New Stubborn Behaviors
I mentioned in a previous post that my DH was recently in a Memory Care facility for 30 days of respite care while I recovered from a broken ankle. He’s been home for 3 weeks now. Since home, he’s experiencing some VERY stubborn and rude behaviors and refusing to cooperate with necessary care. I don’t know if it’s the transition from home to facility to home. He also was taken off Memantine recently (slowly stepped down over a period of weeks). The doctor warned that it can cause irritability if stopping the drug too quickly but he’s been off of it for a couple weeks now. So I don’t know what to think of this new behavior. Maybe just another symptom of decline? He has always been very cooperative with me and his aide with whatever we needed to do for him. He and I talked about our “teamwork” in his care. For example, he lays down on his bed fully dressed and refuses to budge to stand/sit when I need to change his disposables and get him ready for bed. A couple nights ago he took his shoes off then wrapped his arms tightly around them and refused to let go. So he slept with them. Last night he refused to let me get him out of his jeans and wet disposables at bedtime. I started to gently remove his glasses and he grabbed my wrists very tightly. How do you all handle this behavior? I usually end up backing off then coming back later and engaging in over-the-top baby talk to him. It’s exhausting. I’m struggling to repress my anger.
Comments
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UPDATE: after I wrote the above post, it got worse. He was napping but took off his disposable underwear and ended up with a very wet bed. I was in process of washing his waterproof mattress cover from an earlier refusal to cooperate so unfortunately his bed is extremely soaked. He knows he’s laying on the wet bed, he said he can feel it, but he refuses to budge. I spent a 1/2 hr trying to convince him to let me get him and the bed cleaned up. I’m still very immobile while my fractured ankle heals. I backed out and left him alone, will give him some time and go back to him, faking a cheery voice, and try again. I seriously don’t know what to do!!!!!!
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Sounds like you need to contact the doctor about this change in behavior. He may need additional medication to settle things down. Don't wait until it escalates further.
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So sorry you're going through these changes. Why was he backed down from the Memantine or replace it with something else to help the agitation.
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we have an appointment coming up in a couple of weeks. I won’t be able to get it moved up sooner but I could at least call their office about it.
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Goodlife2015 - When he was in the hospital in late August, the medical team went through his medication list to take out what was no longer needed. In consultation with his Alzheimer’s Dr., it was determined that the Memantine is very likely no longer working. He is still on Sertraline, Quetiapine, and Mirtazapine, all behavior related meds. They have been working quite well and he’s been very nice, content, and compliant for a long time. I suppose it’s possible something needs adjusted now.
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Hugs - I think I am looking at contacting my DW's PCP as well because I think we need a med update too. One of the hardest parts just when I get it all settled in and maybe a little bit of routine things progress and the meds may need adjusted.
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so sorry this is happening. It’s difficult to know if it’s due to him being in respite care and then coming home or due to normal progression. I think you mentioned he’s Stage 6? That was when my husband’s agitation and aggressiveness started. It usually happened when the caregivers had to change him or give him a shower. He was on Risperidone and they added Depakote which made him sleep more. But there was no choice. He kicked one of the caregivers. Your DH could hurt you. Call the doctor immediately and if he becomes aggressive again call 911 and have him admitted to the Geri Psyche unit at the hospital so they can adjust his meds. I doubt if coming off the Memantine caused it if they did it slowly. Have you considered placing him in a VA memory care facility?
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My DH who is in a later stage of mixed dementia has been stubborn all along. He is also rude and he likes to call me names. He doesn't like to be told what to do. It is very hard to cope with but many of his behaviors are not harmful. If he wants to sleep in his shoes I let him. He gets very angry if I suggest he take his glasses off before he goes to bed so I let him sleep in them and get them off of him when/if I can. He refuses help changing his clothes so sometimes I have to let him sit in a wet pull up for a few hours before he decides he wants dry clothes. I think it is important to sort out what is a critical safety or health issue and what is not. For example last night he didn't want supper so I ate and I put some aside for him. He ate several hours later. When he refuses food I often leave it at his place for a time and he eats it, If not I put it away. This is all very hard, None of us are equipped to handle caring for LO with dementia. You are enough and you are doing your best.
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If he did ok while in MC for the month it might be time to make permanent if that is doable. Talk to an elder law attorney about options to help cover the cost.
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I would ask to put him back on the Memantine. The combination of medications may have been working for him and that balance may now be upset.
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My wife has been on Rexulti for agitation and aggressive behavior. Before taking it she was extremely agitated at night and physically aggressive towards me. Since being on Rexulti it's a night and day difference in her behavior. Minimal agitation and no aggressive behavior. I believe it's the only FDA approved drug for those two characteristics.
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Commonly Used Abbreviations
DH = Dear Husband
DW= Dear Wife, Darling Wife
LO = Loved One
ES = Early Stage
EO = Early Onset
FTD = Frontotemporal Dementia
VD = Vascular Dementia
MC = Memory Care
AL = Assisted Living
POA = Power of Attorney
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