What about an abusive patient

Jjlrdomom

I had a whole thing typed out explaining things in detail, but it disappeared and I wasn't sure I should post it anyway.

Suffice it to say I live 4 hours from my parents, Mom has alzheimers and has become extremely verbally and mentally abusive of my Dad who takes care of her at home. She has cut them off from their friends making accusations to dad and the friends about affairs, she will not let Dad out of her sight and absolutely refuses any outside help. They tried a day program last week and staff said she was pleasant and engaged but the minute my dad showed up she was enraged and threatened him if he ever tried to do that (drop her off) again. I am afraid I'm going to lose my Dad. He now needs a pacemaker due to the stress and has other health issues he won't get seen for because recovery would be to long.

All I've read says to " not take it personally" but Dad is under attack day and night. We're heading down for a week and I'm just not even sure what to say or do. I want her on meds but docs keep warning us it will turn her into a zombie. Wouldn't a zombie be better than a bully?

towhee

Hello Jjlrdomom, welcome to the forum. I am sorry you lost your post, I have had that happen, but it is rare with our new platform now, I hope it will not happen again. This particular forum does not get a great deal of traffic, please feel free to post on the general or parent platform as well.

I am sorry that your mom is verbally abusive, this behavior is fairly common in mid stage dementia, and usually requires a combination of medication and caregiver interventions. Your father does not deserve this, and truly, having your father in good health is the best thing you can do for your mother. This dynamic can lead to placement in an emergency situation where you might not have control over where she ends up.

"The docs keep warning us meds will turn her into a zombie" I suspect you are not hearing this directly from the doctor. While oversedation is certainly possible, (I had a LO that this happened to) with proper care and supervision this will not happen. The choice you are being given between your father's health and your mom being a zombie is a false one. The accepted standard of care is that unless a person is a danger to themselves or others, non-medication interventions are tried before medications, but if those do not work well enough medications are added. All doctors weigh risk versus benefit, but if your physician will not work with you at all, you need new physicians. If you read more posts you will find that medication use is common, you just have to be careful.

This is a link to a discussion of medications used in dementia, it is a very balanced view. Medications Used in Dementia: What Caregivers Should Know | Sarah Mourra MD | UCLAMDChat (youtube.com) You will find some neurologists that prefer to use Ativan in some situations instead of anti-psychotics. You will want a geriatric psychiatrist or neurologist with a lot of experience with dementia. In approaching this you want to make it about your moms' quality of life and your dads health as primary caregiver.

The way you avoid oversedation is to make clear that you want to start with the lowest possible dose (or half of the lowest dose) and increase slowly. Get a good baseline on your mom, how she walks, moves, eats, sees, bathroom use, what she is capable of, how she sleeps, and communicate back to the doctor if you see anything that causes you concern. The doctor needs specific feedback to properly prescribe, so communication is key. The doctor should tell you about common side effects and what to look out for, and I also recommend looking at drugs.com for interactions and side effects, just don't let the side effect list scare you.