Agitation, cussing, delusions and more

ran2much

Hi friends,

Folks who have experience with loved ones with dementia who experience a lot of agitation, then cuss and yell and hit... please weigh on

So my mom has lived with us off and on for 8 years with Alzheimers. She has always experienced agitation. Of course, we do all of the non pharmacological things. Quiet the room, low stimulation, reassurance etc and try to keep her from hurting herself or us. Really, we are in our 40s and 50s and she is 77. She won’t hurt us even when she hits. It got so bad, we moved her to assisted living and then memory care. She got booted from the ALF due to her agitation and behaviors. Same at memory care but they sent her to a geri patch hospital where she stayed for 11 days and had meds adjusted. Unfortunately, she still struggled mightily with anger and agitation and Alzheimers of course worsened. She’s a solid stage 6. Well, of course she fell and broke her hip. They repaired it surgically. She is now back living with us and my husband is retired and is staying home with her. However, she has taken up a new delusion - now, she LOVES him and is mad when he won’t marry her... then she turns it into she’s pregnant and is cheating on her. She calls him every bad name in the book, shrieks, and just won’t stop.

Of course, he’s never done anything but be kind and patient with her. Then when I come home sometimes she calms right down or I have to calm her. It’s insane. I have to work. I also need to leave home to go run, go to the store etc. this is all very hard now that she can’t walk, is fully incontinent etc. suggestions? Also are there any meds that worked for your loved one? We always make sure she’s not hungry, thirsty, in pain, gotta potty or consitpated... she currently takes 50 mg of Seroquel 3 x a day and is on Donepezil and Memantine. Also, pls don’t think she’s just agitated at my husband because of the change from memory care to home after hip fracture - she was always in trouble for flipping out at the facility too. 

terei

She might need another stay at geri psych + then to MC IMO

ran2much

Thanks and you’re probably right. I just wondered what meds anyone had experience with. She is meeting with a home based geriatrician on Tuesday and I’m wondering if there are things I can ask for us to try.

jfkoc

I am a big cheerleader for non-medical treatment but not blind to the fact that drugs are the only answer in some cases. Additionally that some drugs carry a black box label and some are very sedating.

That said, the choice must be made whether the agitation/aggression is better for your mother than taking a risk with the black box labeled drugs or sedation.

Additionally are you going to be able to keep your mother at home or will she be accepted into a facility w/o an increase in drugs? 

I know I had to make the decision to use a drug that was essentially a do not take but my husband was living in misery... screaming in torment. I would make that same decision again.

Please consider calling  her Dr. and ask about upping the Seroquel. She is not taking a lot right now. 

M1

Agree with jfkoc, there's a lot of room to move on that Seroquel dose.  Hospice evaluation is another consideration if you don't want her to go back to MC

ran2much

Yes - hospice would be welcome. However, she’s in stage 6 and not quite 7.  Her previous doc in FL guessed she had about a year to live so unless someone takes mercy on all of us...

ladyzetta

It would not hurt to get a hospice evaluation. A person does not have to be close to death to be seen by hospice. Hospice would be a real big help for the care your LO needs.

ran2much

Also - she has been kicked out of two facilities for agitation, cussing , hitting, throwing things. There are about 2 decent hours a day for her and then she’s agitated and fighting or sleeping. There’s no quality to preserve. I’ll be advocating for sedating drugs with. Black box warning. She won’t be accepted into facility without Med change and are all suffering too much here - can’t do school work with my 7 year old, work for myself, or any house chores. I hate this disease. This isn’t who my mom ever was. It’s making me make hard choices.

ran2much

Thank you Lady Zetta

M1

Btw ran2much you don't need a doctor's order or referral to initiate a hospice evaluation, you can request it yourself. I'd call Monday, and you can also ask more than one agency to evaluate her.

mommyandme (m&m)

I’m waiting for my mother’s hospice evaluation tomorrow.  With Dementia, the 6 mos or less of living doesn’t really apply.  

Mlewis501

We had to have two different hospice groups evaluate.  The first said no, the second yes.... Hospice with Alzheimer's patients is different than with a terminal illness such as cancer.  There doesn't have to be the 6 month window.    Have her evaluated.  Look in to another AL/MC unit that can deal with her issues.