Dimensia, Alcohol Withdrawal and Cardiac Problems

[natalie_1982]

I'll give you a quick background so my question makes sense......
My grandad is 78, he has always been a heavy drinker; not an alcoholic, or that he drinks to the point that he cannot stand, but he drinks a lot, and always has done. When he was 47 he had his first stroke, since then he has had about half a dozen more, although not as serious, and he had a serious bout of pneumonia about 10 years ago, which is when he quit smoking. About 6weeks before Christmas 2007 he was having problems with his heart and was discharged before Xmas being told there was nothing they could do. He was admitted by ambulance 3 times in two weeks at the end of April, again because of his heart, and consequently has now spent the past three weeks in hospital.
.....cont.....

[natalie_1982]

When he went into hospital for the first time three weeks ago, despite having a history of heart problems, he was of sound, if not cantankerous (sp??) mind. Three weeks on he has a chest infection, a water infection and what seems to be a form of dimensia, but only with my nan. When I visit, or my brother, my cousins, dad, uncles or anybody else, grandad is fine and in tune - he is up to date with the news, knows everyone's names, ages, jobs, etc etc, yet when my nan is there with him on her own he refers to things from yonks ago, i.e. he'll ask her to stop at a certain place for fish and chips on the way home of somewhere they lived 45 years ago, or tell her that the people from the place he worked 40years ago were having a party last night and he had to chase them out at midnight. He will tell her the staff allow all the other patients beer, but won't let him have any. My nan find this extremely upsetting and at 77, is under a lot of stress as it is and she still works. He phones her 3 or 4 times a night, sometimes as late as 10:30 telling her that he has seen her with another man, that he is being held in a mental asylum or that he is ready to be collected from somewhere that closed 20years ago but could she bring a fried egg sandwich and a sausage roll.

I have tried googling, and have found information about dimensia caused by alcohol use, but what about alcohol withdrawal specifically? THe treatment for alcohol dimensia is suggested as stopping alocohol intake, but in this case it seems to be the problem. Has anyone heard of that causing dimensia? It just seems so odd that his marbles started going as soon as he was admitted to hospital and wasn't allowed any beer. Also, what's more confusing is the fact that he is only like this towards my nan? Is this familiar to anyone?

My other grandmother has Altzheimers so I am familiar with the condition, but my other nan is senile with everyone - not just select people!
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[natalie_1982]

One last thing.... the reason they have kept him in hospital for three weeks is because they now say they can treat him and intend to implant an ICD, but the op has been cancelled five times so far for vairous reasons - not enough staff and more recently, because his blood is too thin.

If this rings a bell with anyone, I'd be fascinated to know - thanks x

[bednobs]

i think you probably mean dementia?
TBH an infection can cause the same symptoms you describe in him. Especially chest infections in the elderly. it can cause them to seem temporarily doolally.
The other thing is he could have multi-infarct dementia, which is cause by many many small strokes eventually destroying enough brain tissue to cause dementia, but as it has happened so quickly, i would think it was much more likely to be an infection causing fluctuating levels of comprehension

[natalie_1982]

Thanks bednobs.

Apologlies for spelling dementia wrong.

Would the temporary doolallyness be likely to clear up when the chest infection does? And what do you think would cause him to only behave like this around my nan? My husband thinks it could be that to everyone else, my grandad has to work hard to appear normal but around my nan he lets his guard down and so regreses and becomes confused? The doctors say they don't know what causes it, have tested him for dementia and say when the op is done he can go home, but my nan cannot cope with him as he is as he also becomes quite aggressive, but only towards her. I plan to speak to the hospital staff myself at the weekend.

[sense4all]

I have to say that I would suspect the water infection as being the culprit for the odd behaviour ... when my Mum had one she was a wee bit spiteful and very out of sorts. Also having a heart condition may make it worse as you can shift less of the water making the whole thing more extreme.

[natalie_1982]

The water tablets he was on have been causing him problems sense4all - he has a leaky valve in his heart causing his lungs to fill with fluid; he takes water tablets to flush the fluid out, with the result in him being dehydrated, so they lower the dosage and his lungs fill up and his legs swell, and then he got the infection....... Thanks for your answer.

[ladyalex]

I'm sure it is the infections that are causing his confusion. As soon as the hospital/doctors can get them cleared up it will disappear.
Worth remembering for the future . If he's confused, he may well have an infection, even though he is not complaining of anything, so get the Dr in to check.
PS what do the nurses say ? and can you ask them to keep the phone away from him at night so he doesn't bother your nan ?

[snow.maiden]

Hello natalie. Yes, infections - and dehydration - can cause the symptoms you describe. After anti biotics, and making sure that your grandad always has a drink within reach (sometimes you have to keep reminding older people to keep drinking more) - it's likely that his confusion'll disappear.

[natalie_1982]

My nan asked them tonight to keep the phone away from him at night, I think it's a bit naughty really as they know she is elderly but still let him ring as and when he wants. My nan asked for his benefit as well as hers, as he gets increasingly distressed when she tells him she can't pick him up in the middle of night!

I hope you are right about the infections, it's definitely worth bearing in mind for the future. Fingers crossed he has this op soon then he can go home and get back to his normal self ;-)

[minniemoo]

Hi Natalie, first of all I want to say that I don't want to worry you with my response but it may be worth thinking about. My mum has drank quite heavily for many years and it all came to a head one night about 3 years ago. She became really confused and was talking about things that happened a long time ago and could be quite aggressive with me and my 2 sisters. She was trying to cut the bottom out of a chair with a knife because she was convinced there was a baby trapped in there. It was so upsetting and we rang the doctor. Her doctor came and said there was nothing he could do and she should really be admitted to hospital. While he was there she had some sort of seizure and was like a baby on the couch. The doctor rang an ambulance and she was taken to hospital. She was there a month. They did all kinds of tests and told us that she had chronic cirrosis (sorry about the spelling) of the liver due to alcohol abuse. Her liver could not flush out any of the toxins from her body and so they were travelling straight to the brain and causing all the problems above. We were also told that that her liver was so badly scarred she only had 6-12 months to live. The hospital did not tell my mum and me and my 2 sisters decided not to tell her (rightly or wrongly, we do not know) because we thought it would have finished her off. Anyway, we are now 3 years on and she is still here but suffering terribly. She is on constant medication and still drinking.

Has your grandad's liver been tested?

I feel for you and your nan and hope that all works out well in the end.

[natalie_1982]

Snow maiden, you have another good point. The old b*gger has to be forced to drink water/ squash/ fizzy - anything except beer, cider, wine or whisky!

[ladyalex]

Hope all goes well for him (and for the rest of the family).

Be prepared to argue with the hospital if they plan to discharge him to your Nan if you think she cannot cope. If you just accept what they say, they will assume that you can all cope.

Good luck

[taichiperson]

Not sure about the alcoholism, but my father in law had dementia, and definatley went downhill when he went into hospital. Is it Alzhiemers, do you know? My FIL had 'Lewy-Body' dementia, it started with hallucinations (he didn't drink)O. He would see people in the garden that weren't there, and wouldn't eat spaghetti because it appeared to him like worms...

[natalie_1982]

Thanks minniemoo - no I don't think his liver has been tested because he lies about his alcohol consumption, this is why I'd like to speak to the staff on my own ideally. I'm the only family they have locally, although theirs sons (my dad and uncles) have travelled every fortnight or so to visit.

Alex, my nan told the nurse that she won't be able to cope at home, and that there is no way she'll be able to get him up the stairs - the nurse said he was quite sprightly and would be fine!!! The man is doddery and frail and in order to get to the toilet he requires a walking frame and help to sit up!!! I totally undersand the NHS are pushed and need beds, but in sending my granddad home without the proper help and support they will on double their intake in a few months because it is making my nan ill.

Thanks for all your comments, it's really helped me to see things differently

[snow.maiden]

Dementia is just premature forgetfulness. Alzheimer's Disease is different, although the two can go hand in hand.

[natalie_1982]

Taichiperson, the hospital have tested him for Altzheimers and he got 17 out of 20 correct indicating that he doesn't have dimentia, but during tests he can hold it together it's only when he's with my nan that he's potty. He is hallucinating though - says things are moving when they aren't and he sees lots of (imaginary) children and ducks on the ward.

[taichiperson]

You need to get Social Services in to asess the situation - my FIL lived with us, and it got to a point where he didn't know his way around the house anymore, couldn't find the toilet, and would wander off onto the road if not watched 24/7, and we also had young children to look after. It sounds as if your nan would not be able to cope with him, and you need to make that clear to Social Services - they can arrange an appointment, either at home or elsewhere. If you can also be there to back her up, all the better.

[taichiperson]

As I said, Alzheimers is not the only form of Dementia, my FIL was told he didn't have Alzheimers but it was obvious that something was wrong when the hallucinations got worse. I'm not saying that your situation is exactly the same, but it is a very complex problem and all things need to be taken into consideration.

[snow.maiden]

Taichiperson's right. Social Services can be of enormous help at times like this. Your grandad may need to go into sheltered accomodation, where people can can drop in on him and see to his needs - or even into care. There are drugs which can now help to combat AD, but the drinking won't help. It's a long slog, but you have to work with your doctor, any carers and perhaps experts in the field of whatever your poor grandad's suffering from. Best of luck. xx