Delirium

[Linzi]

I have bought hubby home to end his days with cancer. We have the pain under control but the delirim is getting worse and we hardly have a lucid moment these days. Is this normal or should I be reviewing his medication?

[RJG]

Hi Linzi,

I have absolutely no experience with this so take my comments with a grain of salt. I hope that my suggestions below don't cause you any further distress...

How is hubby reacting to his delirium? Is he getting confused and thereby it is causing him significant anxiety and worry, or is he somewhat oblivious to it all? That is, are you concerned for his sake or is it you who is having difficulty dealing with his oblique view on reality?

If it is causing him stress, then by all means speak withthe doctors about dosage levels and/or alternative medications.

I have a cousin who recently sufferred a series of strokes. While in hospital, he thought that he was travelling the world doing train spotting and other unusual things. But he was happy in his reality and it wasn't hurting anyone else.

So if it isn't causing him any grief, I suggest that you simply go along with it and avoid any conflict between fact and his new view on "reality"; join in on this new facet of his journey and maybe you might look at your life a bit differently.

Warm regards and with best intentions,

Rick

[Linzi]

Hi Rick
You're probably right. Although he does get quite anxious as he often thinks that something is cooked and needs to come out of the oven right now or the ceiling fan is now a chimney and is falling on his bed, I think I should learn to chill out and just go along with it and reassure him that everything is OK. Thanks for your input.

Regards

Linzi

[RJG]

Hi Linzi,

I must confess that I have had to deal with delusions on two occasions. Both were while in hospital following my gastrectomy.

The first occasion was my own delusions in the form of  nightmares - I was a party to mass murders and than I was analysing what had happened and trying to rationalise that they were necessary. I got over this by getting off the opiates.

The second was where an elderly fellow in the bed opposite from me was firmly convinced that he was in a neighbour's house and that someone had changed all of the furniture without permission. And outside the window were people playing poker machines and a large carpark full of cars. The truth was that we were on the 10th floor in The Canberra Hospital. For him, these delusions were causing him reasonable levels of anxiety and stress.

From 1 am through to 6 am, I talked him through each of his concerns and then revisiting them numerous times through the episode. I quite enjoyed the psychological challenge, but was exhausted by the end of it - mostly from lack of sleep. The next evening it started again, but he was transferred to another ward before it got too bad. I was quite relieved that he had been transferred because I doubt that I would have had the strength to go through another night with him.

So I do recognise the difficulties that come with dealing with delusions that are worrying to the patient.

What you probably need most is the occasional respite. Do you have other family members who can come in ant take over from you from time to time? I am not saying that you should abandon him, but just get some time-out every now and then so that you can regroup and prepare yourself to assist him to deal with his "realities". But anyone who does come in to help has to understand the approach you have been taking, right or wrong, and continue along the same line. A different approach may cause even more anxiety for your hubby.

So ask for help. Those who truely love you and/or your hubby should be all too ready to jump in to assist.

Keep strong for yourself as much for you hubby!

Rick

[Linzi]

Thanks again Rick. I am waiting for the palliative care team to call me back about maybe changing the opiates to something else. He was in hospital for 10 days and was awful. He got really violent and was attacking people which is so out of character. When he came home, he was good for 3 days and very lucid but started going downhill and is never lucid at all now. I have a daughter who sits with him while I go shopping and just do a few chores but I always feel I have to rush back in case he needs me (martyr, I know). Anyway, since we last spoke, I have been going along with his "reality" and keeping us both calm.

Regards

Linzi