My husband has been in a geriatric psych unit for 3 weeks. Assisted living director suggested a placement to help adjust his meds - he was verbally aggressive during care, and getting worse. Upon entering, he was continent, ambulatory, and able to converse, even though he’s at a late stage. Now he is none of those things, and he is also physically aggressive during care. I am beside myself. Is this a typical experience?
It is a small community and most everyone despite being in varying stages of decline remained happy and optimistic.
Now the individuals are mostly unrecognizable.
Just In the past week she has developed combined
incontinence issues. Due to the sudden loss of control I am researching other potential causes. One of which may be
spinal stenosis.
In her twilight years, I expected mental decline and forgetfulness. After a serious fall, hospitalization and rehab her brain scans indicated she had a ‘perfect’ brain.
I now believe the ‘dementia’ May have been drug induced. She too was prescribed Ativan (PRN).
After being off the Ativan for more than a month she was administered a full dose.
Her blood oxygen level was dangerously
low. This too may be contributing to
her recent decline.
Based on my experience Ativan is harmful when prescribed to the
elderly. (Given a choice, she would choose Ativan and probably believes she is still having it prescribed).
Another good question is how the facility
handled medications when they return from rehab or hospital?
How they handle discontinued meds?
Are meds still on the med cart?
If med is PRN (and not on Med Cart) how
is it removed from premises so not
mistakenly administered?
If this is Assisted Living who is qualified to dispense meds? Full time, part time or temporary employee? Who is qualified to
order meds from pharmacy?
Mom was on hospice at the time and they recommended a smaller care home environment. So, hospice can help in these sorts of situations. The care home was a much better placement for mom and probably would have been from the beginning. But, we didn't know about them. The care home had a lower resident caregiver ratio and was cheaper. Mom also had private caregivers on and off for two years, yes it was private pay in addition.
Yes, it is a constant change of needs resulting from behaviors that, in mom's case, were often uncontrollable. Seroquel worked great for my mom, but ativan had the completely opposite effect as intended.
I would suggest that you ask about hospice evaluation, they may have some ideas that haven't been thought of. Don't consider bringing him home, that definitely would not work. Don't let hospital tell you that they cannot find placement. Stand firm in your knowledge that he needs more care than you can provide. It would not be a safe situation for anyone.
mom has been in memory care for over 3 years - she is fortunate in that we also have private aides with her
seroquel was prescribed initially for her but didn't help other than to make her sleepy so rather than increase it, we switched to risperdal which worked better for her -
at 96 and immobile, she still fusses but it is dealt with easily enough and she's been off Risperdal since early this year
I've seen many others walk in happy and pleasant, and within weeks, they're in a wheelchair - these anti-psychotic meds do take a toll
Once I took him to the ER for shaking and jumping all over. I'm not sure what they gave him but he became very uncooperative, trying to pull needles out, get up etc. They gave him another shot and he got worse. They were talking about releasing him. I told them that before I brought him I could handle him but at that point, there was no way I could. They decided to keep him for a couple days. That night he was out of his head and and it took awhile for him to calm down.
If you haven't already, I would fight the release, talk to the doctor, tell them what's going on, but It sounds like the medications may have caused some of the problems and needs to be adjusted or changed. I'm thinking you said he was in Assisted Living. If so you probably need to talk to the assisted living director, as this doesnt sound norm to me. But, no case follows the same path. While my husband seems to be in the 6th or 7th stage, his body and other areas aren't. I think you said your husband was in late stages.
My husband is going on 6 years since diagnosis but started with the beginnings probably around 4 years before his diagnosis. He is still ambulatory, continent, eating well, but will not bathe, or dress himself, very confused, sundowns, coherent sometimes, sometimes not, doesn't know me or even family and still gets belligerent with me if I refuse to let him do crazy things. He doesn't know why he's doing things but doesn't want to be told not to. This last year he will go to the bathroom and urinate in the floor. At other times, he uses the trashcans, closet, its horrible. Luckily he still finds the commode for #2. Diapers are not feasable for now as I think he'd refuse them or still do what he does anyway. So I don't know if the inappropriate places he urinates has anything to do with incontinence.
I do think he would probably go down a lot faster and would again have to be put on more behavioral medications in a nursing home environment. I suspect this may be what has happened to your husband. I feel the medicine has caused some of it and they need to get him better so you can care for him. I don't know, but maybe he's reached the point that you can't take care of him. If so, I hope you can arrange for permanent care as I'm not sure I can when that time comes.
I would be interested in hearing what happens with your husband and do certainly wish the very best for you as I know how difficult it is for you! I pray for all of us as caregivers and especially those of us who are doing our best with husbands out there. My Mom had it also but this experience with my husband is even worse. But we'll make it somehow, Right?
While I cannot really know for sure regarding his situation without knowing all the details, I have some thoughts on it that may or may not be helpful.
Sometimes, a change in enviroment can really take a toll on a dementia patient's behaviors. Any change is an upheaval in their world and may be part of the problem. Sometimes, also, when readjusting meds it takes awhile to see positive progress and it may take awhile to get the right meds for a particular individual since everybody responds differently to different meds. I realize that it is frightening and heart-breaking to see your husband in this condition and I am so sorry for what you are going through. Always feel free to ask any questions of the staff at any time. They should be eager to answer any questions at any time for you and your family and you should feel like they are very openly communicating with you. You also can request to speak with your husband's doctor in a meeting if you feel that might be helpful.
I would talk to the AL and ask them for help understanding and getting him a more appropriate drug regimen.