Manic

blr3655

So even with mood stabilizing meds, mania still occurs?? Does anyone else experience this? Is it just random when the manic episodes occur or is this going to be a constant? I thought getting her on meds would help and we were good for a little over a week and now she’s Manic again. I’m kind of at my wits end on what to do. I am her only daughter her only child and my kids and I moved into her home back in feb. and she is totally mean and cruel and angry and even violent towards me and wants me out. it’s awful.

M1

So sorry. Have you considered hospitalizing her for stabilization? May be necessary. The meds are tricky and adjustments may be easier to do in an inpatient setting.

blr3655

How would I go about that? She’s fine. So she thinks nothings wrong.

M1

Blr, do you have power of attorney for her? If you do, then you have the authority to take her for treatment, especially if she is threatening herself or others. If you do not, you probably need to talk to a certified elder low attorney about how to pursue POA or guardianship.

There's a name for the "I'm fine" business--it's called anosognosia, and it's much more than denial, she really can't perceive her deficits. Pretty common.

I'd start by calling whoever is prescribing for her and describe the situation. Hopefully they can help. If you're in the US you also need to have HIPPA privileges, which gives the docs the right to talk to you about her without concerns about privacy. If you don't have them, you can talk to them, but they may not be able to answer back. But you can still tell them what's going on and ask for help.

Shan

I’m so sorry you are going through this. We are experiencing the exact same thing with my mom. Her dementia, specifically her anxiety and agitation has been escalating quickly since we moved her from AL to MC. At first we though it was just the stress of the move to a new place and trying to get settled into a new routine so we relied on behavior modification techniques and redirecting. But she got to the point where she was refusing to let staff help with her or her dog’s care, she got combative with the staff she usually cooperated with, and even started barricading her room door to try to keep staff out. She tried an anti anxiety med once a day that her Dr prescribed and for the first week it really helped. And then like a switch turned off, it didn’t. They increased it to two times a day and that actually made her behavior and confusion the worse we’ve seen. They cut the dose in half and kept it at 2x a day and no change other than she seemed to continue to decline rapidly. We had an emergency care conference to plan next steps and her care team decided to try a mood stabilizer and a different anti anxiety. They started the mood stabilizer first and again it seemed to work. She was happier, less confused, and more cooperative. A week on that and she was off the rails again. They just started her on the new anxiety med last night and we are hopeful this combination and dose works. It is just terrible watching my mom go from 0-100 for no apparent reason after a positive start to a new medicine. We keep saying this disease is absolute hell to try to navigated and just when we think we take a slight turn toward helping our mom cope with it the journey turns 180 and we are punting to try the next idea. It just feels like nobody knows what to do to help my mom and we just keep throwing ideas at the wall and pray something sticks. And our situation with my mom is complicated with the fact that we are tying everything we can think of to keep her beloved lap dog, Angel, with her. But if she keeps refusing to let staff help her care for him, and gets combative when they try to redirect her from feeding him foods that make him sick, we will have no choice but to separate them. We and her care team, based on how mom is with Angel, are extremely worried that if we can’t get her moods more stable we will have to remove Angel and she will get so bad that our only next step will be a geriatric psych admittance, which I’m extremely sad to say might be inevitable and as hard as it is to see the light through the trees right now, might be better for her than the experimenting they are doing now in MC.

in your case, if you think geriatric psych admittance would be the next step to try to balance your mom, you can talk to her medical team and they can help you get that process going. Don’t expect your mom to buy into this decision, she won’t because as you’ve said she doesn’t think there is anything wrong with her, my mom doesn’t either - it’s typical with the disease. You won’t ask her if she wants to go, she doesn’t get to decide this because she can’t make theses types of decisions anymore. Based on her behavior being out of control and to the point you are no longer able to safely care for her, if it’s to that point, this is what she may need next and as her care provider you will need to let her care team know you need help. Good luck, and keep us posted.

blr3655

M1- yes I have poa. But if she is still competent enough to say no, I can’t send her anywhere, correct?

shan- I will reply to you shortly. I’m at work.

M1

I don't know that saying no means she's competent to make a decision. ..you may need to video her manic behavior to have concrete evidence to show them.

blr3655

M1- I record almost all conversations with her. I also have a ring camera in the dining room to monitor her while I’m working which also captures our interactions. It’s batty to watch her throughout the day. I was able to talk to her dr today. We are gonna try adding an additional seroquel tab in the am. So she’ll take one tab in the am in addition to the one tab at night. Cross your fingers!!! Will give it a week and see.

blr3655

Shan- I also thought by us moving in back in Feb that that was the cause of her agitation but it just became even more heightened and even more concerning in my eyes. This whole situation is crap. I really appreciate your input. Will try the extra seroquel dose as mentioned above for a week and see what happens. I hope that things go smooth for the both of us. Keep me posted.

​fesk

blr3655 - I am sorry you are going through this. I didn't see it mentioned but, if it hasn't been done already, please rule out all underlying medical issues that may be causing the behavior (UTI, have bloodwork done, etc.).

Also, I don't believe a week is long enough for any of these medications to take effect. Some may take 4-6 weeks to reach full potential. My recommendation is to go as slow as possible with any increases and additional meds as long as everyone is safe. When you start adding meds to an already new medication, you won't know what may be causing issues or helping.

Keep us posted.