So confused. I don’t know what to do.

LaneyG

I just read Clarinetist’s post about Plan D. I think I’m in the exact same predicament. DH has been in and out of hospitals in at least 8 different nursing units since mid July. He had been doing pretty well but sundowning with quite a bit of aggression kicked in. During these pat. 2 mos. He had one unsuccessful GPU stay. He was discharged after 2 weeks and brought back in to ER 2 days later worse than he was before. He spent several weeks on a med surg floor because GPU declined him because of his Type 1 diabetes. A psychiatrist worked with the med surg staff to treat his aggression and agitation. At last he went to MC. The combativeness and aggression continued there for 4 days until they sent him to the ER because he wouldn’t let them treat his diabetes. He is still hospitalized after another week much of the time in restraints. I’ve been trying with the support of MC, to get him transferred to their GPU. Doctors at the hospital tell he is a poor fit because his dementia is too advanced, they won’t be able to help him, another transfer would just add to his confusion. They say that the compassionate thing to do is to bring him home with round the clock care, or back to MC with palliative or hospice care. The MC director thinks he needs another GPU stay. I don’t know what to think. Part of me thinks he hasn’t yet received a good GPU assessment. I’m not convinced the meds he is on are helping him and something needs to be added or adjusted. In the meantime the agitation continues. What will my next steps need to be if MC.cant handle him. So the other option I guess will be the hospice route. I imagine all they will do is medicate him so he is sleeping all the time. Maybe this would be better for him if he is not so unhappy, stressed, agitated desperately trying to get home. But it isn’t like they would see him every day. Will his quality of life be any better? I suspect the agitation will continue when he is not sleepy. In his case would a good quality nursing facility be better? I know I am all over the place. I don’t know who to listen to. I’m considering hiring my own Geri care manager. THANKYOU for listening.

M1

Laney I’m so sorry. I think you are in a very similar position to clarinetist, and if sedation is what it takes, then that’s likely your only option. I wouldn’t hold out hope that another Geri psych stay would help. I think hospice is a good idea. This sounds awful, but there’s some truth to it: untreated type 1diabetes may give him a quick exit from this torture.

midge333

@Laney: I am sorry for the situation you and your DH are in. I agree with M1. I also want you to know that you do have the option of stopping your DH's insulin. With type I diabetes, he will slip into a coma and die in less than 7-10 days. My wife has had type I diabetes for 60 years. When she developed vascular dementia 8 years ago, she added a clause to her advanced directive that calls for stopping her insulin when she is in the severe stages of dementia. Insulin is a medical treatment, and as such, can ethically and legally be stopped by the patient. It is a little more complicated because you will have to make the decision for your husband.

terei

If this was my mom, if he remains calm if he is not being pestered to take any meds, so be it. Try to figure out what is agitating him, if you can, and put a stop to it, regardless of what it is.

When my mom started refusing meds, I just told the facility: ‘ try once, if she says no, stop’ . It made every one involved much calmer + happier.

cdgbdr

Hospice may be the compassionate choice but you have to be comfortable making that decision. Know that you have been doing your best to care for him.