Now what do I do?(1)

Paris20

My husband’s aide has been the victim of his abuse for months. It’s only getting worse. The vile verbal violence is frightening and hurtful. The aide has dealt with many Alzheimer’s patients and confessed to me that my husband’s rages are the worst she has ever had to deal with. One of my daughters has the same mantra when I tell her what’s happening…MEMORY CARE. I truly think it isn’t time yet. My husband is still too aware of what is going on.  He is verbally abusive to me but he is horrible to the aide. I cannot see her staying much longer. Now what do I do?

Ed1937

Sorry you have to deal with this. Many people say it is better to place them while they still have a lot of abilities. This gives them a chance to get acclimated to the new environment. But I can understand where you are coming from. I think I would be the same if it were me making the decision. Just make decisions with your head instead of your heart.

June45

Keep in mind that the potential MCF will most likely ask if your husband has aggressive or abusive behaviors. And it is likely that any such behaviors will have to be addressed before he can be admitted.

Jo C.

This is indeed a significant challenge.   I also read your Profile; highly negative behaviors have been going on for years and appear to have gravely worsened.

Have you consulted in private with your husband's Neurologist?   Considering the length and breadth of his behaviors and how severe they have become, it appears it may be time to initiate medication to provide modification of that behavior; in severe situations that is usually Seroquel or Risperdals with adjustment until effective.  You may want to make a consultation  appt. with the Neurologist to communicate the severity of the situtation without your husband being present.  Sending Neuro a detailed memo by fax can also be done, but I preferred the confidential appt. when I was faced with a very severe problem issue.  Up to you, but Neuro needs to know the severity of the details so an appropriate plan of care with medication can be prescribed.

Frankly, I would not tell him what the medication is for; to discuss his condition with him would only induce stronger resistance and he would in likelihood refuse the medication.  I would use a fib as uncomfortable as that may feel.  If this behavior continues or if it should even ramp up to his becoming physical, this will present even worse problem issues and if aggression is not quelled, getting him into a care facility will probably not happen as most facilities will not accommodate such behaviors.

Sometimes, a LO must be admitted to a GeroPsych Unit for full assessment and initiation of medication while assessing for effectiveness and side effects.  For your husband, this would be an involuntary admission if all else fails.  This of course would be an action initiated by his dementia specialist in concert with a Geriatric Psychiastrist who would manage the care at GeroPsych. 

Letting things sit as is may well lead to other more severe issues and does not sound like a good idea; please let us know how you are and how thing are going; this is a tough place to find oneself; so hope you are able to get to help soon.

J.

Buggsroo

When my dad was in long term care, he got very aggressive with the staff. He was very inappropriate and very rude. They telephoned my mother and she told them to medicate him. He had been very abusive to her, my brother and I all thought his life. The doctors put him in mood stabilizers and anti psychotic drugs; the difference was like night and day. 

My point is you may have to go that route, whether he stays home or is placed. I know this can’t be easy for you. Good luck with this.

Paris20

Thank you all for your replies. I welcome any and all thoughts. My husband has been on antidepressants for quite some time. His neurologist is well aware of the behavior and upped one of the two antidepressant doses a couple of weeks ago. Today was the last straw, however. I contacted the neurologist on the patient portal, the fastest way to get through to him and said I have avoided his suggestion of an antipsychotic long enough. I’m ready to try it. The alternative, watching these outbursts and fearing where they might lead, is no longer possible. I always thought an antipsychotic was a last resort. It still is but I’m there now.

abc123

I hope he gets the meds soon and they work quickly. You will all have a much better quality of life. I agree with Jo about NOT discussing the new meds with him at all. I hope everything works out well and the aide will be able to stay a part of your care team. Good luck!

Jo C.

Paris, I too was a target.  When my mother (behavioral variant of FTD) went over the moon with dread, dread behaviors on a 24 hour continuum, and when all lesser measures had failed to assist; and when all of the several different antidepressants failed to help - and it was bad, bad, bad, BAD . . . . I finally relented regarding an antipsychotic.  I had not wanted to do that; but oh my; she had been going gang busters for so very long. . . . I discussed it with her primary care MD, her cardiologist as well as the Neurologist; all said the risk of the med was very low.

I then realized that if she was driving me to distraction; imagine what it is like to live inside her head believing all that she falsely believed driving her to such noxious persistent behaviors - but she was also FEELING it  - hellish for her too.

So; Risperdal it was and I held my breath not expecting much to happen.   Oh my; within 24 to 48 hours, ALL noxious behavior was quelled; no more agitation or lashing out.  At first I thought it was only a temporary thing - but no; it was permanent.   She had no side effects; she did not become sedated; in fact, she seemed brighter and she had so much more quality of life. 

My only regret?  That I had not moved forward with that med sooner.  She was on it for several years without anything negative happening. Tried to taper it off since she was doing so well, but the dread behaviors began to resurface; so we just kept the med since it worked so well for her.

Only one person's story; I so hope that the new med will be helpful; let us know, we sure will be thinking of you.

J.