psychotic episodes and rapid decline?

ghphotog

My DW has been having psychotic episodes such as screaming, yelling and verbal outbursts including insults and hitting. She doesn't hurt me when she hits me and I'm trying to let her know that hitting is not allowed. She also has "phantom boarder" syndrome where she thinks strangers are in the house when they are not. Among other issues like delusions and she still sees people that aren't there.

My question is, do daily episodes like this mean a faster mortality or faster progression of AD?

loveskitties

You need to contact her doctor and ask for meds to control her episodes.

Telling her hitting is not allowed means nothing to her in this condition.

This is just a part of what some patients experience in the dementia journey. I have not heard that it is an indicator of faster mortality or faster progression.

ghphotog

I thought I read that somewhere in a publication. I was wondering if anyone has experienced a relationship between psychosis and faster decline. I know telling her hitting not being allowed is futile but I was hoping I could nip that in the bud before it got worse. I know I know. I've been down this road a long time now but I gotta try.

Meds for psychosis I've read can exacerbate dementia but I don't know. She's only on Memantine right now. She has a neuro appt tomorrow.

mrahope

Just hoping the neurologist has something he can offer to help, regardless of the potential for harm (of which there may be some), this is just no way to live.

Also, I had never heard of "phantom boarder" syndrome. My DH came and told me yesterday that someone had come into his bathroom, used the toilet, and forgotten to flush. I was able to convince him that no one had done this other than he himself, but it made me wonder. I had no clue this was a recognized phenomenon. Thanks for the education.

Jo C.

Oh my, that is a challenge for sure. So hope the Neurologist puts your mind at ease that the helpful medication will not speed up and advance the dementia. It is not effective whatsoever to "tell, scold, lecture or remind her" that hitting is not acceptable. Her ability to process that AND to retain such input is not effective. Her brain is broken; the ability to process, to use logic, judgment, reasoning and to have memory retention is harshly damaged. That is in the past now.

NOTE: It really is important to realize that if she is driving you to distraction with such behaviors; imagine how dreadful it must be to live inside her head not only having all that whirling about but FEELING it. She will act out the feeling in an instant; there is no logical control nor ability to appreciate consequences. It must feel horrible to her to have such anger, rage, upset and to have to lash out.

She needs help to relieve her suffering such episodes and she is suffering. She cannot seek medical help herself, so she must depend upon you to do that for her. Neuro; will in all probability, be able to prescribe medication for her to quell such behaviors as well as delusions and hallucinations which will be a positive for the both of you.

I recall when I was in a similar situation and was not comfortable with the meds in the antipsychotic category . . . .I delayed getting help which meant much more highly negative behaviors and ramping up.

Finally; it was evident that my LO needed help to stop the suffering from the highly negative delusion driven behaviors. Neuro prescribed Risperdal in low dose. It was like a miracle! Within about a day all such outbursts and behaviors were quelled and my LO had a much better quality of life to the point it could be. My only regret was that I had not had the med started earlier. Just one person's experience.

So hope all goes well for you and your wife, let us know how it goes,

J.

Dio

So sorry you're going through this. Does your LO have a diagnosis as to which disease is causing her dementia? Not all causes are created equal, so the medications are quite different. Antipsychotic meds are different and must be carefully monitored, especially for Lewy Body Dementia, which by your description, sounds like it's LBD. Someone in one of my support groups once said LBD symptoms are Alzheimer's Disease, Parkinson's Disease, and Schizophrenia all wrapped together. I'm no doctor, but you need to contact her neurologist for meds to manage the psychotic behaviors. As for your original question, I think each PWD is different. If you've seen one PWD, you've seen one PWD. The roller coaster ride for this disease is too unpredictable.

Ed1937

I'm sorry you are dealing with this now. It seems like yesterday when your mother was placed, although I know it has been a while.

To the best of my knowledge there is no correlation between this and making progression faster. I think the only thing it means is that it's time to consider medications which could drastically make things better. But it might take time. Hopefully you will find something that works fast.

ImMaggieMae

I’m so sorry you are going through these psychotic episodes. I agree with Jo C on the use of antipsychotic medications. For my DH they worked quickly and have been very effective. They don’t turn him into a zombie. In fact, his cognitive abilities seem sharper, inasmuch as they can be somewhere in stage 6, than back in the middle stages when he was bouncing off the walls due to agitation without the antipsychotic. Not only was he making us miserable with lack of sleep and fear of what he might do next, but his behavior scared and confused him as well.

It seems like a lot of PWD who are having aggressive episodes and not on these types of medications end up being placed and then they are prescribed while in the facility because they are a danger to staff, themselves, and other patients. I sometimes wonder if some of the calmer demeanor and increased participation in these institutions is because of the medication?

​fesk

I didn't see it mentioned but has a UTI been ruled out? It can cause many of the same behaviors. It can also take quite some time after it is clear for behavior to calm.

As for antipsychotics, I would see if there is another medication that can be tried first. If an antipsychotic is needed, I would start with a low dose and make changes very slowly. Everyone will have a different reaction. We ended up using them in a time of crisis and my mother remains on the smallest dose possible. One sent her into delirium. Too high of a dose creates issues with standing and can create the zombie effect. Depending on the antipsychotic, it can make cognitive issues worse - it has been our experience. Other medications were tried but not effective. Others have posted their loved ones can take them without issues. I recommend reading up on the pros and cons and discussing all with the doctor if they are recommended.