New diagnosis for LO: dementia psychosis

sjohnson

My mom is in a great facility about an hour 45 from me.  Got a call yesterday that she was out of control aggression and they couldn't calm her down.  they were afraid that she was going to hurt herself.  So they sent her to the ER.  i was able to go and be with her.  the ER doctor finally diagnosed mom with dementia psychosis and started her on some anti psychotic meds.  She was put on Risperdal.  Plus she is still taking Depakote.  The facility allowed her to be released back to them if I would stay with her last night.  so I did.  For now, the facility is willing to work with mom to see if these meds will help.  If these meds don't work, then we will have to find another place for mom that deals with aggressive behaviors.  We don't want to move mom at all.  But if we have to, the thought is to move her closer to me.  Because of COVID protocols still in place for skilled nursing care facilities in my state, they can't have an outside private duty aide come in to be with mom and help the staff.  So the facility has asked that they be able to call me if they need me to come out and be with mom.  I work at a children's center.  My director has been so understanding about this situation; but we are short staffed at the center and me being gone is a hardship on the staff.  We have to maintain certain teacher to child ratios.  

First question is does anyone else have experience with a LO on Risperdal?  And are there places that would take an aggressive PWD?  

Feeling exhausted again.

  

MN Chickadee

I would not rely on an ER doctor; I personally would want a specialist be the prescribing physician in this case. Dementia and associated behaviors are not the ER doctor's wheelhouse. A neurologist or psychiatrist who has experience with dementia would be a better fit. Some facilities are better than others in terms of handling difficult behaviors, some are more willing than others to accept someone with behaviors and some have better trained staff to head off issues through good communication and techniques. But finding a place that will take someone known to be aggressive may prove to be extremely difficult. Ornery and challenging is one thing but a danger to yourself or others will be a tough sell. Especially if you are not coming from the hospital. The hospital social worker can help to find proper placement if you say you can't take care of her yourself, it will be harder from her current memory care. I would find the right professional to help get her stable. Or maybe you will luck out and Risperdal will do the trick, who knows. Good luck and take it one day at a time.

sjohnson

Thank you.  The staff at the place my mom is at is very good.  I have been relying on their experience.  The head nurse is the one who wanted her on Risperdal and wanted the diagnosis changed to dementia psychosis.  She talked to the charge nurse at the hospital and got the doctor to do all that.  I do want a psychiatrist or neurologist to look at her; but not certain how to find one.  Back in March, my mom broke her hip and had a partial hip replacement surgery.  The nurses at the skilled nursing told me that sometimes the anesthesia they use for that surgery can really affect a PWD.  I am praying that she can stay where she is.  The building is not the prettiest; but the staff is amazing and I feel like the truly care about my mom.  Every nurse, CNA, housekeeping staff, admin I have talked to seem genuinely concerned about mom and I get the feeling that they are working together as a team to help her.  I know that we will have few options if we have to move her.  

How would I go about finding/getting my mom to be evaluated by a neurologist or psychiatrist? 

jfkoc

There was no UTI, right?

sjohnson

No UTI.  There was no infection.  My mom was given one dose Clonapin in the hospital and is now on Risperdal and Depakote.  She has been on the depakote for a couple of weeks.  They just added the Risperdal on Thursday.  I talked to the nurse at the care center on Friday.  She said that mom is responding to the meds.  Mom was calm and cooperative, eating, drinking, sitting up in the chair, having conversations with the staff.  No aggression at all.  The nurse said that they are monitoring her closely.  They don't want her to become too sedated.  The nurse said after she has been on the meds for a few weeks, then they will look at adjusting them.  This is all great news.  It means we don't have to find another place for mom.  I am cautiously optimistic.  I just want to get her to a state where she is not agitated.  The nurse said that they are also going to try to figure out what triggers her agitation.  The nurse suggested that I get a doll for mom.  She was holding a box of gloves like it was a baby.  I am looking at the dolls at alzstore.com  

I am taking a break and not going to see mom for a few days.  The nurse suggested that I do that.  She said that if mom gets out of control again, they would call me to come out there.  I can call anytime to get updates.  It is hard to be with mom; but I am finding it hard to not be there.  Even though I know I need a break and need to take care of me, it is hard for me to not be doing something for mom.