She had been diagnosed with vascular dementia in 2019 but was "gregarious, lively" and "never missed a social evening" at her independent living flat in West Yorkshire before she fell and fractured her pelvis in February.

The 86-year-old was taken to her local hospital in an ambulance and within the first 36 hours had already been moved to five different settings.

Her son Pete, 66, tells Sky News: "I was shocked when I saw her, because from a woman who could sit and chat about anything, her speech was completely garbled and incoherent.

"And that was just after 36 hours of not really knowing where she was.

"I told the nurses 'I think my mum's suffering from delirium' and there was a six-foot poster outside the ward on how to recognise delirium, but no one seemed to recognise it."

Delirium linked to 'accelerated cognitive decline'

Delirium is a state of sudden confusion and disorientation, which affects speech and other basic functions.

It can be brought on by infection - one of the main reasons dementia patients are admitted to hospital - alongside falls and dehydration.

People with dementia are generally six times more likely to experience delirium as hospital inpatients than those who don't have the disease, according to research by Oxford University.

Professor Paresh Malhotra, a neurologist and researcher at Imperial College London, says that one or more episodes of delirium can be "associated with accelerated cognitive decline" in people with the condition.

"There may well be a two-way relationship between delirium and dementia," he says.

"People with dementia are more likely to get delirium - and an episode of delirium itself is likely to speed up the dementia."

He says that some studies have shown that this "speeding up" is caused by inflammation - either throughout the body or in the nervous system itself.

As a result, he adds: "It's important for people with dementia to be discharged from hospital as quickly as possible when safe to do so."

Click to subscribe to the Sky News Daily wherever you get your podcasts

Dementia symptoms are unpredictable and get worse over time.

But the NHS says that "with the right treatment and support, many people are able to lead active, fulfilled lives".

By contrast, Kerry Lyons, Consultant Admiral Nurse for frailty for the charity Dementia UK, describes the negative impact being in hospital can have on someone's symptoms.

"Dementia patients are coming into a strange environment, with noise throughout the night, so their sleep is disturbed," she says.

"They may sustain several out-of-hours ward transfers, being moved from place to place.

"There's often a breakdown in communication and the right information doesn't always travel with that person about what their usual baseline is.

"All these factors contribute to delirium and cause a reduction in cognition, more confusion and more distress."

People settle on 'much lower baseline'

Describing his mother's time in A&E, an admissions ward, elderly care ward, and finally a medical stepdown ward, Pete says her experience in hospital was "atrocious".

"It was very difficult to get any clinical information - most people would refuse to speak to me with the excuse they were too busy, so I had to get information about her from other patients.

"Nurses would walk past her bed and she'd put her hand up to get their attention and they'd just say 'aw bless'.

"There was no stimulation - sometimes she had an electric clock to look at and that was it."

Kerry says the lack of stimulation and physical movement in a hospital ward are huge issues for people living with dementia.

"With dementia it's really important to maintain neuron-to-neuron connections by stimulating the brain everyday - if you take that away you will find deterioration in cognition.

"And it's not just neurological, if you don't get a patient out of bed and up on their feet in a timely manner, from a muscle mass point of view, their mobility can go really quickly.

"What we often find is people settling on a far lower baseline."

Lisa from Telford had a similar experience with her mother Audrey, who was diagnosed with Alzheimer's disease in 2018.

Before she was admitted to hospital in October 2020, she describes her as "feisty", "actively involved in her grandchildren's lives" and able to walk for around 10 or 15 minutes at a time.

"Conversation was difficult and interesting at times - but we went out for cake and coffee - it was nice to still have those moments," she tells Sky News.

"We weren't even close to thinking about a funeral for her."

'What should've taken five years took 10 weeks'

Lisa was her mother's full-time carer and the family - her father, three children and partner, all lived together until a flood in August that year meant Audrey, 81, had to be looked after in a care home.

In October, the most recent Care Quality Commission (CQC) report showed that there are 165,000 staff vacancies in social care and 132,000 across the NHS.

Inspectors found these shortages have left both systems "gridlocked and unable to operate effectively".

Lisa, 46, says that after she stopped eating and drinking properly in the care home, she was taken to hospital with severe dehydration.

She claims she was moved wards in the middle of the night, there was little reference to her dementia, and after three weeks in hospital she had "really deteriorated".

Asked if she thought it had sped up her decline, she says: "In 10 weeks in hospital and care homes she did what should have probably taken five or six years minimum.

"I do feel very strongly about that 'fast forward' or 'springboard' effect.

"She didn't have a clue where she was and I'm not convinced she knew who I was until I'd explained it to her when I visited each day."

At the beginning of her third week in hospital, Audrey was placed on a discharge ward, with staff saying she was being transferred to a care home for rehab services that day.

But for almost a week the discharge was delayed, Lisa says.

"By the time she got to the care home they felt she was 'end of life'. She managed six days there before she passed away.

"If they'd received her when they were supposed to five days earlier, I think it would've been a different story."

The hospital trust told Sky News it "works closely with our partners to ensure that patients can be discharged as soon as possible".

'I expected her to be able to go home'

October's CQC report also found that only two in five hospital patients can leave hospital when they're medically fit due to shortages in social care.

Pete says he expected his mother to be discharged back home with a wheelchair and physiotherapy exercises after a few weeks.

"She'd have been able to live - and carry on with her gregarious life - before she lost her coherence.

"But it didn't work out like that because of the lack of attention to her personal needs and the fact she was unable to express how she felt to anybody."

Margaret suffered grade four bed sores while in hospital and a serious case review has since found lapses in her nursing care and failure to follow the correct protocols properly.

She was discharged to a nursing home on 1 April and died on 24 May.

Read more:
What is Alzheimer's and will new drug really help?
70,000 people in England have early onset dementia
People should have insurance to offset dementia care costs

The hospital trust told Sky News it offers its "sincere apologies and sympathy" to the family.

Its investigation "recognised that errors occurred and the treatment fell below the standard we aim to provide" and "to which Margaret was entitled", a statement said.

A "number of actions, including stringent audits and an increase in training were identified and subsequently implemented in order to make improvements to patient care," it added.

Government yet to release 10-year plan

Kerry, of Dementia UK, says the "current landscape" of dementia care within the NHS is "very difficult".

"We're working in a really stretched workforce with really limited resources.

"I'm a daughter who supports my mum living with Alzheimer's disease. And I know the local hospitals should I need to go with her - have limited dementia provision."

There are almost 900,000 people in the UK living with dementia - the equivalent of 7.1% of over 65s.

This is expected to rise to one million by 2024 and 1.6 million by 2040 as the population ages.

At any one time around one in four hospital beds are occupied by someone with the condition, according to the National Institute for Health and Care Excellence (NICE).

To help patients and their families, Dementia UK employs Admiral (specialist dementia) nurses to work in hospitals, care homes and the community, as well as providing a national helpline.

They try to avoid preventable admissions where possible, but when patients do go to hospital - ensure their needs are catered for, risks are minimised, and discharges are quick and well-planned.

Dementia UK and other charities such as the Alzheimer's Society are calling on the government to deliver its 10-year plan to tackle dementia - promised by then-health secretary Sajid Javid "later this year" in May.

A spokesperson for the Department for Health and Social Care told Sky News: "We want a society where every person with dementia, their families and carers receive high quality, compassionate care in the right place, and we are providing £500m through our Adult Social Care Discharge Fund to speed up the safe discharge of patients who no longer need to be in hospital.

"The government made £17m available to clinical commissioning groups last year to tackle dementia waiting lists and increase the number of diagnoses, and we have committed to double funding for dementia research to £160m a year by 2024/25."