Depression, dementia, delirium… devastation

The euphoria of my lovely trip has had to be pushed to the back of my mind as I face a new challenge. Some may remember that I spoke of ‘inheriting my ex husband’s wife’ when she called out for help.

We were so happy when she moved into her lovely little unit in a care facility. We had chosen this particular facility because they offered end of life care so we felt that this meant that she could be there safely for the rest of her life. When we found Alfie, a beautiful little wire haired Jack Russell, her future looked much brighter.

‘Pat’ set up her unit with furniture chosen from her previous home. She has a natural home making ability and everyone commented on how lovely it looked. It took some time for her to feel confident to get herself down to the dining room for lunch and she was not making a great deal of effort to join in activities, using her little dog as an excuse, but on the whole she felt happy and safe.

I organised for my daughter to be a point of contact while I was away and she visited frequently and took her for several outings so when I rang her on my return, I was feeling very positive. She was very excited to hear from me. My daughter had shown her my photos from each place visited on my Facebook but she couldn’t even remember my daughter visiting. I promised to visit her the next day.

I was shocked at what I found. Physically she actually looked much better, but immediately she pulled me into the unit and whispered that we could not talk as there were cameras in the room and she wanted to leave. She said she didn’t want to be there anymore and wanted to swap her unit for one further down the coast. At that time I hadn’t realised how much she had deteriorated cognitively so I attempted to reason with her, with no success. She said people were breaking into her unit and stealing her band aids and her dog’s lead. This really set alarm bells ringing.

In the afternoon, I took her upstairs to a musical afternoon and she insisted on taking the band aids and dog’s lead. She sang along and seemed quite happy until she stood up abruptly and said we had to leave.

I noticed that the little dog she had grown to love, was scratching her legs and she mentioned that he needed his nails clipping and his coat trimmed. I said we’d get that done a few days later when I next visited.

I made an appointment with the resident doctor who she really liked, as I wanted a referral to a geriatrician, to get some advice on ways she could be helped with the paranoia that was severely affecting her quality of life.

By Thursday, she seemed to have lost interest in the dog. She came with me to pick him up after his grooming. Even though he emerged looking extremely handsome, she showed no interest. My heart sank.

We visited the doctor in the afternoon. I explained my concerns and asked for a referral. Instead he and ‘Pat’ began a flirtatious dialogue and he said, “You’re alright aren’t you ‘Pat”?” She assured him she was and proceeded to joke with him. It was as if a different woman had changed places. It reminded me of a few years back when my husband’s brain tumour was causing him to exhibit some bizarre behaviour at home, but when we visited the doctor, he could always put on a show and the doctor would not believe me when I was trying to explain what was happening. I felt quite angry and said I would be in touch.

The very next day, Pat had a heart attack and has been in hospital ever since. Immediately she exhibited very strange, confused behaviour and was referred to a geriatrician. He diagnosed her with a severe case of delirium and explained the differences between depression, dementia and delirium. I have since done some more research and find that sometimes they can be mistaken for each other.

It has been heartbreaking to watch her rapid decline. She has become fond of getting out of bed, stripping off and going for walker strolls around the hospital. She used to joke that she badly needed ironing so this is a very uncharacteristic behaviour.

Four days ago she had a moment of lucidity when she said, “You are so good to me. I’ve never done anything for you. Why are you so good to me?” Whilst there have been moments of aggravation on my part, at that moment it was as if I was looking into her soul and my heart overflowed as I told her it was because I loved her. She told me she loved me too and since then she has not had one rational moment. It is as if she is diminishing right before my eyes.

As well as the delirium, she has also been diagnosed with vascular dementia and we now know that she will never go back to her lovely little unit. I am looking for a home for lovely little Alfie. I don’t think it will be hard as he is a very special dog.

We had a meeting with the care team yesterday and I now have the responsibility of finding a suitable placement for her. She can’t go anywhere until she is stabilised.

This has really affected me and she is not even my relative so my heart goes out to those who have to see a loved one become a different person and watch the deterioration. I am undertaking a grief counselling course at present and hopefully this exposure to this devastating illness will enable me to be able to assist others who experience many types of grief. I hope so!

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