Don't know what to do

lzerbe

Over the past few weeks our cat Squeak hides under the bed when we go to bed. (Probably senses the stress and anxiety) And every night LO spends hours calling Squeak and crawling around the bed trying to get Squeak up.

Last night was the same but it turned into a horrible night. LO's frustration over not being able to get our cat Squeak to sleep with her grew into outright rage. I have never seen such hatred, anger in someone's face. Long story short LO took the keys to both cars, plus my wallet. I called the police and their search found her a couple of hours later at a gas station. They brought her home.

At this point she was not in a rage but still very angry and agitated so I backed off and went to bed around 330am.

When I got up at 600am LO was in the downstairs bedroom sobbing. She knows something traumatic happened but no clear recall of the events. Over the last couple of hours she seems to be settling down.

I am very concerned about being able to handle these 'episodes' and must say that I was frightened. I don't think LO would harm me or our pets, but when she is in this heightened state of anxiety and stress, she is not really my LO.
Don't know what to do!

SusanB-dil

I'm so sorry you are dealing with all that.

Can you hide the car keys and wallet? A lock box if necessary?

Please do tell her doc what is happening. I know that you already realize that level of aggression really needs to be dialed back ASAP. Also, have you tried melatonin? Is there someone she would actually listen to that could calm her down? I'm sure at the height of the episode, she may not listen to anyone, though. Hopefully, someone could weigh in with other suggestions, but do start with her doctor.

lzerbe

Thanks for the suggestion and I know I will definitely heed your advise. We saw our GP this morning and LO refused any RX to calm her down.

Plus, things now are starting to disappear, and I am to blame for throwing 'whatever' out. Really stressed here and struggling to regain composure.

Robert1320

Your local Council on Aging may be able to give you free guidance that is relevant to your location.

See ncoa.org for more information,

Emily 123

Hello Izerbe,

This stage of the disease, where the person can tell there's something wrong but can't pinpoint or fix it, is a very tough stage for everyone. Full of anger and fear and confusion.

You'll have to work around her disease to help her, since she can no longer grasp what's going on. She doesn't have good insight or judgement about what's happening because the disease blocks her from remembering events from even a few moments ago.

I would get her on the medications however you can.

It might not feel right for you to make decisions about medications without her input, but It's not kind to either one of you (or sweet Squeak!) to have her in this angry, desperate state.

Her poor thoughts must be going a mile a minute. If she had diabetes you would want her on a medication to help her, and this is no different.

Can you get the prescription and see if she'll take it if you add it to her other meds? Or tell her it's something the doctor added for [put a reason here] if she pushes back? Sometimes the person with dementia will agree because they can't remember the office visit.

terei

I would try a geriatric psychiatrist if you can find one. ‘She refused meds to calm her down’. is not acceptable. If she is doing this on a regular basis, it has come to the point of medication. Do you have DPOA? Either this dr prescribes something that you can give her(new vitamins, hon) or find a different dr.

easy23

Since you were at the Dr today I would call tomorrow and ask for that prescription. You're going to have to trick your wife into taking it. It is for her own well-being as well as yours. Many doctors prescribe antipsychotics for agitation, maybe Seroquel or risperidone.

If anything happens again like last night, call for an ambulance to bring her to the ER for altered mental status. Let the hospital check her out and make a recommendation. I wish you luck. This is very hard, I know.

H1235

She needs medication. When my mom was having some anger issues the doctor prescribed something. Mom was very angry and said she didn’t have any (there might have been some cussing, very unlike her) mood problems. She said she was not going to take the medication. I waited a week and added it in with her other medicines. She recognized it as being new and I told her is was a vitamin the doctor wanted her to take. She took it with no problem. You might also claim it’s to help her sleep or for her blood pressure, whatever works. If none of these work, ask the doctor if it can be crushed and added to some pudding or favorite food. A therapeutic fib is a common way to handle theses difficult problems.

https://iona.org/therapeutic-fibs-ok/

Quilting brings calm

I can’t tell from your post if your wife drove to the gas station or walked (taking both sets of keys). Either way I would call that eloping. Eloping/wandering abs aggression are often what causes family members to place their loved one in a locked facility for their own safety. Medication is required because logic/ talk therapy will not work for someone with dementia

As for the cat, my guess is that she is hiding under the bed to stay away from your wife.

harshedbuzz

@lzerbe

The goal here is to proactively prevent these episodes rather than react to them.

Behavior is communication. Your wife's anxiety is being expressed as agitation and needs to be addressed. This level of distress is well outside of a GP's wheelhouse. Ideally a geriatric psychiatrist could prescribe something to dial back these big feelings. Her neurologist might be able to prescribe if you can't get a geripsych appointment. You can pass the meds off as something for her BP, vitamins or even hide them in her ice cream (check with pharmacist first).

You might want to share the police report and/or video of one of your DW's meltdowns with her doctor via the patient portal or email so they can see what things are like at home ahead of the appointment. This avoids throwing your DW under the bus at the appointment.

I had a friend whose mom became obsessed with controlling the cats who had become spooked by her behavior and avoided her. I suggested a Joy For All robotic cat. These cats aren't at all realistic looking, but they are very engaging and many families and MCFs employ them to help settle and entertain PWD. Friend borrowed one from the library and mom liked it so well, she bought one.

https://joyforall.com/products/companion-cats

The time has come for you to secure any valuables and irreplaceable papers. A safe or lock box is best. If she can access mail, considered a locked mailbox or P.O. box. Rummaging is a common behavior; some caregivers find it easiest to limit access to basements, garages, spare bedrooms and offices to avoid things missing. Interior doors can be locked by reversing knobs.

Exits to the outside need to be locked as well to avoid elopement. Some people add alarms or motion detectors so they can redirect the PWD before they get outside.

Good luck.
HB

lzerbe

Thank you so much for this. The information is invaluable. We will be seeing a geriatric psychiatrist on Friday and a social worker who is familiar with our case has been in communication with me.

I do have another question. My LO destroyed a screen door. She must have done it with the keys. She will ask "How did this happen?" How do I answer that???

terei

https://alzconnected.org/discussion/comment/273351#Comment_273351

I dont know how it happened.

H1235

https://alzconnected.org/discussion/comment/273351#Comment_273351

I find it’s easiest to be vague. I don’t know, I’ll have to think about that, I’ll see if I can find out, I can’t remember.

lzerbe

Thank you. My LO keeps coming back to the same questions. In some ways the mind becomes fixated. I guess we live in an alternate reality, theirs.

MN Chickadee

Do not take any chances. People with dementia (pwd) who before dementia were gentle souls have been known to become combative and even violent and threatening, sometimes even hurting their caregivers. Is there a way to get a message to the psychiatrist ahead of time describing this behavior, perhaps in the patient portal? Reporting on someone when they are right there is not only uncomfortable but will further her anxiety and distrust of you, however the doctor needs to know about what is really going on at home. Some (not all) meds can be crushed and hidden in a shake or pudding, ask the pharmacist. SOme may be available in a liquid form. You will have to find work arounds and therapeutic fibs to get some meds into her, or else this may escalate into a stay in the emergency room and/or psych unit where they would sedate her a bit and then slowly work on medication balance. Most PWD do not return home after this, the doctors insist they go to a memory care facility. If your goal is to keep her home then you must be steadfast in finding the right meds to calm her down and a way to get them into her. Better living through chemistry. This often improves the qualify of life for both the caregiver AND the PWD, because they are not enjoying living with rage and anxiety. It sounds like you need to invest in a locked safe for keys and important things, as her leaving in the car in a rage could be life altering for you and another family, and/or financially devastating.

Obsession with a family pet is common. I would second the Joy for All cat - even though it seems ridiculous, a surprising number of PWD take to them. If you think she might hurt the real cat then you need to re-home it at least temporarily, that's not fair to the animal. My mom was also obsessed with the cat. A couple things helped - sleeping medication so she at least slept thru the night, and when the cat died we did not get a new one. This phase of dementia is extremely difficult, when they are ambulatory and know enough to get into trouble but do not understand anything else. We also had everything disappearing. Mom was constantly squirreling things away and even throwing things in the trash. We lost a variety of things, from family heirlooms, pictures, and jewelry while she was still home. She took scissors and cut up bed spreads for no apparent reason. Even now years after her death we occasionally find some random thing in a random spot that she hid. Still hoping my favorite ear rings turn up. If something is valuable, irreplicable or important, get it out of the house. Maybe see if a friend or family member will store some boxes for you. We took to hiding the can opener and things that there weren't duplicates of because she was always ransacking drawers. Eventually we babyproofed the kitchen with cabinet and fridge locks because she was taking food out to spoil. Eventually we had to move her to memory care, because this behavior plus incontinence was more than we could handle. The stress of this phase is no joke. This phase will pass, but it is extremely challenging day to day while you are living it.

lzerbe

We never made it to the geriatric psychiatrist meeting. She refused to go to "that hateful awful doctor who didn't even talk to me and told me I had Alzheimer's". The social worker though will be coming over on Tuesday and we will work to get a community nurse in. We've rescheduled the psychiatrist for mid June. I am so grateful for your response. Grateful for all the responses. They have helped a lot. I am hoping this phase passes more quickly than not. And I do realize that this is not going to get easier and I have some tough decisions to make. I have some calming medication I will mix in with her late-night snack perhaps that will give all of us including Squeak our cat a good night sleep.

sandwichone123

Don't mention the rescheduled appointment. In mid June, when you're heading for the appointment, be vague about where you're going, "I thought we could go out for lunch. We'll need to stop here before lunch. It's still early."

harshedbuzz

@lzerbe

I was certain I'd have a difficult time getting dad to the geripsych. He'd been dismissive of psychiatric care despite having come from a family who clearly could have benefited.

What worked was not mentioning the appointment until the day of and framing it as a second opinion because none of us were comfortable with the diagnosis the neurologist gave him and we wanted him to have the best care possible.

HB

lzerbe

that's a really good idea thanks