Delirium

[marksroomspain]

What a nightmare 9 days myself and my family have had after my father was diagnosed with delirium after a water infection.

It all started at the beginning of October with my dad going out of his mind by trashing his bedroom and throwing furniture down the stairs and after a diagnosis of a water infection and hospitalisation they concluded he had delirium which cleared after infection subsided.

Fast forward 3 weeks later we saw the signs again but luckily enough he was admitted back to hospital and this time the delirium come back with a vengeance after docs discovered first bout of antibiotics which was thought to have cleared the infection actually didn't and the nightmare started again only worse.

After hospitalisation dad was hallucinating that people were trying to kill him and he also attacked a family member and had to be sedated also after a week he was discharged to a care home for rest bite only to be in there for one hour where a member of staff was assaulted and he smashed his fists through windows to try to escape causing damage to his hands.

After been returned to hospital and after been treated with a drug called haloperidol he has slowly started to get better also the water infection is now well under control so we hope to have him home soon.

He is 80 years old and still a fit and powerful man for his age but this condition turned him into what some would call a raving lunatic but what I prefer to call a sane man's madness and although tests show unlikely dementia as they both show similar symtons it's really opened my eyes to a condition which is not very much understood.

Would appreciate any input from others on the forum who knows about this condition or has gone through it themselves or with family members....

Cheers Guys...

[raynaputi]

It happened to my late grandma a few years ago (I was still in college that time). She was not violent but she seemed to be out of this world. Like cooking food for my young cousins when she clearly knew they don't live with her and getting annoyed whenever we told her they're not in her house. Telling us some weird stories that we never heard of. Also talking about death and not even recognising us. We thought she was losing it at that time and will die soon! My parents and aunt took her to the hospital after persuading her a couple of days after and that's when we found out she had diabetes and was getting worse symptoms when delirium happened. She was okay after she had treatments for her diabetes and it never happened again up to the moment she passed away 2 years ago.

[cheekee]

As a senior nurse I see this a lot.

Infections can cause delirium and it's quite common in the more elderly patient. Usually when the infection is under control with the right antibiotics it gets better. The two most common antibiotics used for water infections are trimethoprim and nitrofuantoin. More severe infections might be treated with IV antibiotic therapy, especially is pylenephritis is suspected (infection of the kidney). I have seen a patient think there is a radioactive pigeon on the windowsill trying to kill them. Haloperidol is an anti psychotic medication that seems to have a cumulative effect. I.E it needs to be given regularly to work better.

Although delerium can happen in sepsis without a diagnosis of dementia, It may be useful for him to have a full dementia screen once his symptoms have cleared as delirium is more common in patients with dementia who contract a water infection.

[marksroomspain]

Thanks Rayna and cheekee for your input and very much appreciated, his GP said a while ago his meds need to be reavaluated so maybe a link there also diagnosis of asbestosis recently has took a real strain on his health with constant coughing due to pleural thickening.

My wife also a nurse seems to rule out dementia in part due to her experience in this, dad has had testing done before and was put at normal score for a man of his age and notes say it is down to congenital impairment but will definitely look into this more deeply for further investigation and testing...

[Doc Alan]

Delirium - also known as an acute confusional state - is indeed frightening, both for the patient and their loved ones.


It is still commonly under-recognised, although it was actually described by Hippocrates, and named by Celsus in the 1st century AD.


During the 20th century the focus has moved away from looking at delirium only as a symptom to a better understanding of how it occurs.


Possibly 1/10 hospital patients may have an episode of delirium.


It is commoner in older people who may also have other health problems and/or recently had surgery. However it can occur in young people ( my son had it aged 8, while suffering a fever with a chest infection ).


Common causes include chest or urine infection ; high body temperature from whatever cause ; major surgery ; or as a side-effect of drugs.


Typical symptoms are as described for Mark’s Dad, and by Philip ( Cheekee ). It often starts suddenly, but improves when the condition causing it is diagnosed and gets better ( for example, antibiotics for infection ). There may be more than one cause ( or no obvious cause ).



Medications like haloperidol ( sometimes called " major tranquillizers " ) may help in certain situations, for example when the patient is very agitated or anxious, seeing or hearing things that are not there, or to stop them from endangering themselves or other people.


There’s a chance it will recur if the patient again becomes unwell.


Both delirium and dementia may be unrecognised or mistaken for each other - each cause similar symptoms, but delirium is acute ( sudden ) whereas dementia is chronic ( slowly progressive ). Each condition is a risk factor for the other - which implies similar pathological changes in nerves. This might therefore mean both could benefit from the same new treatments. Be reassured that research, while still not enough, IS progressing in delirium and other ( hopefully ) reversible conditions causing dementia .


This is so important as life expectancy increases both in the UK and elsewhere such as the Philippines. In 1917 King George V sent 24 messages to people having a 100th birthday ; in 2011 the Queen sent nearly 10,000 .

[marksroomspain]

Update:

Dad's condition deteriorated slightly showing blood markers for infection were up and had an agitated night last night.

Docs have come back with results after chest xray which was clear also no water infection so are looking at an infection elsewhere.

I just want to thank Doc Alan for his input and just hope there is a turning point and thinking positive going forward...Thanks guys...

[cheekee]

Hope things start to improve soon.

Thank you for the rep.

[marksroomspain]

Just an update, Dad went into restpite after 4 weeks in hospital to an EMI nursing home for a further 4 weeks and has improved dramatically since my last post even to the point that we brought him home for good on Xmas Day.

Took a while to settle in after been away for so long and he worries a bit more than usual but is also calmer in the way he deals with things.

Still a little bit forgetful but it's what we expected at his age due to what he's been through also I know this can take time to resolve itself maybe months or even up to a year but we are thankful he is back where he belongs also memory testing in 3 weeks so we have a fuller picture into the extent of it all...Thanks for your input guys....

[grahamw48]

Good to hear that he is on the mend.

I took my son out for a meal and drinks today... to the pub that used to be my regular when I was his age.

.

[marksroomspain]

Cracking pic Graham you must be proud of him, bet he's got a few admirers...

[grahamw48]

Thanks... and yes, he certainly has. In fact he married one of them last June.

I wanted to get together before I go out to visit my new son in just over a week.