Psych Exam for exit behavior

ileanabeatriz

Our LO, likely with FTD, has been at MC for close to 3 weeks but after an initial period of apparently positive acclimation they report he has started to attempt exiting the facility more often, wanting his car, resisting redirection. They will have a psych consult via state mental health services. My questions are what treatments might be recommended (which drugs?) and what should I do on my end? (I have notified his geriatric physician). Also, how often do MC’s release residents in such circumstances (and where could they go?

Maru

As i am sure you know, his attempts to leave are not abnormal. I am curious as to how a psych consult could help someone whose brain is deteriorating… or any mental health service.??? It seems that the geriatric doctor is better suited to treat your LO, probably with drugs to calm him/her.

easy23

My DH started off with an antipsychotic (risperidone). That calmed him down for awhile and then the doctor added depakote. I would go along if there is a medication recommendation because there is really not much more that can be done. Good luck!

harshedbuzz

@ileanabeatriz

I am sorry your family is dealing with this situation.

A geri psych consult will likely result in medication trials. Talk therapy isn't an option by the time a PWD needs 24/7 care. Depending on what meds your LO already takes and the urgency of the behavior, an SSRI, atypical antipsychotic or shorter acting anti-anxiety med might be chosen. He might even be given a combination with the hopes of keeping doses low to minimize side effects like sedation; my own dad was on 3 different psychoactive medications.

How often a PWD is asked to leave a facility will depend, in part, on the facility. This was a question to ask when touring MCFs. Some places cherry-pick for the pleasantly befuddled while others have more training and experience helping those who are struggling. Sometimes, especially in the absence of aggression towards others, a medication adjustment is enough to calm the situation. Sometimes a PWD is sent to a geripsych unit for inpatient medication adjustment and then returns to their previous MCF or the social worker helps family find another option if that isn't desired or possible.

HB

ileanabeatriz

thank you all. The consult was with a nurse practitioner whose firm is contracted with the facility and the only change recommended was to change the nighttime sleep aid to “as needed” to calm when necessary. The geriatric doctor agreed. Meanwhile I am keeping my distance for time being in hopes acclimation continues. He is engaging in activities.