Dementia and medicating to control aggressive behaviors in memory care.

No, you are not alone, and anyone caring for an AD loved one is never alone because, regardless of the problem, other caregivers have experienced a similar situation.

Unfortunately, most MC facilities don't know how or don't want to deal with aggressive patient behavior. My wife's facility did. Shortly after being admitted to MC, she became quite violent. She broke family pictures that were placed in her room, tore off the room thermostat, damaged the venetian blinds, and made caring for her quite impossible for the staff. She would use vulgar and racist statements, totally out of character for her. The nursing director suggested she be sent to a psychiatric hospital for her behavior. We were stunned at the suggestion but destroying the place didn't seem to be an option, so the family agreed, and she was placed in the psych wing of a local hospital the very next day. My daughter and I were called to come to the hospital to discuss my wife's history and to discuss a plan for her. After 12 days, the staff called and said we could come and take her back to MC. I don't recall the drugs that were used, but she returned a completely different person. She wasn't drugged up and could function almost normally. The staff established a wonderful rapport with her for which I was so grateful.

So, some facilities expect and plan for difficult patient situations. Luckily, I found one.

Thank you both. We know more medication is going to be necessary. My sister is still physically vital, but this disease’s affect on her personality is tragic. Her sons and daughter-in-law and I are just trying to make sure what lucid time she has left is not cut short too soon. We may not be able to control it, though, if she keeps becoming so agitated and reactive.

Feeling angry, upset and aggressive isn't a good thing for your sister, either! So not only is she suffering, but she's causing others to suffer which means she needs medication to control her dementia symptoms. Calling it "doped up" attaches a stigma to the art of trying to manage dementia effectively and thereby giving your sister a better quality of life w/o being asked to leave her memory care AL.

You can take her out for a second opinion, of course, but ultimately, the memory care AL will decide whether or not she can stay there as a resident based on her behavior. My mother had to stay on Ativan to control her Sundowning agitation and we were fortunate in that it calmed her down for the most part. Had we needed to medicate her with a stronger cocktails, we would have bc to see her so upset and acting out was awful. I would rather have seen her calm and "doped up" than screaming for her dead siblings all day. She was inconsolable w/o meds.

We all lose with a dementia diagnosis. There are no happy endings and we wind up taking the least bad of a bunch of rotten choices. The goal is to keep your sister as calm as possible and thats how she may be able to enjoy some quality of life nowadays. The meds help take away some of the angst and mood swings that threaten the calm we strive for. Dementia is as ugly as it gets.

I'm sorry you're facing such a predicament and I wish you good luck and Godspeed.

In the case of care placement it is utterly impossible to have patients acting out in an unsafe manner. It is a terrible liability, and often they need to move on to SNF care centers which have psychiatric arms; something rare now as hen's teeth.

There is often no good answer to this. Not only are drugs and drug cocktails very difficult to titrate and manage when the patient is in a facility on the other end of town, but they are almost impossible to find a good combo for, one that allows for autonomy and alertness while remaining mellow enough to be with others. Once found, these "cocktails " don't work over time.

I can only wish you luck. This is quite honestly about as bad as it gets in elder care manner with dementia diagnosis.