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Old 08-30-2011, 07:13 AM   #1
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it`s me again.....

I just have to ask your opinion on this issue with psychiatrists.....or your experience.I do NOT feel the need for my husband to see one,despite his delusions and hallucinations.I would like to avoid medications unless really necessary--like if he gets aggressive or something like that.He is more anxious and afraid than anything else.Other family members (some of them live abroad) think he should see one.I think I need to do things like more reassurance,refocus,more activities,exercise etc.with him.I went to different websites and some of them advocate medication,some of them warn against them unless absolutely necessary.I am confused.....perhaps I should trust my own judgement in this--my inner voice.If things get worse,I`ll re-think.Some of you already commented on this and I`m sorry I`m going on about it but would like to do what`s best for him.
In any case,can a psychiatrist help in any other way except meds?
I feel that as I`m the caregiver,it`s my call---is that selfish?
A lot of his anxiety is helped by simple things like shutting the door when it`s dark,using the flashlight at night to check things,holding his hand,simple things like that.And every day is not the same--why should I put him on medication when there are quite good days and nights still? He likes music too so I have the radio on a lot.Will also start monitoring what he watches on telly.
I am going on a bit here so goodbye friends for now

 
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Old 08-30-2011, 07:42 AM   #2
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Re: it`s me again.....

It really depends on how you can cope with him. If you can deal with the episodes and convince him to calm down, there is no need for medications.
Some medications have side effects and may not stop his delusions and wrongful logic anyway. Seeing a psychiatrist won't help - the GP/family doctor can give him the antipsychotic drugs as well. My FIL never really saw any psychiatrist at all.

My FIL had been in his old house with Alzheimer's for at least 4-5 years before he was moved to the residential house last year. During the whole time, we had personal caregivers and we stayed with him when we visited him a few times a year. He had never had any antipsychotic drug. What we had done was to cope with his fantasy and deal with it. He wanted a wife so we played along (not to make it real) and he wanted to work, so the caregiver pretended to listen to his "talk". When he was upset, they walked him to the lake or drove him to the lake and etc. It is a lot of work though. Thinking back, toward the end he might need some antipsychotic drug as he was going crazy in the hospital. He pulled out all the ivs and tubes...

You are right in a way, however, there is always a limit. So be flexible about it.

Also you should not remind him that he has dementia - most of them don't want to know and would be very anxious about it. My FIL knows something is wrong with his brain (he would make a circle around his head) but he denies that he has Alzheimer's. He probably knew that later on but he does not understand it anymore. (He is in stage 6/7, near the last stage.)
What you should really do is to distract him - don't bother to tell him oh it is his dementia that causes such delusions.... It would upset him more.

The caregivers for my FIL turned off the TV on bad news and changed the channel or took my FIL out for a walk to distract him from his delusions about the bad news.

Also my FIL never sees invisible people - he treats all people around him as his colleagues or potential girlfriends... The reality is his fantasy.

Take care,
Nina

Last edited by ninamarc; 08-30-2011 at 08:42 AM.

 
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Old 08-30-2011, 07:48 AM   #3
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Re: it`s me again.....

Nothing selfish in what you are doing at all. You are investigating, researching, questioning, and trying to come up with the best options possible for you husband. Others are not there with you! They don't know the situation like you do and they don't know your husband, as he is now, like you do. They are "trying to help" but you are the one with the final decision Sometimes others don't realize how their statements and comments can shovel emotional turmoil on an already difficult situation.

As for a psychiatrist. It HAS to be a geriatric psychiatrist that specializes in dementia behavior. Going to a general psychiatrist is not the answer. Many of them have no experience in dementia and do not know how to treat it. You don't need a psychiatrist that is treating symptoms that do not understand the underlying cause of the symptoms. General physicians are not experts at geriatric psychological problems either. When the time comes that you do need extra help with his behavior please find a geriatric psychiatrist, neurologist, or specialist that knows the best course of treatment for someone with dementia.

Yes, there are major potential side effects to some of the anti psychotic medications. Some of these side effects (cardio vascular) that you hear so much about are actually very rare. Yet some of these medications are very effective at controlling symptoms. So you have to weight the pros and cons and come to the best decisions for your hubby.

If you can manage the symptoms that you see right now then that may be the best answer for the time being. But most of all you need to look at what these symptoms do to your husband. If he is in emotional distress much of the time then it would be time to do something different. This is absolutely your call. Also know that if you make a decision today it is not etched in stone. You can rethink this decision every day if necessary. Just be aware of the changes in hubby over time, how those changes impact him, and what you can handle. Just don't let it get out of control and you will be ok.

Love, deb

Last edited by Gabriel; 08-30-2011 at 07:51 AM.

 
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