Delirium after a stroke

[millertime78]

My Dad has been diagnosed with having delirium after a stroke. He is continuously restless and agitated, he is always pulling at the bedclothes or taking off his own clothes. Is there any treatment for delirium and is it reversible?

[PamRam228]

When did your dad have the stroke and what kind of stroke?  Sounds like he's doing what my husband did while in the hospital...pulling his clothes off and exposing himself.

[lahinva]

My dad also did this.  The doctors said it was a normal effect of the stroke.  They called it "picking".  My dad would pick at the air.  It was like he saw something in the air and would try to grab it.  He would also pull the sheets and his clothes off.  He even would try to pull out the catheter.  What was sad was that he got so bad they had to put his good hand in a restraint so that he would quit pulling at everything.  It seems like I only remember it lasting a couple of weeks.  

[millertime78]

Dad is doing exactly what both your loved ones did. He is "picking" at the air also and will pull the catheter out of his hand/leg etc. He pulls the sheets off his bed and is always removing his clothes. Although he can walk with assistance he cannot look after himself, he cannot feed himself or go to the bathroom.  I'm praying that this will subside. Did both your loved ones recover their mental faculties???

[lahinva]

Yes, my dad recover some of his mental capacities.  He still cannot walk much, and his short term memory is pretty bad, but other than that he is pretty good.  One thing is they had my dad on dilantin from the time of his stroke until just this past month.  While he was on this, he would do weird things like wanting to go home whenever he was already home.  Every day he seams to get a little better.  It is a long hard road, and we have been through many ups and downs, but hopefully he will continue to get better.

Good luck...

[PamRam228]

Well, my husband has made a remarkable recovery.  The delirium has subsided.  He wasn't able to go to the bathroom on his own but now the incontinence is gone.  I'd say that took about  5 weeks to recover.  My husband can walk unassisted but I feel better if he would at least use a cane.  It took him about 6 weeks for him to start walking again.  While in the neuroscience ward my husband tried to get out of bed and he fell.  This was at 4 in the morning and the hospital called me to let me know what happened. They did a CT scan which showed he was ok, but, my husband thought that he had fallen through a wall (which was his head going through the CT scan opening).  

Also, when I was able to bring him home he kept thinking I was some strange man and that he was in someone elses house.  He also thought the hospital was someones house I just dropped him off at.  His mental state was shot!  Now, he's greatly improved.  He realizes that his thinking was off.  He no longer thinks I'm someone else and he knows where he is now.  It has been 7 months since his stroke and he is doing wonderful.

I'm sure your dads mental capacity will come back to him.  How long has it been since the stroke?  Keep us posted and thanks for sharing.

[fallgood]

My husband had a stroke on the left side of the brain,that left him with no use of his right side.This happened 2 years ago. He is totally bed ridden and I feed him through a peg tube.And take care of him by myself. He has started shaking his left arm and hand is this normal.

[millertime78]

It's wonderful that your husband made such a good recovery. I'm sure he's getting stronger every day. Dad had his stroke 15 days ago. He has improved in some ways since it happened, he's eating, can be fairly alert and responsive and can walk short distances when assisted. He's still very restless and is always pulling at the bedclothes, the bed or pulling his clothes off. He's not yet able to use the toilet. At times I believe he recognises us. They are treating his delirium (with what I'm not sure but will find out) so hopefully it will subside soon.

Thanks for sharing your experience. It is a great consolation to know that someone else has been though it and came out the other side ok!

Will keep posting!

[millertime78]

Just to update, Dad is still quite restless, he is eating which great but cannot yet use the toilet.At times he seems to recognise us and sometimes responds when asked a question though it is difficult to understand what he is saying.  We're praying the next week will bring noticeable improvement.

[millertime78]

Another update. Dad seems much improved, he's holding and reading the newspaper and does seem alert. We've brought family photos into him and he seems transfixed by them. He's eating well but is very grumpy and frustrated. His memory seems to be coming back in spots but his speech is still very slurred. However he is engaging more with those around him

[PamRam228]

HURRAY!  Congrats on your dads improvement!  You have much to look forward to because it's so early in recovery for your dad and he is already doing better.  Once he gets into rehab you should see even more improvements.  Thanks fo the updates and, please, keep them coming.  

[millertime78]

Still very slow going here, little or no noticeable improvement this week, he's very sleepy and will doze off into a deep sleep in a matter of minutes. He's still incontinent and his speech is still slurred. He babbles on incoherently and points to his right alot. He isn't receptive to therapy and rarely interacts with those around him. It's hard, we're trying to be patient but we're praying for a glimmer of recognition to give us renewed hope.

[millertime78]

Latest update. He's quite alert at the moment, still won't interact with us and cannot yet feed himself or go to the toilet. However he is walking around but is still in a state of confusion. It's been one month since the stroke.

[pixie822]

Pray ans BELIEVE and it WILL happen.  That's whating I've been doing, and it's working!

[millertime78]

Latest update: The doctors are happy with his motor function but he still has severe behavioural problems - removing his clothes, pulling at the bed and anything around him, trying to eat the newspaper, tissues etc ( this sounds funny but it's heartbreaking) They have him on haloperidol to ease the restlessness but it doesn't seem to be working.

I just don't know what to do other than pray, we really need a positive sign

[PamRam228]

Thank you so much for posting the progress of your dad.  I look forward to seeing posts from you.  The behavioural problems you mentioned doesn't sound funny one bit to me.  My heart dropped when I read it.  It doesn't sound funny because my husband had some issues like that, too.  One day when he was eating, he tried to eat the design off the napkin.  Another time he tried to drink milk without removing the lid first.  That's only a couple of instances.  It was heartbreaking to see this and I kept wondering how I could take care of him when he got him.  Thank God that subsided as his brain healed.  

It's barely been a month since your dads stroke.  It took my husband nearly two months for the delirium to go away.  Keep the faith.  Your prayers will be heard.
God be with you and your family.

[millertime78]

Thank you so much for your kind words. God Bless you and your family also I take comfort, strength and courage from them. I will keep updating the progress however slow. Hopefully we'll have a breakthrough soon.

[millertime78]

Latest update: still very agititated at times. The "picking" seems to have ceased but he is continuously grabbing and pulling at what ever he can reach. He's on haloperidol at the moment but it doesn't seem to be that effective. What was your husband treated with for the delirium? His speech seems to be improving but we can't understand what he is saying as he's speaking to fast. However sometimes the occasional sentance can be understood..

[lahinva]

They put my dad on risperadal.. And it really helped with the agitation...  He is still on it, and it is still helping.  My dad was also on dilantin.  Once we took him off the dilantin (18 months post stroke) his mental state also improved.  His short term memory is still not good and he still thinks he walk and do all the things he used to do, but he no longer gets mad and he no longer asks to go home when he is already home.  This stroke has been very dificult on all of us.. We just hope and pray that he will continue to improve over time.

[millertime78]

Thanks for the advice, the problem with the agitation/delirium is that it prevents any real progress with the rehab & speech therapy. Will ask the docs about risperadal

[PamRam228]

Actually, my husband wasn't given anything for the delirium.  It would subside after about a half hour and then he would be ok.  Seems like it gradually went away.

You mentioned that your dad was speaking too fast.  My husband did that, also.  It was almost like his brain was on fast forward.  He did that a couple of times. Now, he talks a little faster than pre-stroke but it's not that noticeable.  I think it just has to do with the recovery process.  Some things you've mentioned I'm sure will go away.  

Thanks again for the update.

[millertime78]

Thanks , he's starting to interact with us some more but I think he's depressed about his situation, he rarely smiles which is not like him. We need to up the therapy and stimulation levels and get him more active.

[PamRam228]

Yep, millertime78...the depression does come.  Doctors can prescribe medicines for that.  Every now and then my husband gets depressed but it's not as much as before.  Once your dad comes to terms with what has happened to him the depression will ease up.  It may get worse before it gets better.  Just keep reassuring him.  Try not to feed into his depression.  Get the most intense therapy you can get for him.  How long is he going to be in therapy?  What other therapy does he have?  Occupational, speech?  God bless you and I hope your father improves greatly.

[millertime78]

Latest Update

Positives
Eating and swallowing is fine, he's starting to feed himself, can lift a cup and drink tea/water etc
Mobility is good, no problem walking, climbing stairs, strength in arms and legs good.
Good hand eye coorindination - is able to catch a ball and throw it back.
Can dress himself sometimes, trousers, shoes, dressing gown - no problems there.
Alert for most of the day, is rarely in bed except at night time.

Negatives

Still no speach or recognition
Agitation - pulling at bedclothes, his own clothes etc.
No awareness of space/ danger - will wander around
Cannot use the bathroom, needs 24 hr nursing care
Very defensive/agressive when restrained from walking where he wants to go
Very hard hard to communicate with.

In summary, physically he's quite good but mentally he's very limited. The OT and Speech/Language says he needs a private room free from all distraction if they're to make a breakthrough with the therapy. Thats the priority at the moment. The doctors are treating him with seroquel for the agitation and behaviour problems.

[PamRam228]

Wow!!!  That's great improvement, physically!  Congrats!  It's still VERY early in the healing process.  Just watch and see how much of the negatives go away.  The brain is very resilient.  I read a post on here about a book called "The Brain That Changes Itself".  It's about true stories of people that have had brain injuires and how the brain healed itself so the people can lead better lives.  I ordered my copy off Ebay and can't wait to begin to read it.  That may help you understand the mental part better.

Your dad most likely will overcome most of the negative issues.  Thanks for the update.

[Lilycat]

To all, actually.
Wow! What a relief to read that so many other stroke victims have exactly the same symptoms as my 93-year-old mother since her stroke almost 4 weeks ago. Glad to hear that these phenomena seem to diminish with time. She takes Dilantin to prevent seizures, Resperadol (sp?), and at night, if needed, another sedative for these issues. A bladder infection and then a rash from the antibiotic also added to her considerable discomfort and agitation.