Dementia? Psychotic symptoms. Prognosis? - Alzheimer's Disease & Dementia Message Board

pshitut · 05-29-2008, 12:05 PM

My mother who is 72 years old has Dementia (?) and showing lot of aggrasive/psychotic symptoms. These are all recent and sudden developments. Here is the brief background.......

- Slowing down in general for the past couple of years. Stopped tasting food about 18 months back.
- Vertigo problem for the past few years.
- Fell down about 3 months back and had several hairline hip fractures.
- Heavy calcium dosage was given for the haireline fracture recovery.
- About twoo weeks after that, started showing disorientation and confusion.
- Admitted in the hospital. Found Calcium and Parathryroid PTH levels were high. Calcium was above 12mg. and PT was 198. A week later, was operated and two Parathyroid glands were removed. Both Calcium and PTH levels came down to normal.
- We were very hopeful (basis of what we had read) that confusion and disorientation would go away after calcium and PTH levels came down to normal. That did not happen.
- 1 week after surgery, also started to show Psychotic symptoms. A medicne was given to slow her down. That slowed her down but also started showing Parkinsons like symptoms. Medicine was stopped after 3 or 4 days.
- Now, almost 3 weeks after the surgery, confusion and disorientation (especially about time and place) is still there but Psychotic symtoms are in full swing..... yelling, not listening to the care takers, very agitated etc.
- By the way, before the Parathyrodi surgery was done a brief brain scan was performed. That scan showed multiple infarcts (Dead spots occuring due to lack of blood supply).
- A couple of days back when we consulted a Psychatrist she is sure this is a case of dementia which was aggravated by the recent illness and parathryroid surgery.

Our questions.......

- What can be done to control her Psychotic or aggrasive symptoms without taking any medicins that gives Parkinson's like symptoms?
- What is happening here? Opinion?
- Prognosis?

Thanks.

Martha H · 05-29-2008, 01:21 PM

Psychotic symptoms can usually be controlled with drugs - it may take a while of trial and error before one is found without bringing on such side effects.

A very predicable and never changing daily routine is often very calming to Dementia victims. Making any decisions - even such as what to wear - can throw them into a state of fear and then rage. During my 5 years as caregiver I did not know that. Only when Mom was in the nursing home and an aide came in every morning, took something out of her closet, and said to Mom, "this is what you are wearing today", did the anxiety diminish. The same for any other kind of choice. Don't ask, "what do you want to eat today?" Making such a decision is too much, too threatening.

Simplify everything. Never argue. If she tells you it is Sautrday and not Thursday, say, "oh, really?" and do not correct her. Being corrected reminds her she is losing (or has lost) her rational thinking, and results in anxiety and then rage.

It is not easy, but we all learn by trial and error. It was such a relief to me when I (an ex teacher) finally got used to NOT correcting Mom's ''mistakes" ... just saying, "that's right," or "uh huh." 90% of the tension in her home vanished overnight. Not liking to admit it was my fault - but I was still trying after 4 years of dementia care to ''make everything all right by just explaining things to her.'' A useless effort.

Good luck. I'm so sorry you are in this position.

love,

Martha

ibake&pray · 05-29-2008, 01:28 PM

Welcome to the boards...
You posted this on the general health board also. Did you get any response? It sounds to me like your Mom is/has Alzheimers. Teh prognosis is that she will get worse. There may be a few better days, but she will get steadily worse. Unfortunately there isn't a cure for this.

What you need to do is to make sure that you or someone has both durable and medical POA for your Mom and you need to be on thechecking and savings accounts that she has. This needs to be done while she is still somewhat coherant. You didn't say what the living arrangements are. Does she live alone? Does she have help? Have you thought of NH, or AL?

I don't know what meds you can give. My guess is that it will be a trial and error until you get something that will work. You didn't say what they tried. It would help to know that. Is she on any of the dementia drugs?

mudcatgrant · 05-29-2008, 09:14 PM

pshitut,

Sorry to hear. My mom has been having trouble with psychotic behavior/emotions over the last year. It started w/ hallucinations in mirrors and then expanded to fear/paranoia/crying/etc. The doctor tried Seroquel and one other while she was at home at the assisted-living facility. They sent her off the deep end, and we had them stopped.

Although we bucked it for a couple of months, our mom had to go inpatient to have her meds adjusted. We should have done it sooner. Not to imply that it's all been peaches and cream, but the vast majority of the psychotic episodes have either gone away or diminished greatly. She had to go back into the hospital 3 months later to have them adjusted again.

It has been quite a roller-coaster ride for us, but the anti-psychotic that she's on (Geodon) has really improved her quality of life. She has also taken Lorazepam for the really nasty episodes that have popped up from time to time.

Hang in there!!!

Gabriel · 05-30-2008, 09:24 AM

We have been through the psychotic episodes with Mom as well. Mom is seeing a Psychiatrist to adjust her medications and what she is on now is an improvement. She also has a return visit in 3 months.... sooner if the situation warrents. She has some not so good days but compared to the past we are on the right track. It is possible to medication without zonking them out. Beyond that I just ditto everything Martha said :-)

Love, Deb