What are the options for severe agitation, aggression when seroquel and rexulti can't help?

scarfire

My 94 year old Mom is in her 12th year of Alz dementia. She is at home. We're not considering a facility but I'm curious what a facility would do in this situation. She will throw dishes, threaten violence, and punch and scratch during any interaction that requires her being touched. Can she be sedated in bed full time? I'm trying to map out her final days even though they may not be here yet.

Damiross

Is she on hospice? I found out it is not only for terminally ill people.

Hospice has my 73 years old wife on Rexulti, Gabapentin, and Quetiapine. The last two are supposed to be for helping control mood and reduce agitation.

Most of the time, my wife is calm. It is when she needs to have her clothes changed that she becomes agitated. The medicine seems to be helping some. When the Gabapentin was added, she was less agitated. She still fights me when I change her but it is not quite as bad as before.

JulietteBee

Unless she has round the clock in home care, the answer is no, you can not. Without someone turning her & changing her position every TWO hours, she is at risk of developing massive amounts of bed sores. The sores can get infected down to the bone. Please put her in a facility for professional care, if you are unable to provide it at home.💔

SDianeL

my husband was in memory care. He was on Risperidone and they added Depakote. He was then bedridden. They could never find the right combo to allow him to get up while controlling his aggression. He kicked a caregiver and bruised her leg. It was always when they touched him or changed him or tried to give him a shower. He was in stage 7 so he was already a fall risk and would have been bedridden soon anyway. As juliettebee posted you cannot do that at home without 24/7 nursing care.

harshedbuzz

@scarfire

A facility would have turfed her to a geriatric psych unit via ER and/or given you 30-day notice to find another place for her.

In your shoes, a geripsych admission is probably the best option. There are other kinds of medications and higher doses that could be safely trialed to calm her down without chemically restraining her. I can appreciate that you only want what's best for your mom and are desperate at this point but the mention of sedating her to the point of unconsciousness might be reported to APS as abuse.

That said, as she becomes incontinent and bedridden, she will need hands on care— regular repositioning and changing as feces will destroy her skin.

HB