advice please(5)

LisaLH

My step father is in a memory care facility.  He has become a little "handsy" and they wanted to put him on risperidone.  I agreed but didn't realize they would start him at such a high dosage which made him a complete zombie.  I got them to reduce it quite a bit but even so his ability to do all the things he could do before this drug such as dressing himself, tying his shoes and he soils himself occasionally now which he did not do before.  I had the nurse contact the doctor to see if they was something different we could try on him and the doctor said this was the best for his actions.  Let me also say, I'm not a naive, uneducated daughter about Alzheimers.  I have read, read and read.  I try to be open minded about all this.  All the aides talk about how respectful he is of women and how he stands up for them if another resident/man is being mean to them.  I know he is "handsy" but I feel they have gone over bored because of incident of a sexual nature(not with my father) that happened there that has them with some legal issues.  I really liked the place the first 6 months but now I'm questioning what to do?  Should I take him to an outside doctor/psychologist?  Any advise would be appreciated.

Quilting brings calm

I would be careful about proceeding here.  If he was always respectful of women  and never ‘handsy’ before, then it’s likely that the behavior change is a progression of his dementia.  Therefore he is not likely to change hack and will need to be controlled by medication.  It will be difficult to place and then keep him in another MC without the medication.  They need to protect all the residents and you can’t explain to a dementia patient that they just need to ignore the behavior of the ‘handsy’ guy.  Nor should the staff have to ignore it,. 

Let me tell you why I say the above.  Here  is  a little of my perspective, I am a stepdaughter of a guy who had always been handsy.    so far ( 2.6 years in) he’s left the staff and residents alone at the AL, but I am sure that will change. I live in dread id when that happens as they can’t afford to live separately nor can they afford MC.   His behavior is well known in both my mom’s and his families.  His son’s significant other was subjected to it last year.  I’m still trying to get him to a psychiatrist. He has no diagnosis at this point, dementia or otherwise.   The appointment has been rescheduled a couple times at his request and is set for later this month.  He will probably refuse the opinion of the doctor. 

The changes you listed in your dad’s capabilities - can you say for certain they are due to the medication or could they be progression of his dementia?  I ask because my Mom was taken off of her memory patch a few months ago.  I’ve noticed more anxiety - but her anxiety waxes and wanes and has for the last few years.  I can’t tell if the medication change has anything to do with it, if it’s progression or if is  just her ‘normal’ anxiety. 

BAM22

Go with your instincts. If you’re able to get a 2nd opinion, I would. 

My mother was on Risperidone a few years ago for her violent outbursts (yelling and starting fights, throwing things at people), but it also made her zombie-like and I did not like it. I was able to see another specialist rather than the in-house dr. at her MC. She ended up getting on anti-depressants instead and she was more like herself but less combative. It did take a few months to see a difference. My mom isn’t on anything anymore because her dementia is more advanced and not trying to start trouble anymore. 

Good luck. 

LisaLH

I know the "handsy" stuff can not be allowed to happen, my real issue was, I didn't feel they were trying to find a different drug solution.  I do agree he has digressed some but they all agree some of the inability issues did not start until the drug.   Within a week or so after you start a drug you can no long put on clothes, tie your shoes and you soil yourself, there could be a problem.  I have since met with the nurse(she's new) and the director.  They too questioned the doctor stating this was the only drug.  We've  all agreed some of the things are being caused by the drug.  So we are having the doctor taper him off risperidone, transfer him to their other facility doctor(I didn't know they had) and try him on something else.  I am happy with this solution.

BakedAlaska

LisaLH: I was going to suggest a second opinion, and you're already there. 

When my dad was in rehab (for physical problems, not mental) the doctor who served the facility was, frankly, a buffoon. 

But near the end of her life my mother was on anti-psychotic medication; it was prescribed and managed by a hospice physician. As far as I could tell, he was masterful at regulating her dosage; most of the time her hallucinations were benign (she spoke with my dead sister, kept cats under the blankets with her, played travel games with friends -- all completely unreal). But when she decided she couldn't swallow the meds, she went absolutely screaming off the rails for a few days.

So yes, there are great doctors and not-so-good doctors. You are doing the right things.

LisaLH

@BakedAlaska, 

Thank you.