I am POA for my aunt and her health has unexpectedly turned for the worst. She has transformed into a different person and has become severly combative with the hospital personnel, doctors, etc. She now cannot walk, seems to be confused and disoriented, very, very disrespectful and doesn't even want to talk to me. In fact, she told me not to call her "aunt." I live out of state and have a short turnaround time to find her a rehab/nursing, perhaps even long-term, if she doesn't come back to her senses. Any suggestions????
Haloperidol is not especially good at genuine sedation, and its risks are very high in the elderly. Not FDA approved for demented, psychotic elderly. Black box warning, in fact.
There is a safer drug than haloperidol but it is IV-only, from what I can tell. it's called dexmedetomidine and is mainly one of the drugs used in general anesthesia.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2717438/
However, there is now a version for dogs who are scared of thunder and it is applied on the gums. I'm getting ahead of the science here...I think it sounds better than Haldol and I hope it can eventually be used without the IV route, in time for my old age.
There are ways staff can behave that increase combativeness and ways that decrease it. A lot of times they think it's an ego war and insist on things that don't matter. See if you can get some time alone with your aunt and find out what is going on. She might need some time just sitting without talking first...
Look for online reviews of the facility, too.
I can 1st-hand attest to:
Too many drugs, not enough drugs, wrong drugs, wrong doses, wrong delivery of drugs, bad treatment, _chemicals used in facilities_, perfumed staff, overwhelming noise levels, staff interrupting sleep, UTI's or other infections, missing glasses, missing hearing aids, wrong hearing aids [mixed up with other resident's!], and much more, can drive a frail elder over the ledge of behaviors.
And:
Facilities coerce staff [under threat of being fired] to document to put the facility in a good light" [mis-document] to look good on paper...even in a hospice unit where people are dying anyway!
And:
Some facility DON's threatened to fire RN's who try to advocate for the patients by requesting Aids to wash off loud perfume [they worked with COPD and asthmatic patients!].
WHY mention chemicals?
Because SOME commonly used chemical cleaning agents trigger really bad behaviors in some people; very few realize this.
Other chemicals can trigger instant fluid build-up in airways [instant pneumonia of unk. origins].
Most people, and Medical professionals as well, are clueless of this, so fail to make changes to using safer products for cleaning, air-freshening, and for antimicrobials.
There ARE safer alternatives; some hospitals are starting to use them; they are NOT listed by State, County or Federal agencies, which are generally still mired in toxic chemical use.
Search: non-toxic cleaning, to find many sites with alternatives to chemical cleaning agents.
And please get your aunt to a Doc who is willing to examine all these various potential causes for sudden behavioral problems!
I am always for trying the right meds in the correct does.
Get her to a geriatric doctor. Family doctors go too soft on the meds and that won't help.
What is the alternative to AL? Living with you?????
I don't know where your aunt is staying now, but I did wonder if it was time to get a higher level of care for her. Rehab sounds like a very good idea, maybe in a place that can become LTC if she needs it. I don't envy the task in front of you.
Have you asked the hospital staff for recommendations on a nursing home? Have you spoken to a social worker about how to get your aunt transferred if that's what she needs? There are a lot of resources at your disposal while your aunt is hospitalized. Take advantage of them while you can.