they have been very reassuring.

Person_one

My grandmother was incredibly confused when she'd had a major infection and surgery, she had no idea where she was, thought the nurses were spies, very distressed.

Within a few weeks, with treatment, she was fine, her old self, she's still winning pub quizzes.

Yes, sometimes confusion signals the start of dementia and the person is never the same again. That's a possibility it's important to be prepared for. However, the effects of illness, drugs and the hospital environment can cause delirium that resolves completely when the situation is better. Don't despair. Best of luck with everything.

poorlittlefish

I've got a similar situation with my Nan. She too got a chest infection which made her very confused and delusional. She was hospitalised, given antibiotics and discharged, but she's back in again now and she's been in and out of lucidity for several months now. She had a capacity test last week when she was lucid and was declared perfectly capable of making decisions for herself, yet if they'd done it on another day they invariably would have had a completely different result. Nan also refuses to entertain things that are intended to help her.

I wish I could offer some advice but all I can offer is my sympathy - it's so hard to watch a family member go downhill.

Armchair23

Just dropping by to say hello and hope that today has been better for you and your Mum.

All good wishes

carolinabirichina

Armchair23 wrote: »

Just dropping by to say hello and hope that today has been better for you and your Mum.

All good wishes

Thanks for your kind wishes - today was basically a repeat of yesterday but the letter which I handed in yesterday seems to have done the trick and they are referring her for a mental capacity check.

This may take a few days so she is staying put for the time being as if they move her to a different ward it may make the confusion worse.

She had had a bit of a wash this morning (she was trying to fight the nurses while they were washing her!) and was in a clean nightie etc but she hadn't had anything at all to eat again or had her tablets. We managed to get 2 weetabix and milk into her and her antibiotic tablet and that took the best part of an hour! She probably won't have anything to eat now till tomorrow afternoon when we go back in.

Her consultant has the bedside manner of a gnat (!) - he phoned me this morning in response to my letter but to be quite honest I couldn't understand a thing he was saying because he was spouting a lot of medical jargon at me and being quite patronising. The main thing he was going on about was did I want to be part of the decision making process regarding Mum - of course I did!

We'll have to wait for the psychiatric test and then see what the choices are.

Thanks again to everyone for your help xx

Errata

I hoep things improve and work out. A tip I've found useful when health professionals start spouting something I can't understand is to say "Can you tell me more about that please".

polka_dots_3

I'm sorry about your mum, hope that things improve after the capacity assessment and that you can keep encouraging her to eat and drink.

As for the consultant asking if you want to be involved in decisions - did you ask for a Independant Mental Capacity Advocate as someone else suggested? If so, this will be what he was checking as IMCA is for when people have no family or friends able or willing to consent/make decisions if they are deemed to lack capacity. If an IMCA is appointed they would be charged with making decisions in your mum's 'best interest' so although the doctor may not have explained it well he was probably trying to make sure you understood what it entailed.