Separation Anxiety

Drapper

I have a fairly new male care helper spending 4 hours 1x week with my DH. He takes him out on walks, driving range.etc ( has been here about 6 weeks ) Last week after 3 hours my DH wanted to go home to see me. I was not there, and he really freaked out. He was yelling and throwing things around. Needless to say, I had to immediately go home to calm him down.  This also happened two weeks ago while I was at dr appt. How can I help him to not get so upset when I am not in his sight. I tell him when I will be home , but it doesn’t help. Also when I take garbage to the curb and he forgets I’m doing that, he will start yelling and screaming for me. ( now I take him with me). He had a prior longer term companion, that this situation did not arise with. Also about 1x week , 4 hours. Does anyone have any advise.

mrl

Might be the helper...never know.

harshedbuzz

@Drapper

Does your DH generally shadow you at home aside from when you take out the trash? Is he being treated medically for this anxiety?

I wouldn't leap to it being the caregiver. It could be associated with progression of the disease. Given an increase in anxiety and apathy, it could be that there is no high stakes outing that is engaging enough for him to settle in. It could also be that a single outing weekly isn't enough time for him to bond with any caregiver who isn't you; he might do better with 3 visits a week. A day program is another option.

If he's not taking something for his anxiety, it might be prudent to get something to take the edge off.

HB

gampiano

I agree with Drapper.

I had similar issues with my husband , who, at one point, didn't want me out of his sight. He didn't throw things, but had high anxiety.

I would suggest a med to calm him down, and it might take a few tries before you find the right one, but you and he need it!

Been there, am there,

Maureen

Drapper

My DH is on seroquel , low dose , which has done wonders for his anxiety overall. I was reluctant to try it, but am glad I did. He tried anti antidepressants first and had opposite effect. Klonopin was helpful but seroquel has worked the best.

Seems like it has helped with behaviors but not this issue. He does shadow me often. Needs to be in same room with me.

I do agree 1x a week may not be enough to bond, but this person has no other time to give me. It could be the caregiver, although I think he is very good, I have spent time with them. he is quite young , 35? Maybe my husband doesn’t connect as well . He is not empathetic on activities He loves to go to golf course and hit balls. But after that us over , he starts looking for me. I do need to solve this . I need my respite .

White Crane

Maybe the outing is too long. My DH will go out with a bird watching friend for an hour and a half or so but then it is time to come home. Could they go out for a shorter time and then return home and watch a program on TV together or play a game or sit outside? Just some thoughts. I hope you find a solution. You need your respite time.

Ed1937

None of this is easy. My vote would be for trying to get medications that work for it. Is it possible that it could be the caregiver? Could it be progression? Yes and yes. You can't do anything about progression, but if medications don't work (they probably will), you could always try a different caregiver to see if that helps. My guess is that it wouldn't.

Another long shot might be to check for a UTI. They can cause all kinds of problems, and it's easy to check for. Since this would be the easiest road to take, I'd check for the UTI first. I hope you find a fix for this.

Drapper

thank you all for your comments. This is our journey

the behaviors seem to happen when he comes home. His outburst was when he was home. Because I wasn’t there. They were out fur 2.5 hours and returning home. I feel the meds are working as other than this issue things have been really good. Significantly better

i think I’ll speak more with his neurologist to see if other meds would help in addition yo seroquel. She had said to give .25 to 50 mg for “situations” , but I have found it makes him so tired given with the seroquel. I do not want to pre medicate but maybe I’ll have too.

Iris L.

I think 2 hours is long enough to be away from home for a PWD. PWDs tire easily.

Iris

Drapper

My problem isn’t how long he is away from home. I agree 2 hours away and 2 hours home is good. I would just like 4 hours a week of respite time so I can recharge. I’m looking for pointers to help him to get comfortable when he is not in my proximity.

my DH is physically very healthy. He is 75 and does 100 push-ups a day. He is in Mid stage cognitively but physically in good shape.

gampiano

Hello Drapper,

Just a few things.

What time of day are we talking about? If its mid afternoon, it could be the start of the dreaded sun downing hours. That would exacerbate the anxiety.

Also, i, like you, have been very careful and even reluctant to use meds for behavior. Seraquel has been working, but most recently we had to increase the dosage. These drugs are great until they aren't, and the increase has been a game changer in my house. Yes, there are side effects, but if fatigue is one of them, that equates to "calm". It's a trade off, but i have come to realize that my health and well being are as important as my husband's at this point, if not more.

Just some insight from a care giver who is now getting some respite at last.

Hope you find a solution.

Maureen

gampiano

gampiano

P.S.

Does your husband like music? that along with an increase in the Seraquel might be helpful

Drapper

Thank you Maureen.

Dr just increased him to 50 in am and he takes 25 at night. He sleeps through the night. Thank G-d. Good thought regarding music. We listen to music all the time. He knows words to every song. I have been using music for awhile now to ease anxiety. He will sit in our kitchen and listen to it and will be very happy. The outburst are around 1 or 2 ish. I’m trying to do detective work. I’m wondering if it is hunger driven. I don’t necessarily think he has big Sundowning issues. But he does have big hunger issues. Craves hamburgers from Burger King every day. I use to get annoyed. Now I just get him one.

regards

Debbie.

SDianeL

https://alzconnected.org/discussion/comment/184549#Comment_184549

Isn't one of the side effects of the medication extreme hunger? Seems like I read that it affects blood sugar and hunger. Maybe take a snack with him? Protein?

Drapper

Yes. I do think the meds drive hunger. I think I’m going to start packing a whole lunch box of snacks for him. He did have s granola bar. Which wasn’t enough. They were on their way to lunch, but never made it. The companion was afraid he would get out of car, and took him home. In hindsight , he just should have gone to drive through at Burger King.

hunger may be a bigger driver than I thought. He can’t get food for himself , so needs to rely on others. Which likely makes him even more angry.

ButterflyWings

A banana or healthy snack can redirect DH from almost any negative behavior. And he gets hungry (or thinks he is), more frequently than before dementia. It is part of his progression - something called leptin resistance. lt also causes him to not sense when he is full, so his intake has to be monitored.

It sounds like the caregiver should definitely plan to head to the BK drive through at the 1.75 hour mark, as part of their routine going forward. Also, is it possible to give your DH .25 seroquel before the sundowning-like behavior begins? With scheduling pre-and post-activity snacks including lunch (+ med intervention if needed) I will bet you can get this under control. Hopefully so. Your respite time is so precious, and who needs to have it cause more trouble for you to deal with on your return (!)

One more thing, it may sound silly, but I am going to remind my new caregiver to smile at DH, just as I have been reminding myself and intentionally projecting a friendly expression to him, while making sure we are having eye contact. I forget the basics learned about our PWD LOs sometimes, and the facial expression is super important, as is tone of voice, etc. Maybe the gender of your new CG is causing these issues, and/or maybe he needs to intentionally project a super-friendly demeanor to your DH vs the boss, or the one in charge, or whatever may be coming across as a threat in his dementia reality. Good luck to us all!

Drapper

Butterfly wings - what great advice - thank you! I do need to think of “snacking”differently. More regimented, time wise , and more variety. The granola bar I send him with is not enough Bananas are a great idea. I never heard of leptin intolerance. But it all makes more sense now. good thing my husband is on the thin side so extra food is not a bad thing

I have to think about more seroquel. I’ve tried giving it to him 3x a day in the past , and did not think it was beneficial. Also not sure if he would take it so readily from anyone but me

it’s not silly to smile more. I recently read you should try to compliment your LO at least once a day. I have been doing that and trying to make eye contact more in order to improve my relationship with him. I have spent time with my husband and this companion and think he is friendly and not bossy. My husband doesn’t know he is an aid. Just a guy hanging out and being friends. His last companion, who my husband looked forward to being with , was more boisterous though, which maybe he liked. I am trying out another person next week, who I found from an agency. Maybe that connection will work out better.

(the current guy can only give me the one day a week at the present time , I’m looking for another 4 hours) I could then transition completely to the new person if works out

thanks again