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Old 02-24-2007, 12:34 PM   #1
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need to talk and get suggestions for help

I don't contibute very often but I need to vent now and see if anyone has any suggestions.

My husband, age 68, has been Dx with AD for 4 1/2 yrs. I quit work to care for him because he cannot be left alone, wanders and won't let anyone else stay with him.

I tried a day care several days a week but they couldn't handle him because he wanders and starts to get aggressive. It was not a locked facility.

I then tried respite during the day at an AD & dementia facility which is locked and he could wander all over. He did well until I tried to leave him there overnight. He apparently wandered all night and he hit another resident when they tried to get their toothbrush back that he took. He does pick up things and put them in his pockets a lot.

He was sent to a geriatric psych unit for 14days for testing and medication adjustments.

I was shocked when I picked him up because he looked so old and frail. He still wanders but is now unsteady on his feet. I'm sure it is from the large doses of medicine he is on. He still gets agressive with me when I try to get him to bathe or take his medicine. He is so much more confused too.

They told me I need to place him somewhere,which I agree with. I am trying to put him in a Veteran's Home here where they have a locked unit but it says in the paperwork they will not take anyone who has violent tendacies.
Now what?

I doubt anyplace would take someone who is violent or combative,especially a man.

They did a CAT scan when he was admitted and also found he had early NPH which didn't show up in a CAT scan several years ago. I researched this disease and know it is usually mistaken for AD. Several years ago I asked his Neurologist if it could be NPH and he said no.

I am a nervous wreck and losing my patience and mind.

He is on Aricept and Namenda, as well as Seroquel 100mg 2x day, Trazadone 25mg 3x a day, Trazadone 150mg at bedtime ,Estradiol.5mg 2x day (a female hormone) for inappropriate behavior and Ativan 1mg as needed for agitation.

What do I do now? Where can I put him? I am so frustrated. Has anyone else had this problem?

Thanks for hearing me out.

 
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Old 02-24-2007, 03:01 PM   #2
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Re: need to talk and get suggestions for help

Hello - I have not had the same problem but I know that nursing homes, including VA nursing homes, DO accept agressive patients providing they can be calmed down with the right medications That is usually the case. First get him on a waiting list for a VA home, and while you are waiting, get his doctor to prescribe something that works for aggressive behavior. Namenda and Aricept work to slow the progression very early stage AD, but not after a while. I think it was 8 to 15 months in the studies done before Aricept was approved by the FDA. After that it is a waste of money to keep taking it.

But I am sure that just about anyone can be sedated if enough of the right drug is used. In the NH where my Mom is, there are a lot of people who look fairly spaced out, and I am almost sure they were at one time hard to manage so they are now on tranquilizers.

I remember how (it was in the 60s and many of you were not around!) the invention of simple tranquiizers like Valium revolutionized the mental health treatment in hospitals all over the world. People who were held in bed by physical restraints were now able to get up and walk around and even take part in therapy because the aggression was dampened by the drug. By now there are better and more specific drugs out there.

No one needs to worry about addiction. Alzheimers Disease is fatal. The person does not recover and does not go out into the world on his own to purchase drugs illegally. So if the NH can keep him happy, calm, and able to participate in life, they are far better equipped to do it than one harassed relative at home on 24/7 duty.

Make sure you speak to administrators at several hospitals /homes. I do not think the information you got was correct. Small privately owned group homes may reject aggressive patients. But surely not a VA hospital ..I think of all the mentally disturbed ex GIs from the Vietnam war, and now the new wave from the current war ...what are they all supposed to do?

Good luck with it!

Martha

 
Old 02-24-2007, 05:54 PM   #3
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Re: need to talk and get suggestions for help

Sadly, lots of our vets are getting less than acceptable medical treatment. The VA is constantly looking for ways to trim costs. And just when you think there's not much more that can be cut, they find a way.

Ceedee, has your husband ever been put on antipressants for this. Zoloft worked wonders for my dad's aggression. Before he was put on it, I was scared. I was his caregiver and there were times I thought for sure he was going to punch me. My dad used to move pianos for a living and he had the arms almost of Schwarzenegger. I was scared to death one night when he drew his fist up at me and almost got me. I told his doctor (a geriatric physician who specializes in AD/dementia) about this and she put him on Zoloft. After about 2 or 3 weeks, he was calm as ever and never seemed sedated.

Ask your husband's doctor about a small dose of anti-d's. My dad's dose was very low and it really made a world of difference. It took away the agression.

Good luck!

Love, Barb
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Last edited by LuvMyLilDoggie; 02-24-2007 at 05:55 PM.

 
Old 02-24-2007, 10:59 PM   #4
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Re: need to talk and get suggestions for help

Hi, Ceedee. I have a son with severe pediatric bipolar disorder. He has been on a variety of med cocktails over the years. When he tried Serequel to curb his aggression, it actually made him more violent. I think I took him off of it within a week or so. Anyway, when I talked with his doctor about our experience he said it was not the first he had heard about this kind of reaction. Even if the Serequel is not the problem, there are a lot of other drugs out there that can calm aggression without sedation. Maybe a med adjustment will help.

Hang in there and please keep us posted.

SeeingRed

 
Old 02-25-2007, 01:22 AM   #5
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Re: need to talk and get suggestions for help

Another medication is Respirdol (sp?) .. a lady I know has an autistic boy and he's just been put on this and she's "got her little boy back" ... no more punching strangers at the shops or major fights.

I know quite a few people on this, and although it's not recommended for long term (more than 3-5 years) in my humble opinion, if it keeps them calm, WHO CARES how long their on it for !!!!

You can get it in tablet form or wafer form. Wafer form is easy for combative people as once it hits the tongue or cheeks, it's melted and voila .. instant medication.

Another medication we have here in Australia is PAINSTOP .. it's in a liquid form and can be masked in drinks if necessary.

And another one for sleep is STILLNOX, it's a tiny little tablet and is apparently quite good at knocking people out. (However, those with paranoid and psychotic tendencies, I haven't seen good results with)

Serenace (or it's sister products, serequel etc etc) .. well, I gave my ex-charge one once, .... ONCE .. the poor thing turned into a zombie for the day and it was TERRIBLE. I felt so guilty !! Never again .. not for her, her little frame just couldn't take it.

Hope this info helps a lot.

 
Old 02-25-2007, 07:37 AM   #6
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Re: need to talk and get suggestions for help

>They did a CAT scan when he was admitted and also found he had early >NPH which didn't show up in a CAT scan several years ago. I researched >this disease and know it is usually mistaken for AD. Several years ago I >asked his Neurologist if it could be NPH and he said no.
........................................ ........................................ .....................Ceedee-
This part of your post really hit home. My husband was also misdiagnosed and we were told it was early AZ. Four years and a change in physicians gave the correct diagnosis of NPH. Early NPH is REVERSIBLE!! Late NPH is not. It is ESSENTIAL that people do not take no for an answer if there is ANY possibility that NPH can be the cause of the dementia.
My husband is in what they call an ALF but it is a locked facility caring for the "memory impaired" only. I would guess he is at stage 6. He takes aricept, namenda and prozac. The first two I think are a waste of medicine, the last has made a difference. There was a brief discusssion about ativan on an as needed basis but the final decision was that by the time the stuff worked the incident would be over.
I wonder if your husband's lack of steadiness on his feet isn't another part of NPH and not the medications. Gait and balance problems, dementia and urinary incontinence are the three most often seen symptoms of NPH. My husband has problems with mobility and frankly it has made him much easier for the aides to handle him. Wandering is not a problem.
I notice that they, the aides, know how to assist him and he accepts help from them a lot easier than he did with me. I have also seen in my daily visits, residents who go from being aggressive to placid. Obviously there is medication being used.
I hope things work out and you find an appropiate placement. Keep posting.
Beatrice

 
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