Sarah,
That's very interesting. OK, it looks like you are going to have to do some detective work on this one.
If I were you I would look at his placement before the hospital. What type of placement was he in? What was his functioning levels, his behavior like? What medications was he on? What precipitated the hospital visit? What meds were changed, decreased, increased, added, or eliminated, while in the hospital? If it was for surgery, then has he had a COMPLETE CHECK-UP after surgery to eliminate any post-surgical pain he might be having? Was he on med's at your place for the first 4 weeks that he is not on now? Could this be the reason that his behavior has changed?
You see, Alzheimer's patients can not always verbalize pain. They may not even know themselves that pain is a factor in their behavior, or that their behavior is in any way out of the "normal" scheme of things. Pain can make an Alzheimer's Patient change suddenly, violently, and can cause moaning and anger, combativeness and crying or lethargic behavior, even thoughts of suicide.
My mom used to sit in the halls and scream, "Help me, oh it hurts, help me !!" When asked what was wrong she'd day, "Oh nothing, why do you keep asking me that? I'm fine".
Usually screaming and hollering and yelling is due to anxiety, or frustration and confusion due to the brain's imbalance with this disease. But, sometimes, and more likely than not, these symptoms do denote real physical pain, a pain that the patient does not know, or does not know how to relate to you, because of the disease of Alzheimer's. (This makes helping them very confusing, you don't know if it is real pain or if it is just something like turrets syndrome, like a nervous, sub-conscience, twitch). Also, with a brain disease, is this pain of the present, or is this remembered pain?
I do find it very unusual that this doctor would have this patient diagnosed for over 2 years with Alzheimer's and not have him on the appropriate drugs, not only for the disease (risperdal, aricept, etc...), but, for the many symptoms related to this disease also, (Like depression, anxiety, psychosis or paranoia, confusion, anger or aggression, or many other symptoms).
(It usually takes more than just one drug to treat an Alzheimer's patient, especially the farther along they are). If he was diagnosed with Alzheimer's 2 years ago and has not been on ANY drugs for this disease or any other related symptoms sense then, then I would suggest getting in a specialist that can put him on the appropriate treatment program right away, (like a neurologist/ or at least a gerontologist, someone good at dealing with dementia and Alzheimer's ).
You are going to have to find out if the hollering is physical, mental or emotional. You will have to ask yourself, when is this event happening? Always after meals, (trouble digesting food). Always just after you leave the room, (fear of being left alone, ie..anxiety). Is it better if you give him aspirin? Is it worse just before a certain medication, (then does that medication have to be increased?). You will have to be the detective, but you are only as good as your medical back up team member,,,(his doctor). If you have one that is uncooperative, than ditch him, but if you have one that IS willing to work with you, enlist him into your program to search and find the culprit and treat it. That way the doctor will have a better patient, you will have someone easier to care for, and the patient will feel better and live a better quality of life. It really is a win, win situation all the way around.
Hope this helps,
Gizmo
Very Agitated Alzheimers
Linear Mode
