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I have found so many great discussions on this Forum and hoping to get some personal experience advice.



My mom, 88, lived independent living community taking care of herself for many years. She had no major health issues. Great memory. Two and a half weeks ago, she complained of severe lower back pain on either side. Made my sister take her to ER (it was Sun). She was diagnosed with a UTI. They put her on antibiotics and the next day she had no idea who we were. A couple days later she was okay but not 100%. Then they noticed her sodium was low (an issue she's had before). Long story short, she was in the hospital 2 weeks and in and out of a confused state. They discharged her because she was clinically better but thought it could be hospital delirium and being home would help.



She has been home 5 days now and yesterday, for instance, was SO much like her old self. She questions why she has been confused and the things she is saying so her brain is somehow remembering that. But then this morning confused again. (Sundowning as well). We have aides with her 24/7 for now but need to think about a long term plan as well if this continues(meeting with her Dr next week). They did MRI and CT in hospital (among a million other tests) and did not find anything else (all typical with 88 yr old). I know others mentioned there isn't a specific test for dementia but wanted to mention that.



Just curious if anyone has experienced this with the constant ups and downs with confusion/agitation and if their elderly parent ever fully recovered? We hoped after being home she would "reset" but not there yet. I know I read some people said it took a month or more but would like to know experiences on timing and if in fact they did see improvement on the confusion where they could go back living independently. Any information appreciated. Thank you.

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Well, first off, there IS a specific test to determine if dementia and/or Alzheimer's is present; it's a mini cognition exam called a MoCA or SLUMS test which can be given if this situation with mom's confusion doesn't clear up. You can talk to her PCP about it; he can usually administer such a test in office and it takes about 20 minutes; it's mostly oral with one written question: to draw the face of a clock showing 3 pm which tests executive brain function.

That said, it IS common for this type of confusion and delirium to drag on for a while after a long hospitalization. I've seen it with my mother who was in the hospital with pneumonia for a week and then went onto rehab for 21 days. She was VERY OUT OF IT the entire time, then went back to her Memory Care AL and within a week or so, she was better. BUT, she was diagnosed with dementia at the time and living in Memory Care! So her 'normal' would be different than your mother's 'normal' who wasn't exhibiting signs of dementia before this whole UTI happened! What you have to make sure of is that mom's urine was cultured to find out what type of bacteria was causing her UTI to begin with. That the correct antibiotic was prescribed and that the UTI is completely GONE from her system after the meds are finished, or, if another round is required. Make sure you're all set on that, and then just give her time to 'reset'. If she isn't back to good within a month, THEN I would worry that she's going down the dementia highway, which is possible I suppose, at 88 and after being ill. Sometimes an elder will get sick which start off a chain of ugly events that never get them back to 'normal' again. That's not to say this is what's happening with your mom, but just a general statement. There is a tipping point for elders from which there IS no return, it seems to me.

Make sure mom is getting enough fluids, too. Did they say why she was low on sodium? And/or why it's been an issue for her in the past? That situation can sometimes mean an underlying health condition is at play or perhaps can be related to medication she takes. Here is a link to info from the Mayo Clinic on the subject:

https://www.mayoclinic.org/diseases-conditions/hyponatremia/symptoms-causes/syc-20373711

I hope your mom's confusion & delirium clears up completely. I know how horrible it can be to witness this in a parent. Wishing you the best of luck moving forward.
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LGNapt Mar 2022
Thanks for the reply. Yes, sorry meant physical tests for dementia like CT & MRI showed nothing & never had a cognitive test prior bc it wasn’t an issue. We are about 1 week post hospital discharge & up & down - some days completely herself & can’t figure out why her brain is having crazy thoughts & next day saying she wants to go home & other confused comments. Been pretty tough. Hoping for a turn but just not sure what tomorrow holds. Thanks for the support.
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Each of our elders is just about as unique as his or her own thumbprint. Glad you have the medical support on board and can address the medical issues that might be contributing. Wishing you luck.
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Dementia cannot be diagnosed with MRI's and scans. Your mother has had delirium in and 'out, not dementia. Delirium is reversible, once the medical cause is resolved. Infections of any kind may cause delirium, also medications like antibiotics. If she is still in and out delirium, it means that her medical problems have not been resolved. Hyponantremia or low sodium is usually the result of a serious medical condition affecting the kidney, the liver or the heart. Dementia has a gradual and slow onset, while delirium is sudden. Her medical problems are worrisome, because they haven't gone away yet. She probably had a kidney infection that damaged them. This was more serious than a simple UTI.
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