My gentle DH becoming more afraid/aggressive

Spanky77

Hi, my DH is still afraid and he’s gotten aggressive towards some caregivers. The staff talked to me about it in front of my DH. He looked so sad and said so clearly “I’m sorry.”  Broke my heart. I know dementia patients still hear and understand things like this. 

Anyway, they upped his meds a little and one concern/question is the owner talked to me today saying she doesn’t think it’s enough. She even mentioned if it doesn’t get better, it may make it difficult for him to stay at the facility.  I will listen to the doctor and thankfully they don’t believe in making patients loopy, but also surely this can’t be the first situation for a business that has been running 30 years. (?). 

I hope I’m making sense. This disease is just so heartbreaking.  

ElCy

I’m so sorry for you. I know it’s so scary to think he will be asked to leave. Most MCs will send  the resident to geripsych. There, the docs can help get the right mix of meds. My DH was in geripsych for a month and it was great for him. He was not over medicated.

Ed1937

Spanky, I'm sorry. Hopefully they will be able to get him to where he is no longer aggressive towards caregivers. If not, I would ask about having a geripsych taking a look at him. From everything I've read here, they are the experts in finding the right meds for difficult symptoms. I wish you luck.

Gig Harbor

Spanky my husband was there too. He was becoming aggressive towards staff and residents and was refusing care. Redirection did nothing and that would have required 1:1 care if it had worked. I opted to ask for drugs to help him calm down and it has worked. At times he has seemed loopy but I think that would be a better feeling than being angry and agreeable. He never looks unhappy and he rarely refuses care. If he does they wait 30 min and try again. I definitely didn’t want him to become more aggressive to the point that he would have to be moved.

Gig Harbor

I meant angry and aggressive!

saltom

My DH is still in settling in phase of a licensed board and care home. It is not a MC facility, but the staff has experience with dementia patients. I have given permission for them to call me whenever DH wants to talk (complain) to me. Somehow just my talking to him helps smooth things over. Keeping my fingers crossed it stays that way.  I have found agreeing with him that his situation sucks, but I know he is safe and receiving good care. And the story to him was that I need to rest to get my strength back so I can care for him which I cannot do now.  He seems to be very concerned about my health and will accept this.  The staff have bent over backwards to help him and have the night time caregiver sleep on a cot in DH's room because he was getting up and wandering looking for me. Spanky77 I hope things get better for you and your DH.

ImMaggieMae

Spanky, what type of meds does your husband take for the aggression? If it’s an antipsychotic, that nurse may be right, about it needing to be increased. My DH has never been mean or aggressive, but he has been bouncing off the walls, always in motion and confused enough that we had to follow him around constantly to make sure he didn’t hurt himself or break something. After a trip to ER and a week in the hospital, he was put on an antipsychotic that quickly brought him back to as “normal” as someone can be with mid stage dementia. When he came home he was calm and able to participate as calmly although the memory losses were still there. 

His PCP at the time did not believe in antipsychotics for dementia patients and had me wean him off of what was a small dose to begin with, over a period of several weeks, to none at all. The symptoms that sent him to ER to begin with slowly came back until he was right back where he was, highly agitated, awake all night, repetitive behaviors, pullingIV’s out of his arm in the hospital etc. Another couple days in the hospital with a knowledgeable hospital pharmacist who put him back on the antipsychotic and prescribed at a higher dose to be used only as needed. We had a 45 minute conversation about the drug and parameters for increasing it. This made all the difference. He came back home calm and cooperative and most importantly, content. He isn’t “loopy” at all. In fact his cognitive abilities are better than when he was bouncing off the walls. He was not happy or content when he was so highly agitated. He seems more aware now and participates in daily life at home. 

From what I’ve read here and in other places, when a PWD ends up in a care facility of some type because of aggression or other over the top behavior, or they are already in a facility and become threatening and are kicked out to another facility they end up being given antipsychotics or a sedative to calm them because of the risk they present to workers that care for them. Doctors who don’t believe in them aren’t the ones caring for them day to day. Yes, there is a risk, but it’s a small risk. The quality of life issue seems more important to me.

Sligo177

I've been going through this as well Spanky.  My DH is usually gentle and easy going, but was throwing and breaking things and cursing people out....to put it in a nutshell, we are adjusting his meds carefully, not too angry, but not too doped up, and that is key.  God bless you both.  It's very hard.  I think we are getting balanced now and I hopw it works for you both too.

ARgirl

My husband also became verbally and physically aggressive. After much consideration, we too went on an antipsychotic. It has helped even at a low dose, particularly for night time sleep. We still sundown around 5pm with increased confusion and agitation, but not nearly as severe and no further physical aggression.  I have found that I cannot "touch" my husband when agitated, as he perceives this as aggression toward him. I suspect it is instead, fear. We will maintain this dose until I see deterioration, which I know will inevitably occur. 

We are still on Exelon and Namenda, entering year 11.  My dilemma is how long to keep on these meds? Any thoughts would be appreciated. 

Spanky77

Thank you for the replies and sharing your situations. Since I posted, they have really increased his meds. He’s on trazodone and resperidone. He’s slightly better—the increase happened after he hit and kicked a caregiver and hit another residence in the arm plus he hurt his thin skin arms and the are bleeding. . If his behavior acts up again, they said he will have to go to evaluation in a hospital and be strapped down. : (.   IF this happens and they still can’t settle him, they’ve mentioned a psyche ward. I am sick to my stomach at this thought. Hopefully it will not happen.   

Anyway—a side note here: my friends said it may be dangerous for me to drive him anywhere. Even our quick drives to the park or getting a lemonade thru drive  thru. Even if I put him in backseat, I’m told it could be dangerous.  

Does anyone have this issue?  Sigh. The disease is awful. Thanks, again, for comments.