An update

Remember Mr W from my last post (The man who cried wolf)?
About five days after my post, he was still on the ward waiting for a psychiatric review (yes it takes ages, but what did you expect - this is a free health service), when he developed a temperature and was unsteady on his feet.
The temperature was easy enough to deal with, but not the unsteadiness: he's a large gentleman (at least 30 stone) and was insistent on standing/sitting in a chair. Neither of which are particularly good ideas, as were he to fall, we would have found it extremely different to pick him up. Managed to get him into bed, but he was forever struggling and pulling off his oxygen mask/cannulas until we managed to get a bed with an in-built remote controlled recliner option (this is a district general, where most beds are the 'normal' sort). Not surprising though: Mr W has spent the last 30 years sleeping in a chair (with the result that he has chronic venous insufficiency affecting both his legs).
We treated him with generic antibiotics for a chest infection, as the only positive clinical finding was a few crackles in his left lung and an x-ray which was not particularly convincing, but for lack of any other source of infection, is seemed a good idea. Blood cultures came back - he had a 'coccus' in his blood, but what exactly it was would take another day. One of the commonest causes of pneumonia, both in the community and in hospital, is Streptococcus pneumoniae, so we continued on the same antibiotics.
The next morning, his right leg was rather swollen, red and tender, compared to the left, which was much thinner and normal looking than it had been in a while. A phone call that afternoon confirmed that he had cellulities (the 'coccus' being Streptococcus pyogenes, in case you were wondering). So his antibiotics were changed and he started to respond...albeit slowly: he was not tolerating cannulas, so it had to be oral (which takes longer).
And what of his chest pain?? Would you believe - he didnt complain of any pain. At all. Zilch. So we stopped the whole cocktail of analgesics, and he still had no pain.
As he got better, he started getting agitated about being in bed- and the nurses not wanting a potentially physical confrontation with him, allowed him to get out of bed and into a chair. He was walking as normal, so this did not pose too much of a problem.
But although clinically, he looks better and his inflammatory markers are coming down, he is really confused. He thinks he's in a hotel, and he does not belong here. And that the management is out to get him. He was very upset that his television did not work for four days - understandable - he was in a side room as infection control were worried, and therefore isolated, and he is probably a couch potato. This led to him storming the ward, causing a right commotion where we had to call for security to be on standby. Eventually he calmed down, but still remained confused.
We finally managed to get a psychiatric evaluation (but it is disappointing that it took such a show down) - who suggested an anti-psychotic.
His wife and daughter who have been spending most of their time with him are very upset. They feel that not enough notice was taken about his confusion, which they report has been going on since July. What they fail to realise is that their GP had referred him to the psychiatrists for evaluation, but with Mr W bouncing in and out of hospital so often, he was not home long enough. What they also fail to understand is that a man who cannot lie flat, will not tolerate a CT scan of his brain. They also don't see that there is little point doing carotid dopplers on a man who surgeons (or more importantly anaesthetics) would not touch with a ten foot pole for all his co-morbities (namely multiple MIs and morbid obesity). So although this has been explained to them time and again, but a variety of doctors and nurses, they still feel nothing has been done. I suppose they have the difficulty of having to live with him, but don't wish to admit it and are instead looking for medical evidence to prove that they find him difficult to handle.
What's going to happen next?