Agitation

RobinNicole

I have not written in a long time mostly because my mom settled in to AL / MC well. She will have been there for two years in March. We just celebrated her birthday and the holidays and she was thrilled. She has been a favorite in the facility as she is spunky, sassy and very with it (considering she has Alzheimer’s). It’s sad that friends of her that I felt were so much better off than her have flown by her in their progression. She is the lead at bingo, knows the numbers, and active at trivia etc. But in the last week she is different. I am hopeful that it’s a phase (like the activity director told us(. She is agitated and does not know our friend , her companion anymore. She is angry and has lashed out at her. Even I sat with her at bingo and while happy to see me, she did not ask about the family like she always does, she got angry at other residents who did not know the numbers called, and overall looked mad. Completely different than it has been. I come with treats as she adores chocolate. This week I have been using them to try and distract her to pivot her back to her normal. Unitl this point in her clear moments she has given wise life lessons to my sons, and her friend. I am sad at her yelling at our friend, and this is new. my questions are does agitation come and go? Or once it comes does it stay permanently and if so, what are the ways to help her?

Funny I just looked at a post from two years ago at this time and it was focused on the same thing. Obviously mom is further along the alz path, but wonder if upping the trazadone and then upping the duloxetine would help her now like it did then. Do those meds still work as LO progress further?

Emily 123

Hello,

Has she been checked for a UTI? It seems like she’s had a sudden change, so perhaps it’s that?

harshedbuzz

@RobinNicole

I agree with @Emily 123 , I would ask for a testing and culture for a UTI given the abrupt change in both cognition and agitation level.

If that is negative, it could be a progression. The other piece to this is that your description of your mom sounds very like my aunt. My aunt was a warm and charming individual who had vascular dementia that progressed at a seemingly glacial pace compared to her sister with VD and my dad with mixed dementia. I noticed my uncle being much more solicitous of her in 2000, she'd been widowed about 5 years before she was finally diagnosed in 2008 and didn't die until 2018. Like most with vascular dementia, her progression was more of a series of significant drops in cognition/abilities followed by, in her case a particularly long, plateau where things stayed the same.

The other concern I have is your description of her facility as AL/MC. Which is it? If it is a hospitality-model AL with minimal assistance, perhaps it's not the level of care she requires now which is causing her anxiety. I question because "trivia" as an activity doesn't seem like a dementia-informed "error-free" activity one would find in a well-run MCF. Even Bingo would require accommodations and/or considerable support to be dementia-friendly.

The aunt I mentioned lived in a very nice CCRC that had AL and MC in the same building. While she lived in MC, she was often included on the AL side during the day for meals, trips and activities (mostly crafts and music events) which worked well for a several years. It gave her the best of both levels of care-- more hands on care and prompting while enjoying programming she enjoyed as long as it was appropriate for her.

Or it could be that her meds needs revisiting. Perhaps that means a higher dose or maybe different medications entirely would be useful. Dad was already on a high dose of an SSRI when he was in the middle stages and it wasn't enough for his anxiety and agitation. His geripsych added a second med for anxiety/depression at a low dose as well as a very low dose of an atypical antipsychotic which made a huge difference in his mood and agitation level.

HB

RobinNicole

thank you both! I should have thought of a UTi. Now, my son visited today and she was smiling and happy. She did not ask about me but was not scowling. The companion goes tomorrow and then I will go Friday. They had a performance today and she loves those, so it might be that or might be she has pivoted or it was just a good moment.

As for the question about her facility, it has AL and MC. Mom went in for respite and the only room was on MC floor. We kept her and We never moved her off memory floor as she will end up there. However, she is free go to the main floor as she is independent enough. She sometimes stays on MC floor and is the star for the modified activities (as she is the most cognitive person ), and even on main floor she plays bingo better than most, and enjoys the conversations and movies. There are some newer residents who have great cognition (who don’t live on memory floor), but mom still is ahead of others.

I guess we will see, but thanks for sharing the pattern of your LO with the different progressions. While she is doing well (or was and might still be)( her memory has gotten worse, but I have not seen a big slide- yet. I know the inevitable will happen. But if she can remain happy and different meds are needed I definitely want them

harshedbuzz

@RobinNicole

That's great that your mom's facility offers the kind of flexibility to meet her where she is on any given day.

HB

CaliforniaGirl-1

We have seen the same things a few times. In one case it was a UTI and didn't resolve until a few weeks after the antibiotics ended. In another case we needed to change her medication so she was sleeping better. Her doctor said, some times, sleeping and eating better will provide a reboot. Sometimes it just passes and runs its course.

It is very upsetting when you feel like you LO is in a better state and feeling adjusted and suddenly this happens. At this point I tell myself whatever is happening with my LO, good and bad is just a moment in time and the disease is going to progress.

Good luck