In 2013 he had a UTI that caused active delirium but it resolved in 8 weeks. This time in May of 2016, dad had a UTI and delerium set in. We are still struggling with this and it has been 10 months. He has periods where he is completely normal and can last 3-4 days and then he relapses into craziness, it is like hyper delirium. He has seen a psychiatrist and we have tried many different meds for him. The psychiatrist diagnosed him with bipolar disorder and dad does fluctuate between depression and hypomania. The psychiatrist insists that he does not have dementia.
But some of the behaviors we are struggling with are very challenging:
1. Binge eating, when he is going to have a bad day he will come out in his wheelchair in the morning and go straight to the fridge and start eating everything out of the fridge. We will make him breakfast ussually 4 eggs and 2 pieces of toast and then 15 minutes later he is hungry again and eating oranges whole or cereal etc. If we limit his eating and try to redirect him to something else of interest he is physically violent with us and yells.
On days he wakes up normal this does not happen.
2. He hallucinates quite abit, sees and hears things that are not there. We have learned to work with this. Keeping him calm and reassuring him seems to be the best thing to do. We just let him know we are here and he is safe. He talks about the devil coming to get him. Alot of persecution hallucinations.
3. Dad has his memory intact. He knows where he is.
How do I help him. He is only on an antipsychotic at the moment. Mood stabilizers did not help. He is not on any dementia meds.
I would want a team of geriatric doctors looking at his metabolism, behavior , brain imaging and blood chemistry to get an accuate diagnosis .
The psychiatrist involved in his care will not order any additional diagnostics as he is determined that dad has bipolar depression. I have asked for dad to be referred to another psychiatrist but there is a 6 month wait.
You might think about whether he's got a bladder infection that never cleared.
Hoping some of our more nedically astute folks will be along soon.
When he becomes violent, do you call 911 to have him transported to the ER?
What I do not understand is why he can go several days with no symptoms and then has a bad day. I thought with dementia it was continuous.
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I would emphasize that you are currently doing an excellent job controlling the violent outbursts and feel you have you family's safety covered BUT if this proves to be a dementia these behaviors will escalate and become unmaneageable. It is a good idea to plan your next steps should it be necessary to admit him to memory care. This will be necessary unless you are able or prepared to provide similar facilities and caregivers at home.
If Dad is sent to the ER it does open the door to getting different Drs and opinions and testing.
CM while brain scans are a good idea unless there is something very obvious like a tumor they can be of limited use in the elderly. When I started having weakness problems and they were eliminating obvious diseases. I had an MRI of my brain and the results showed changes in my brain. The neurologist said they were usual in the aging brain but if I was 40 they would be diagnostic for MS!