Please help: My mom has delirium at night

Senior health
1

My mom is 83. I took her to the ER a couple of months ago for what I thought was a wound (burst blister on her shin) that had gotten infected. At the time, she had AFIB, stage 4+ kidney failure (but holding steady), mild/early congestive heart failure.   They determined she had too much fluid and was given massive diuretics which sent her into real kidney failure, requiring dialysis.  In the hospital, she began to show signs of delirium.

She was discharged to a a rehab/skilled nursing facility, where she was fine the first week, but delirium returned.  Right before her scheduled discharge, she was diagnosed with a uti and sent home with antibiotics.  

She spent one night at home with me, and yelled the ENTIRE night, without ceasing.  Back to the ER.

She was treated with IV antibiotics and seemed far more comfortable during the day.  She was sent back to rehab to regain strength.

BUT... she continues to scream and scream all night long.   She will be calm, pleasant, and very sleepy during the day. At night, she is awful.  I tried white noise, soothing words, stroking her arm, offering water, etc....   NOTHING worked longer than a few minutes. I'm afraid she is going to get tossed out.   

I need advice!!  The staff at the rehab think that since she is well during the day, there can't be anything medically wrong with her.  I don't know if we are unique.  The entire facility is filled with seniors, and I don't hear any yelling at night. I hear plenty of snoring, and I would LOVE to hear my mom snore........ 

She had no issues with night delirium until her first hosptial stay.

 

2

Well it could be that your Mother needs to go to the toilet, is afraid to go herself, keeps calling and is not being attended to.. Is your Mother now compus Mentis? Does she wet the bed, is she being left unattended.

What are they doing with her in the day? Is she being kept busy, and stimulated mentally, is your Mother mentally alert now? No Dementia, this can cause issues with agitation if she has senile Dementia..She needs an assessment in case she has psychiatric issues.

Is you Mother sleeping during the daytime? she may have Day/Night reversal daytime too much rest, nighttime not tired.. Get her Medication checked this could affect her? Or could help with something to relax her at night like Amitriptyline 10 x2.

The environment is not easy to settle into or what she is used to this won't help. 

Its about routine, check he fluids, dehydration can cause delirium senior care is no mean feat hard work!..

 

3

Dear TMNA, this must be such a worry for you. I was going to suggest a urine infection as my mother did have similar problems to yours, kidney, heart etc.  She actually caught ESBL (a urine infection that can only be treated with intravenus antibiotics) in hospital and this is usually caught through the use of unclean catheters.

The staff in these places can be very unsympathetic bordering on unkind.  My mother was in a nursing home and whilst some of the staff were lovely, one or two of them would suggest mum was being lazy when she lost the use of her arms. We since found out that the GP had her on a drug for several months which she should not have been on for more that 5 days and this caused her many problems.  Sadly mum has now passed away.  

If you have the strenght just keep pushing for help and answers. It sounds to me as though she should be in a nursing home and if she is very ill it should be funded by the NHS. She would have to be assessed and in my mother's case this was arranged by the hospital staff.  

I also agree with Diana that she should be kept occupied during the day as much as possible and that her medication should be checked. I wish I had done more to check my mother's medication, having known what I know now.

Good luck. I feel your pain.

Angmh

4

A lot of drama since my post, and I thank you fo commenting. On Sunday night, my mom was uncotrollable. Finally, she hit rock bottom, which led to the er and finally, her diagnosis of a pulmonary embolism.  So many symptoms and her complaints of chest pain and shortness of breath (especially when lying down) could be explained for the emboiism (even her clammy skin).  I am so upset, that some of these clear symptoms were overlooked, given all the dr appointments my mom goes to.  Her rapid heartbeat? AFIB. Nausea? Kidney Shortness of breath? AFIB Discomfort when lying down? AFIB and Hearburn. Pain in chest? Anxiety, AFIB, Heartburn.   

No wonder my mom awoke frequently holding her chest. Pulmonary embolism can be painful.  

No wonder she couldn't walk a few steps without panting. No wonder she never got a good night's sleep.  No wonder she was chronically fatigued.  Every time she dozed off in a chair, she was placed in her bed, where it would be safer. So,  basically, she never slept. 

All those sleepless nights x months..... Eventually would lead anyone to a state of delirium.

Please, read up on pulmonary embolisms, and try to remember the symptoms. You never know when someone you love may have similar signs.

Now, I just want to know what I can do to help her recover. She still wakes up and calls out. She still has the pain. Any advice? What can I do  to make her feel better until her symptoms go away (which could take months to even a year, or two). 

5

So sorry to hear all this.  At least now you know what the problem is. It is very painful seeing your mother suffer and feeling so helpless.  I do hope now that you can get some good advice to deal with this.  Best wishes.

6

Thank you. She still has the delirium, but as we remove the triggers, I'm hoping to get my mom back.

7

Anyone experience delirium with a loved one? What's the best way to keep them rested at night?

8

After four hospital admissions since February, my mother passed away early this morning from complications to kidney failure (in the hospital for a UTI).  I want to thank those of you who passed on good advice. 

9

Dear TMNA, I am so sorry for your loss.  Your mother passed away knowing how much you loved her and did for her.  That is probably little comfort at the moment but hopefully in time it should help you.  My heart goes out to you at this very sad time.  May your mother rest in peace.

Angm

10

Thank you so much. I wish you and everyone paort of this online community good health. Sometimes, I've gotten more answers here than from anywhere else.  I do think the drug, Amiodarone was the  catalyst for so many things that went wrong.  Please, question doctors who are not aware or don't share the risks with medications.

11

Hello TMNA.  When I read your post, bells and whistles went off.

It could be that your mother was given a fluoroquinolone while in the hospital.  Hospitals use these antibiotics routinely in IV,s (something they never tell you) and they could have also sent her home with them in pill form.

If she was given that  particular family of antibiotics, i.e., ciprofloxacin, Levaquin, Avelox, et all.,  it would certainly explain her distress.

Delirium is only one of myriad distressful things that occur when a person is given fluoroquinolones....and doctors are particularly fond of prescribing fluoroquinolones for urinary tract infections.  

Unfortunately, doctors are of no help when this happens.  They have no understanding as to what this antibiotic does, and they very likely will not even believe it's the cause of any problems. Despite this, if your mother was given this particular antibiotic, there's a one-hundred percent chance that it is causing her  delirium. The delirium from this antibiotic tends to occur at night.

To check this out you need only to google "fluoroquinlones" along with a symptom, such as delirium; heart trouble; kidney damage; liver damage; central and perifpheral nervous system damage; seizures;tendon ruptures; retinal detachment; etc., the list is endless.

(Your druggist will be able to tell you if she was given something from the fluoroquinolone family; he will also, no doubt, be more knowledgeable about it than any doctor would be.) 

I certainly hope they did not give this drug to your mother. It has three black box warnings, one of them stating that it should not be given to anyone over sixty years old.  But doctors consistently ignore this warning  and, because of this,countless people around the world have had their lives destroyed.

 

12

I am SOOO unhappy to hear about your mother, TMNA.  

After reading about all of her symptoms, I am 100% CERTAIN she was given fluoroquinoline antibiotics....probably in her I.V., at the hospital as well. It began with the delirium, but it damages all organ systems.... and the older the person, the more devastating the damage.

Bless your heart for taking such good care of her, and, clearly, for loving her so much.

 

13

Dear  Nabur: Thank you so much. It saddens me that you probably were correct. Yes. She was given anbiotics. She had gotten cipro for a uti a couple of years ago, and it took at leats 3 months for it to work its way out of her system. She had rashes all over her body and other side effects (she called it poison).  After that, over the course of this past year, she was given anbitiotics on and off... and levaquin was one of them.... she was given cocktails of a wide variety. I am going to see if I can get a list from the pharmacy, but you're right on all counts. My mom suffered tremendously the last 3 weeks of her life. She was in a lot of pain and she couldn't even express what was going on. Again, thank you. I hope others will think twice before agreeing to antibiotics that could be dangerous.

 

14

I kept mentioning to medical professionals that her delirium came on at night.....and they said it's called "sundowning."  I  knew it had to be more.

15

Does your Mother have low vision?  If so, she may be suffering from Charles Bonnet Syndrome.  This causes silent visual hallucinations - and the condition is often made worse if someone has a UTI.  Please look at my website for more information -

Most doctors and nurses have never heard of Charles Bonnet Syndrome but it is worth ruling it out.  The hallucinations happen at any time, to someone who has lost 60% or more of sight.  If you think it might be this, there is a printable explanatory leaflet on the website, which can be taken to the doctor, nurse or carer.  Otherwise, please feel free to email me on

I do hope you manage to solve the issue. 

Judith Potts

 

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16

Her vision remained about the same....definitely not such a rapid/dramatic decline. I never heard of Charles Bonnet Syndrome.

I think I'm going to step out of this forum.  I hope that's okay.  My mom passed away almost 3 months ago. I have enough reminders of her illness.  I appreciate  you all, and it was very helpful to weigh in. I've met the loveliest and most compassionate people, here. But, I need to take a break so I can move on.  Good luck and good health to everyone.