Distinguishing Between Delirium and Dementia in a Mother’s Rapid Decline

We now know just how vulnerable older adults in long-term care have been during the pandemic. COVID-19, especially in the pandemic’s early months, cost many their lives far too early. Even today we are seeing the disease bring premature death to the elderly, especially at facilities with lower staff vaccination rates. Just two days ago, NBC news reported the following disheartening NEJM study results:

“People in nursing homes are much more likely to die of Covid-19 if the staff caring for them remains largely unvaccinated, a study published Wednesday in the New England Journal of Medicine found.”

Other forms of decline accelerated by the lockdown.

But the isolation from family members and other external contacts imposed by the many months of lockdown had other less easy to measure costs. This month’s Reflections essay, “Again in a Heartbeat,” by Jeanne Kessler, MSN, RN-BC, details her own dawning awareness that something had begun to change in her mother as time went by during the lockdown at her assisted living facility.

Suddenly her mother couldn’t talk on the phone any longer. This wasn’t like her at all. Her attention span had shortened drastically. There were other worrisome indications. […]

2021-12-10T07:55:02-05:00December 10th, 2021|Nursing|0 Comments
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Questions Dementia Patients Can’t Answer

by Ann Gordon, via Flickr Photo by Ann Gordon, via Flickr

By Amy M. Collins, editor

A few weeks ago I visited my grandmother, who suffers from dementia, at her assisted living home. In her room, my family and I noticed a complicated form with instructions for residents to get their flu vaccination. Residents had to fill it out, sign it, and bring it to the person administering the vaccine on a certain date. For my grandmother, this would be impossible—she can no longer remember what day it is, when or if she has eaten, who she’s spoken to within the last five minutes, or where her room is located.

When this concern was broached with the front desk of the facility, they seemed to be adamant that she needed to have the form with her on the day of vaccination. We could, of course, help her fill it out—but since it had been given directly to my grandmother, who was to say we would have ever learned of it except by chance? And who would make sure she brought it with her on the day of vaccination?

While the facility offers assisted living, they often remark that they are not a “dementia facility.” Looking around, however, one is hard-pressed to find a resident […]

2016-11-21T13:05:26-05:00February 11th, 2014|patient engagement|14 Comments
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Downsizing with Dementia

fence 2 Photo by Shawn Henning, via flickr.

By Amy M. Collins, editor

I’ve blogged before about my grandmother and her dementia, which has long since been staking a claim on her memory. A few years ago I wrote a post called “No Country for Old Women.” In it I tried to describe the feeling of helplessness that my family felt when a series of providers had failed to diagnose the cause of sudden delirium superimposed on dementia . . . a frustrating game of hot potato had ensued, with each physician passing her around to the next. It ended when a nurse finally diagnosed her with an impaction.

A similar sinking feeling strikes me as her dementia advances, and again, there seems to be no place for her to go. At her independent living center, we know she’s just barely scraping by. If it weren’t for the nurse we hired to keep an eye on her each day, her difficulty living there would be much more obvious.

Our nurse faithfully calls to let us know when my grandmother has forgotten to shower; when she’s been seen in the same clothes a few days running; when she won’t stop cleaning the break room, the distant memory of her long-standing career as a housewife stubbornly clinging to her; when she’s been found wandering the corridors at night. I think we’ve kept her there so long because everyone there loves her, she’s allowed to have […]

2016-11-21T13:07:59-05:00March 29th, 2013|Nursing|5 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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