Obsessive Episodes

Asterik

My FIL (cared for by my MIL), had another concerning episode today.  He continues to say he wants to go home (even though he is at home).  He went to the garage, got in the car (he only has a fake set of keys), and said he was leaving.  Although he could not leave, he began to threaten my MIL verbally.  As he tends to respond to men better, my husband arrived and he started to calm himself a bit.  These episodes have been increasing lately.  He is part of hospice, and when called they suggested crushing meds in juice.  My MIL did that but it took awhile to help.  I think they are considering some sort of medicated cream.  We are worried about anger....for those who have experienced obsessive episodes, is there anything that helps?

M1

Hi Asterik, hope the hospice folks can come up with some medications that can help.  As much as it would be ideal to manage these behaviors without medications, if he's making threats that could escalate, I'd go with medications first and ask questions later, or he'll end up not being able to stay at home.  There are a number that could work--quetiapine/Seroquel, Zyprexa, Depakote, Risperdal are all commonly used for things like this.  Again as I said on your other thread, it was verbal threats (of coming after me with a knife) and not recognizing me that landed my partner in the hospital and then in memory care.

ButterflyWings

Hi Asterik, 

This is certainly very concerning. I think it is super important that you and your family be very clear in recognizing and describing your FIL’s behaviors. It is especially crucial for your MIL’s safety that things not be minimized inadvertently. 

He is not himself anymore, even if he often looks. sounds and acts like the pre-dementia LO. When reporting to hospice, Drs or first responders they need to have an accurate assessment or they can’t properly prioritize. If you say obsessive behavior when you mean threatening or potentially violent, the appropriate sense of urgency is missed. Hospice NP has pressed me to distinguish between agitation and anxiety, irritation and anger, frustration and confusion, purposeful or random wandering, etc. 

Obsessive behavior that includes verbally or physically threatening your MIL is a big deal. Especially as you suggest it is a pattern and is increasing. Please make sure the med team knows this if my understanding is accurate (even once is enough to warrant urgent and immediate intervention). She is not emotionally safe and may be in physical danger. Please don’t downplay it or allow her to.  Better safe than sorry. 

There are temporary “safe” actions and a prep list your MIL needs to take in the meantime. Are there weapons in the home, car, shed? (Even makeshift ones?) I’m sorry to sound the alarm but “ BTDT”- take it from one who knows. This is a red alert. 

Asterik

Thank you so much.  My FIL is now on more meds and is calmer, however, they are re-evaluating the dose as he is too drowsy and became incontinent.  Thank you for the concern! It is always better to be safe!