Care home wants more meds because of aggression

ampeterson13

My DH has late-stage early-onset Alzheimer’s with aphasia. For his safety and because I work full time, we had to move him to memory care 10 months ago. Before moving he would sometimes strike out at our home caregiver. In memory care he became aggressive when exit seeking and during grooming. We tried medication but ended up in the ER four times when he was over medicated.

Three weeks ago we moved him to board and care. The quieter home has helped but he continues to show aggression when they change his diaper in the morning and get him dressed. Yesterday he kicked a caregiver so the director of the home wants to increase his meds. He’s already sleeping most of the day and he’s unsteady on his feet. Combined with his history of falls and drug interactions, the doctor said no to changing the meds (and I support the decision — his last fall involved a bad cut above the eye).

The director has pushed back and I’m afraid she is going to evict him since therapeutic communication and redirection aren’t working and she is concerned for the care providers. I’m now getting care for my own health that I delayed because of caring for my DH. I also have a 14 year old who is in therapy for severe grief. I’m overwhelmed and scared. Has anyone else dealt with aggression from their loved one during grooming/changings and had success with non-medication treatments? Is there anything I can do if they evict him? What else is there since a memory care facility and now board and care haven’t worked?

Thanks for any advice.

Michele P

I know there are others here who have dealt with this issue. I think attorneys were contacted to find out what legal options you have in this situation. So sorry you are going through this.

harshedbuzz

@ampeterson13

I'm so sorry you are dealing with this situation. Your concern about being evicted is justified; facilities have an obligation to protect their staff.

Who is prescribing your DH's meds? If he's not under the care of a geriatric psychiatrist, that could be helpful. Geri psychs are the subspecialists most experienced in the prescribing of powerful psychoactive medications. Given the urgency of your situation, I would consider having him transported to a geripsych unit for medication management. The social worker from the unit should be able to help you find a facility that has more experience with PWD who have more challenging behaviors.

It's hard to make blanket judgments about which kind of facility is best. Sometimes the more appealing looking settings invest heavily on decor and extras rather than training and retention of staff.

HB

easy23

My DH was having trouble with aggression and agitation while he was in subacute rehab. He shoved one of the male aides that was trying to change him in the morning. Then he started wandering at night and hit a nurse that tried to direct him to his room. The next morning he took a shower and was walking naked in the hall. I asked to have him placed in the nursing home, long term care. The doctor didn't want to increase his meds and said we should try to figure out why he was acting out.

They transferred him the next day. It was much quieter there, but that night my DH tried to hit his roommate with the remote. That was enough for me and the doctor. She upped his risperidal, depakote and started him on zoloft. Once the zoloft kicks in (six weeks) she will lower the antipsychotic. So far he is tolerating the meds and hasn't had any aggression in two weeks. I don't see any other answer other than meds and I definitely know my DH would want me to do what I'm doing if he understood what was going on.

I hope you find a solution to your problem. Believe me, I know how upsetting it is!

jfkoc

It is hard, very hard, to get the right Dr, the right meds and a pacement with a well trained staff.

SDianeL

my DH also was aggressive with staff during showers and changing his diaper. He kicked one of the caregivers. The facility had no choice but to increase his meds. They upped his Risperidone and added Depakote. It caused him to be bedridden. They tried to lower the doses but they never found a dose that would work. They did reduce the dose and got him up in a wheelchair and he fell head first and hit his head and had to be transported to the ER. After that he was bedridden again. The nurse said he was either asleep or aggressive with no in between. You really don’t have many choices when they become aggressive. They cannot allow their staff to be injured. I hope they find a dose or combination of drugs that works for your DH. 💜