By Dio - Medication(s) to Calm Agitation

Dio

I got a call from MC today requesting permission to contact DH's doctor to prescribe medication to help calm DH. Apparently, today it took four people to change DH, as he got extremely agitated when he needed to be changed and have dirty clothes taken away to be cleaned. This behavior is consistent with what I had to deal with at home when WW3 would break out whenever I had to change him. Anyhow, I suggested that they contact DH's neurologist rather than his primary care physician, since the agitation is a dementia related behavior. Although the MC staff reassured me not to worry, I'm still full of angst at the moment. Has anyone experienced any fast acting calming medication for LBD patient?

M1

I'm so sorry Dio. They'll probably use a short-acting benzodiazepine like lorazepam/Ativan. These are okay in LBD if dosed cautiously--there can be paradoxical reactions to any of them, so they'll have to watch him carefully. but that's probably what will work the quickest and can be dosed an an only as needed basis. Better that they handle it than that you try to struggle with it yourself.

Dio

Thanks, M1. He's on lorazepam already... I wonder why staff didn't give him a dose upon agitation? Gosh, what will happen if he becomes combative? Will he get evicted? Then where will he go? What will I do? I'm scaring myself silly, I know. How can I not worry?!

ladyzetta

Dio. Iam sorry you having to deal with this. If and when the time comes, they ask him to leave just tell them he cannot come home, you are not able to take care of him with these combative issues. Safety would be a concern for both of you.

They will then find him a place where he will get the care he needs. Please don't get yourself in a frenzy worrying about this, you're in my prayers and things will work out. When my DH was in MC he was given antidepressants that helped him a lot.

You are his advocate by getting him the care he needs. Take care of yourself. Hugs Zetta

M1

Dio that makes no sense that they didn't use it--maybe just needs a dose increase. That's just silly and preventable.

Dio

So it turns out that the MC needed to hear from the doctor, or rather, get a written note from him regarding increasing (or decreasing) current medications. Thank goodness DH's neurologist timely responded this morning and gave them instructions to increase lorazepam at .5mg intervals as needed to help curtail unexpected agitation. I guess because DH is still relatively new to the facility, the staff is being extremely cautious in following medication protocols. Phew! Staff also told me that once changing clothes and taking away laundry ended, DH returned to calm, and for me not to worry. Staff asked if there're any tips to share as to how I got him to change. So I shared what I've done, to varying degree of successes, to get DH changed. Basically, in spite of his screaming, I stayed calm and told him that changing clothes is to keep him clean to avoid infection, "just easy-piecey, push pants straight down" and pull up the clean one. Generally, he'll follow the directions, all the while screaming at me. Staff was very nice and compassionate, that they are learning to get to know DH. I think now I can sleep better tonight.