Agitation

Charliesmama

Hello,

I am caring for my 84 year old mom. She has Alzheimer’s. I live with her. I work outside the home three days a week and have caregivers come in so she has never alone. Lately her agitation has escalated even when I am home with her. She will sit down and get right back up, pace the floors, ask for help or just constantly repeat she loves me. She gets herself so exasperated. She gets really out of breath. It is really hard to watch. I feel so bad for her. Her doctor has her on the lowest dose of Ativan only to be used as needed, that no longer does anything for her agitation.

Last week when I reached out to her doctor , I got an odd response. She is a new doctor for her. Her regular primary just left the practice. We have met this new doctor twice and both times she never really seemed to want talk about the Alzheimer’s diagnosis with me which I thought was odd. When I asked her regarding this agitation, she said there are new drugs, but maybe placing might be an option if financially possible. This really struck me funny, at this moment, I have no intentions of putting my mom in a home and I felt her response without any other prior discussions seemed cold to me. I am in the process of looking for a new Dr with more experience with elderly. My apologies I am rambling, my question is what are your tips for helping with agitation and being scared for an Alzheimer’s patient?

M1

Ask for a referrral to a geriatric psychiatrist. There are many medications more effective than Ativan--it's a benzodiazepine, and use in the elderly (except on hospice) is not recommended for a number of reasons, including risk of tolerance and increased risk of falls. Definitely sounds like you need someone with more experience.

Anonymousjpl123

@Charliesmama i am so glad you found this site, and sorry that your mom is struggling with this. Your mom sounds like her progression is fairly standard - that is to say, my mother is experiencing these things and she is already in placement. So I think her symptoms are not related to where she is.

There are lots of medications that help with agitation without terrible side effects. I think a geripsych consult would be good. Also, there are some places that have hospital or university practices that specialize in Alzheimer’s/dementia. If you need help finding a doctor, you can also call the Alzheimer’s association hotline at +800.272.3900. They may be able to check a directory and find some referrals in your area.

It’s actually really good you can be with her, but also get out for 3 days.

Charliesmama

Thank you, I wished I would have reached out sooner, instead of spinning my wheels and feeling so isolated. I will get busy with both of your suggestions. I appreciate it.

jfkoc

Drugs are not one pill fits all. My husband, for instance, became volently agitatedon Ativan. It pay to discuss all drugs with your phamracist and to look up each on a site like drugs.com.

Additionally any seemingly abrupt change in behavior can be causeby a silent UTI and a test must be done ASAP. UTI's can become very, very serrious.

harshedbuzz

Hi and welcome, @Charliesmama

I am sorry for your reason to be here, but pleased you found this place.

PCP can be great around routine care, but dementia is far from routine stuff. I would encourage you to look for 2 new doctors for your mom. The first would be a geriatric psychiatrist for medical to dial back the agitation and resulting behaviors. They are the experts on psychoactive medications. The second would be a new PCP for her. You might consider a geriatrician-- a specialist in the care of the elderly.

I would also work on a Plan B. Who would step in for your mom if you weren't able to be with her? If you predeceased her or were unable to prove care even temporarily because of an illness or injury, who would take over for you? In your shoes, I would tour SNFs and MCFs even if you don't plan to need one. After a qualifying hospitalization, mom/you might benefit from a short stay for rehab and will be asked which want you want to use. If you needed surgery, a MCF might be a good option for you mom while you recover. My aunt could be a "busy" PWD and she really thrived in MC; she enjoyed the socialization and activities.

HB

FTDCaregiver1

Agree with all the above as well, my DW has severe agitation, we've run the gambit of drugs. Ativan actually increased her agitation (paradoxical). Definitely support getting a specialist involved perhaps geripsych as suggested. I have a good one now and agree with others above that no one size fits all in terms of pharmacology. Our latest med switch was last October when DW had a prolonged spike in agitation, we tried Rexulti with good results and no noticeable side effects thus far. There is hope and expertise out there, good luck.