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Old 05-22-2012, 08:03 AM   #3
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Re: "Problem Child"/FTD

I am sorry that you mom - and you - are going through this.

My aunt has vascular dementia and the best thing they ever did was find the right anti-psychotic for her.

She was becoming very unmanageable, yelling, screaming, hitting, punching, poking, throwing, trying to get up and run, stripping clothing off, etc. In addition to all this she was miserable, suicidal, had fearsom delusions and hallucinations and she could not get through a day without incident. At that time after feasible suicide threats she was moved to the geriatric psychiatric center because her behavior was very disruptive and scary to the other residents in addition to being taxing to the staff. She is only 90 pounds but they could not have such a disruptive resident.

I was disappointed but I completely understood why they had to move her for a while and try to come up with another solution. If someone acts up occasionally it is one thing, but if someone is a frequent problem, it is not fair to the other residents. They are not "labelling" her, it is not "her", it is the disease, but the facility has an obligation to all its residents as well.

At the geriatric pyschiatric center, they worked up a 'happy cocktail" for her consisting of two anti-depressants, one anti-psychotic and anti-anxiety medications as needed.

Her behavior has calmed down - she is not totally docile, but she is easier to calm down and less extreme, just a notch or two beyond normal behavior. (She will roll her eyes or make a gesture and get snappish or raise her voice a tad, but usually not hit, yell, punch, poke or throw.) She will still occasionally try to take her clothes off but can be easily persuaded to keep something lighter on. She is much more manageable.

But the more important feature is that she seems a lot better off herself. She has far fewer delusions and hallucinations and almost seems somewhat rational a lot of the time. She is able to kind of coast through normal activities and enjoy her days, her meals, her TV, some games... instead of every day being an absolute torture for her that she could only react to loudly and aggressively. It is like night and day.

What convinces me even more is that when there is another resident who acts up - even just yells and screams - my aunt finds it very upsetting - it can upset her for days. She thinks that people who act up should be forced to leave :-) So I don't think we need to feel bad for preventing her from becoming one of them.

Now, with your mother's situation, I do not have any idea whether the anti-psychotics would have a good effect.

But, I would not necessarily rule them out automatically just because they are anti-psychotics.

They are frequently used in dementia and often prove very helpful to help the person have a better time of it.

The only proviso I would make is that it is tried under the right circumstances - under the direction of a geriatic psychiatrist and with the proper support for the first few weeks to change the medication or adjust the doses as needed.

Good luck whatever you decide.

Originally Posted by all4mom View Post
Apparently my mother presents a real problem to nursing homes and rehabs; already we've been kicked out of one and rejected by a number of other nice ones, and now she's being called on the carpet at the not-so-nice rehab for her "behaviors." Not only does she not participate in therapy on the regular basis, but she yells, screams, insults, and repeats herself.

More and more I'm convinced that she suffered damage to the frontal lobes of her brain in that fall, resulting in (chronic bilateral subdural hematomas and thus) disinhibition and loss of impulse control, and there's NO CURE; they keep treating her like a "psych case" and trying to throw heavy-hitting antipsychotics at her. She's not "psychotic"; she just can't tolerate discomfort and says so... Often... Loudly... And rudely...

It's really very hurtful when staff praises her quiet little roommate for being so "good" and shoots my mother dirty looks for raising a ruckus; hello, she can't help it. She has BRAIN DAMAGE. Can I get an "amen"?

Never has she had an MRI/PET/SPECT or anything but non-contrast CTs (most of which have been inconclusive due to "motion infarct," since she can't sit still when agitated). It seems as if the whole world is geared toward AD and no one -- not even professionals -- can comprehend the FT dementias, which manifest so differently and really more disasterously.

At any rate, rehab keeps hinting that her days are numbered, and that's just fine with me. So not fair to label my formerly sweet, docile mom a "problem child." Again... Is there anyone else out there dealing with an atypical dementia? Anyone? I see threads in archives about FTD, but...