Dad has recovered Physically but has been suffering from Terrible Confabulations

My Father (M-57) suffered from a Subarachnoid Hemorrhage due to an ACOM Aneurysm on the 7th of June 2021.

He was discharged from the Hospital on 29th of June 2021. Since then, he has been going through a lot of Confabulations, Anger and Confusion.

It has been 12 days since we have come home. He has recovered physically but cognitively, it is not done. He frequently says that his Mother in Law (dead since a year) was travelling with her in a Taxi yesterday, or his brother is in the next room (He lives 2000 KMs away). He does not see them like a delusion but mostly suffers from confusion and confabulation. He invents his past. When challenged, he goes on a rage.

Second thing is he frequently confuses me (his only son) for someone else. He once accused me of being an imposter who was faking the identity of his son since I looked like him. At other times, he confuses me for one of his brothers. However, at some other time, he seems to be able to remember that I am his only son. This is an everyday affair where he says that where is the other guy who looks and speaks like you. I have to end up convincing him everytime that it is me. This ordeal The by night only to start again the next evening.

The Neurologists say that he might get better with time. The Neuropsychologist administered him the ACE R Test where he scored 92. The cutoff for normal people was 88. Therefore he said that my Dad is pretty normal and said that he needs no cognitive therapy. The rehabilitation doctor has diagnosed him with Mild Dementia and has started him on a memory drug (does not seem to be working).

Has anyone suffered similar ? The doctors say he will get better with time but for some reason I see no hope.

Hey Sad,
Firstly, Welcome to Ben’s Friends. Secondly, sorry to her of your father’s situation.
Technically, your father has had a brain bleed, which has caused a brain injury. Every brain injury is different, some people can bounce back remarkably well, as if nothing happened, but for others an injury can be catastrophic. For some their physical abilities can be impacted, for others their psychological abilities can be affected, for some it can be a little of both. There is no exact measure of ‘How bad’ nor which regions maybe affected by any such injury. So trying to gauge can be a problem.

The brain is a very unique organ. The theory used to be the certain areas of the brain controlled certain functions. This has been shown to be false, it is now understood that areas of the brain can be retrained to take on the role of other regions of the brain that have been injured via a process known as neuroplasticity. Your father’s injury is all very new but so is his recovery. For some people even years later they can still see a progress in recovery. So please do not be looking at this point in your father’s injury as being the end, it is far from it. His recovery has only just started. It can be a slowly, slowly sort of a process and can take a long time to see some sort of progress.

Now, you say about confusion, especially with people from his past. Sometimes a process of repetition with photos can help reprocess memories. ie 'This is a photo of John. Do you remember John? He use to own the shop (Then show a picture of the shop). This can help realign those connections and the repetition can help to reaffirm those connections. This process of repetition can be used for many life skills. As a former teacher I used this ‘repetition’ to assist clients to learn a new skill. The advantage for you is that your father most probably has that knowledge, it just needs to be unlocked and reaffirmed.

This is not an easy process for anybody to go through, we understand this because we’ve been there too. So come talk to us.

Merl from the Modsupport Team

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Welcome @Sadforlife! We are glad you joined us, and hope many members will reply. Give them time, we are a world wide support group.

For members who don’t know what the ACE-R is, the long name is Addenbrooke’s Cognitive Examination-Revised . The purpose is early testing for detecting dementia and mild cognitive impairment. It’s a short test, no longer than 30 minutes and covers orientation, attention, memory, verbal fluency, language and visuospatial ability there’s a caveat with educational levels, higher education usually scoring better if I recall correctly. I may be wrong, so if someone knows, please let the group know.

The Hunt and Hess Scale can be found here Hunt-Hess Scale • LITFL • Medical Eponym Library. The higher the score, the higher the possible mortality rate. It is widely used all over the world.

It’s really hard to be a caregiver to not only a parent, but someone who has had a
SAH and subsequent personality changes. I have had both experiences. I would imagine your dad will be tested again, perhaps in a year. I don’t know and I don’t know India’s medical hoops you need to go through for everything. I’m pretty ignorant with other countries. Hopefully you can enlighten us.

Please be patient. It can take years for our brains to heal, not months or days. When we rupture, we have the awful “thunderclap” headache and then the blood from our brain mixes in with the CSF (cerebral spinal fluid) and that’s not a walk in the park either. For me, it felt like a Mac truck had ran over my entire spine and I had migraines daily, most times they didn’t stop for a couple of years I think. I’m not sure how long the body takes to separate the blood from the CSF, it’s probably shorter than I think.

With proper hydration and protein, our brains have a better chance of healing, check with his doctors on the appropriate amount of both or ask a Dietician, they will definitely know.

I remember that despite me knowing the date and where I was whilst my 26 day stay in ICU, I would often “cheat”. I’d ask the RN before the team came in to do all the neurological testing as I soon figured out they would ask me. One day, they asked me who the President was, I couldn’t remember and said “Some nitwit.” I just couldn’t remember despite going through the ones I did know. But I did know the hospital’s mailing address as I had used it a lot prior to rupture.

Personally, I had no affect (emotions) for about 4 years I guess. I had good recall of things from my younger days and horrible short term memory. When I was in the step down unit, I thought I still owned horses and hadn’t for decades. Your father may be recalling things from his youth and stating them as fact too. You might want to check with relatives that knew him back then. What my family did was allow me to talk about it and then gently guide me back to the present. Is pretty futile to argue or get upset. It certainly doesn’t help anyone. Somewhere in our brain, we know it’s not correct but we often don’t know how to correct it. I think that’s where anger may come into play, anger and frustration. When I did get my affect back, I was often frustrated.

Medication can take months to work, it depends on the medication and the person. Ask the doctor about it.

Remember the members here are a great avenue for support and we are here for you.

All the best,
Moltroub

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Hi @Sadforlife

I am an unruptured aneurysm survivor, so I did not experience any of the issues your dad is having, however I did and still do have short term memory issues. It took me a full year to get my groove back so to speak, and I did not have a SAH. As Merl stated above, the brain is a unique organ. It is literally WHO we are. And when something happens to it (whether surgery or a rupture), the brain will need time to heal and so the WHO may not be the same right away.

I am so glad you found us! We are all here to support you!

Hugs,
Kim

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@Sadforlife, How are you and your Dad doing?

All the best,
Moltroub