When to start considering meds

annie51

I know this is a question for the professionals but wanted to get some insight from caregivers on this. At what point should meds be considered? What kind of behaviors are most helped by them? I’m having a more difficult time with DH lately as he progresses but I think it’s more my behavior or reaction that causes the issues. He’s not violent or anything but quick to get angry (but just as quick to forget about it), and firmly uncooperative when it comes to certain things - mostly around hygiene. I walk on eggshells most of the day. I don’t want to use meds if there is not a real benefit. Any insight would be appreciated.

M1

Like so many things here, if you're asking the question it's probably time. Responses are so variable that you won't know till you try. I think anxiety, anger, and delusions respond, but nothing has increased cooperativeness for my partner.

harshedbuzz

Behavior is communication.

Irritability, especially in men, is often associated with depression/anxiety. These are typically treated with an SSRI. This could improve his mood.

We never really hit on a medication to improve compliance and cooperation around hygiene, meals, or medication dramatically. An atypical antipsychotic kept his resistance from rising to aggression, so that was a plus. The Teepa Snow videos on showers found on You Tube are good. Some have found a combination of her strategies combined with mood management can help with this almost universally challenging phase.

HB

jsps139_

I remember those days … walking on eggshells everyday. I could say something one day and he would laugh, then say the exact same thing the next day and he would get so angry. At other times, he would have angry outbursts for no reason calling me names and telling me to get out. And, he started getting up during the night agitated and anxious. He suffered from hallucinations and delusions daily. This is when I wrote down all of these behaviors and discreetly handed it to the nurse to give to the Dr at his appointment. The Dr immediately put him on Seroquel once a day, then months later twice a day. The meds caused him to sleep all night at first dose; they made him so tired. The hallucinations and delusions stopped for awhile, but now they are back once or twice a week, but without the anxiety and fear. Sometimes I have to remind myself not to look for the pills to make him “normal”again and just accept that they take the anger, anxiety, and agitation away for the most part. Caregiving is so much easier with the meds.

ButterflyWings

@annie51
I agree with all the members have said. You got some great guidance here.

We were never “pill people”, either, but dementia changed everything. The warnings on some of the meds can be worrisome but they are a non-issue in comparison with how miserable DH and I were becoming without any intervention.

Delusions (false beliefs), hallucinations (hearing, seeing, things that aren’t there), wandering off, sundowning impulsive behaviors signaling anxiety, agitation and more were getting out of hand. And it just keeps getting worse. That’s the reality of progression due to brain decline. Do yourself a favor and consult a geripsych or dementia-savvy neuro psych.

Seroquel and Sertraline combo made life manageable again. No sedation, as in he is not out of it, but it made it possible to care for him at home up to now - early Stage 7.