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Medical Forum / Diseases and Disorders / Alzheimer's / July 2005Father In Psychiatric Center
My Father was diagnosed 13 months ago with Alzheimer's. The doctor said that he was moderate to severe with a score of 26, if I recall correctly. The last couple of weeks have shown a significant decline in his memory. He has become extremely paranoid and violent. He cannot recall a conversation that took place moments earlier. We can deal with the memory troubles because he can still function in everyday activities. However, the violence is unbearable. We were able to get him placed in a psychiatric hospital and the Doctor said he is going to start him on an anti-psychotic drug. He mentioned that there were five primary drugs of this nature. Can you tell me the names of these drugs so that I may research their effects and affects? Thank You, James Hendrix > My Father was diagnosed 13 months ago with Alzheimer's. The doctor said > that he was moderate to severe with a score of 26, if I recall correctly. [quoted text clipped - 15 lines] > > James Hendrix why dont you just ask the doctor? better that than have someone here come up with a name, you spend a lot of time researching it, and then find that its wrong, or its not been prescribed.  SignatureTumbleweed email replies not necessary but to contact use; tumbleweednews at hotmail dot com > My Father was diagnosed 13 months ago with Alzheimer's. The doctor said > that he was moderate to severe with a score of 26, if I recall correctly. [quoted text clipped - 15 lines] > > James Hendrix James, there are a few of them. In my mother in law's case she was given one called Risperdol. It was very effective against agitation and delusions. But there are others. You need to weigh the up-front effects against the side-effects, and if you ask me, violence is something that you absolutely need to consider first priority, no matter what the side effects may be. You need to see how it effects him and how much is needed to keep the behavior in check without the side effects being too bad. In our case we discovered that the need for the drug diminished over time, and we were able to reduce the amount as time went on, and after she was admitted to the nursing home, the drug was stopped altogether. Everyone is different because the brain deteriorates in a different pattern for different people. Our experience may not be what your loved one experiences. So if I were you, I would trust the doctor and know that he is probably going to choose the one that is most effective for the kind of behavior you are seeing, with the least possible side effects. SignatureBest Regards, Evelyn (to reply to me personally, remove 'sox') >> My Father was diagnosed 13 months ago with Alzheimer's. The doctor said >> that he was moderate to severe with a score of 26, if I recall correctly. [quoted text clipped - 32 lines] >is probably going to choose the one that is most effective for the kind of >behavior you are seeing, with the least possible side effects. My mother is on Risperdol, too. It has been a godsend in reducing her delusions and aggressiveness. She is, however, much more inclined to sit around all day and do very little of anything now and I am sure that this is due to the Risperdol. Her Psychiatrist also advised me that it could affect her balance, so falls can be a concern. She is clearly less sure of herself and moves slowly and deliverately, holding on to railings and watching the ground carefully. That's a good thing, but it is something we are watching and aware of. If you haven't gotten your father to a Psychiatrist specializing in elder care, you should do that. They are much better equipped at prescribing anti-psychotics. -steve <snip> > My mother is on Risperdol, too. It has been a godsend in reducing her > delusions [quoted text clipped - 13 lines] > anti-psychotics. > -steve my father is exactly like that that (as are most of the inhabitants of the home he is in) and he certainly isnt on Risperdol, I think it goes with the age and the condition. People do sometimes get concerned about them sitting around all day, but I think thats because they visualise themsleves in that situation. If you only have a memory of 5-10 seconds, then you have only been sitting around for 5-10 seconds, so boredom isnt really an issue. Thats not to say they shouldnt be given activities to do, but there is a limited point to them compared to someone with unimpaired mental functions. As long as my father is happy/content, thats the main thing. And restricting violence is defintely going to help in that regard. That also applies to the other inhabitants of the home as well, one person *not* on such a medication ina home can cause alarm and harm to many others, all to avoid some theoretical side effects that in many cases are only of interest if you expect to live another 25 years, not 5. SignatureTumbleweed email replies not necessary but to contact use; tumbleweednews at hotmail dot com >>>>why dont you just ask the doctor? better that than have someone here >>>>come up with a name, you spend a lot of time researching it, and then >>>>find that its wrong, or its not been prescribed. I was trying to get a head start. We meet with the doctor tonight at 7. His violence has been replaced with humility in the last two days. I didn't tell you guys in the earlier post that he was arrested on Friday and spent the weekend in jail. It took an "act of congress" to get the judge to send him to a treatment facility; there is no way he would have gone with us. The judge said she hadn't the authority to send him anywhere. She stated that she could only set his bond and possibly require him to talk to the jail psychiatrist, who COULD send him to a facility. She finally agreed to meet with him in chambers. She said that he was nice and very calm, but that he made one statement that concerned her. She told him that if he continues to respond aggressively to others, one day either he or another person will be hurt. His response: "I hope so." She then referred him to the jail doctor. It didn't take him long to decide that there must be an intervention. We are extremely relieved. My fatheer is a tough 72 year old. He was golden gloves champ in Texas and Virginia in his day, and he was a member of the Naval boxing team in the late 40s. He has put that experience to use over the years in the nightclub that he owns, and has stayed fit and strong. He is really a bull. It took three deputies to handcuff him. He then assaulted two jailers when they tried to put him in a cell. We are longtime friends with the sheriffs department, so they allowed us to view the tapes of the incident. It scared me. I have never seen him achieve the sort of aggression that I witnessed that night. The change in his temperament has been rapid. It is as if someone flipped a switch in his head. Two weeks ago he was a different person and now.... Well, I just wanted to share with persons that understand. Thank you, James >>>>>why dont you just ask the doctor? better that than have someone here >>>>>come up with a name, you spend a lot of time researching it, and then [quoted text clipped - 36 lines] > > James that is scary...I believe that with *some* people, Az releases social inhibitions there may be..for example, I have heard read here of "sweet little old ladies" suddenly swearing like troopers and making sexual allusions that would make a porn star blush. I guess the point I was trying to make was that one can get overly concerned about 'side effects' without considering the situation. Lets say there was a side effect that meant that the risk of cancer was ten-fold. Maybe that is way-better odds and a better choice than the absolute certainty they would be hurt or would seriously hurt others. If they are only going to live another 5 1-0 years, and most of that would be v low quality of life, better IMHO to have 2 or 3 years *now* of good quality of life, and perhaps on average die a year early, than 10 shitty years. Not saying thats the choice, but side effects are never 100% anyway, my dad has been fine on aricept but there isa small but significant minority who are unable to take it because of significant nausea. Lets not go down the route that says 'no taking X if there are any possible side effects" Good luck tonight.And I wonder if he can recall his spell in jail now? SignatureTumbleweed email replies not necessary but to contact use; tumbleweednews at hotmail dot com you make a good point about the side affects. he does recall events while in jail, but his recollections aren't correct. He believes there were eight men that beat him while one was filming. He does not know why he was arrested. Part of the game, I guess... >>>>>>why dont you just ask the doctor? better that than have someone here >>>>>>come up with a name, you spend a lot of time researching it, and then [quoted text clipped - 57 lines] > > Good luck tonight.And I wonder if he can recall his spell in jail now? >>>>>why dont you just ask the doctor? better that than have someone here >>>>>come up with a name, you spend a lot of time researching it, and then [quoted text clipped - 32 lines] > > Well, I just wanted to share with persons that understand. James, My FIL had the same issue. It took going inpatient in a psychiatric ward to get his meds balanced in a way where he became his former docile self. MIL never shared the info on what the meds were, though. I agree with the others, unless a side affect has immediate impact on health or safety (making them too woozy to stand/walk safely, etc.), side affects should be lower on the list of concerns than controlling the aggression. Please be aware of some issues which arose for our family: 1 - Many dementia patients forget they have health issues and then refuse to take medication. This can become dangerous to caregivers when a volatile patient refuses to take medication. My FIL's tendency to become 'combative' was the final straw that put him in a NH. My MIL just couldn't get him to take his medication and he'd get aggressive if she tried to press the issue. If your dad is that strong, the medical/psychiatric team needs to come up with a plan for this possibility. 2 - Psychiatric facilities are not set up for dementia patients. Example: Dementia patients often do not attend to hygiene because they can't remember the order in which one showers, etc. But psychiatric facilities will not help a patient shower, as the ability/desire to attend to those kinds of needs are a psychiatric issue. Whether or not someone showers will let them know whether meds are working or not. Sorry you are in this situation with your dad. Adelle thanks for your insight. don't be sorry for me, though. far more suffer greater than i will. i am grateful that he still knows me and still wants to fish. i have prepared myself, as others in the family have done, for what is to come. the hardest part will most likely be the point where i might have to introduce myself to him. but still, he has been a wonderful dad and an excellent provider. what more can one want from a father? wiping the tears from my cheek, james >>>>>>why dont you just ask the doctor? better that than have someone here >>>>>>come up with a name, you spend a lot of time researching it, and then [quoted text clipped - 63 lines] > > Adelle James, I'm afraid you may have many more tears before this is over. Unfortunately, it only gets worse, not better, unless medication handles the problem. You have my understanding and sympathy. Gwen > thanks for your insight. don't be sorry for me, though. far more suffer > greater than i will. i am grateful that he still knows me and still wants [quoted text clipped - 74 lines] > > > > Adelle > thanks for your insight. don't be sorry for me, though. far more suffer > greater than i will. i am grateful that he still knows me and still wants [quoted text clipped - 6 lines] > > james Dear James, Please don't ask us not to feel compassion for your circumstances, since we all are here as caregivers for loved ones with this illness. We cannot help but feel compassion for anyone who is in this club that no one wants to join. Sad to say this is a disease in which the family deserves and earns as much compassion as the sufferer. Sounds like you are in for a rough ride with your dad. The illness affects everyone differently. Not everyone has a tendency to get violent, but it makes caregiving a lot harder. In our case it was my husbands mother who had the illness. She is now deceased as of April, but I remain on this group because there are newcomers to this journey every day, and having been down that road, I remain to give back, because there were those who stayed and gave me advice when I first came here. Believe me we have all shed a lot of tears here, and as usenet groups go, this is one of the kindest groups there is. I found it to be a valuable resource in so many ways. SignatureBest Regards, Evelyn (to reply to me personally, remove 'sox') > The change in his temperament has been rapid. It is as if someone flipped a > switch in his head. Two weeks ago he was a different person and now.... > > Well, I just wanted to share with persons that understand. You have my sympathies on dealing with this. My grandfather attacked his neighbor across the street with no apparent provocation and spent a night in jail for it. My grandmother had refused to that point to deal with the issue, but the judge informing her that he would either get treatment for Alzheimer's or go to jail for assault cut through the denial. Even my MIL, who was the world's warmest, sweetest woman prior to onset and decline, was combative at different times. She ended up in a locked unit for about three weeks while they worked out what combination of medications would stem the violent impulses (she had knocked a picture into the fish tank in the lobby of the nursing home, and then she pushed one of her fellow residents' wheelchair into a wall and kept slamming the woman's knees into a radiator) without turning her into a zombie. Beth SignatureDon't go around saying the world owes you a living. The world owes you nothing. It was here first. ~Mark Twain thank you i hate to think it might take time to work out the meds. until i read your post i kind of expected to see a different more improved man tomorrow. >> The change in his temperament has been rapid. It is as if someone >> flipped a switch in his head. Two weeks ago he was a different person [quoted text clipped - 17 lines] > > Beth > thank you > > i hate to think it might take time to work out the meds. until i read > your post i kind of expected to see a different more improved man > tomorrow. Some meds work quickly and some don't. I am happy to report that the Risperdol worked like magic for my mother in law, but then she wasn't really violent, she suffered more from upsetting delusions. SignatureBest Regards, Evelyn (to reply to me personally, remove 'sox') And it took a couple of days back on Risperdol before my MIL settled down. Her doc had tried to take her off but when she tried to break a window to get to "her car" and the next day slapped another resident, we told him to put her back on it. When she first went on Risperdol, it took 3 weeks on the locked Alzheimer unit in her town to get her to the point where she wasn't trying to attack people with her fingernails and slap them. It was _not_ a pleasant time. This last weekend I noticed the memory care facility she is in (now in our town) has a new resident that is having similar problems. He threw his water glass across the table at another resident and hit him in the face. They do experience tantrums but unfortunately it's tantrums backed by adult muscle. IMO, if there's no cure, quality of life counts for more than what might be a side effect 10 years from now. And the drugs allow her some dignity that she can't have any other way. That's worth a lot because if there's one thing Alzheimer's takes away, it's personal dignity. Karen > Some meds work quickly and some don't. I am happy to report that the > Risperdol worked like magic for my mother in law, but then she wasn't really [quoted text clipped - 6 lines] > > your post i kind of expected to see a different more improved man > > tomorrow. And it took a couple of days back on Risperdol before my MIL settled down. Her doc had tried to take her off but when she tried to break a window to get to "her car" and the next day slapped another resident, we told him to put her back on it. When she first went on Risperdol, it took 3 weeks on the locked Alzheimer unit in her town to get her to the point where she wasn't trying to attack people with her fingernails and slap them. It was _not_ a pleasant time. This last weekend I noticed the memory care facility she is in (now in our town) has a new resident that is having similar problems. He threw his water glass across the table at another resident and hit him in the face. They do experience tantrums but unfortunately it's tantrums backed by adult muscle. IMO, if there's no cure, quality of life counts for more than what might be a side effect 10 years from now. And the drugs allow her some dignity that she can't have any other way. That's worth a lot because if there's one thing Alzheimer's takes away, it's personal dignity. Karen > Some meds work quickly and some don't. I am happy to report that the > Risperdol worked like magic for my mother in law, but then she wasn't really [quoted text clipped - 6 lines] > > your post i kind of expected to see a different more improved man > > tomorrow. > i hate to think it might take time to work out the meds. risperdol is one of the few fast acting anti-psychotic and anti-delusional drugs. unfortunately, it also has some side effects from long term use. there are some other drugs that are also very effective, but most of them take several weeks to become fully effective because the level in the blood needs to build up to a therapeutic level. it can also, in some people, have the opposite effect to what is intended ... so the fact that he's where he can be monitored is a good thing >> i hate to think it might take time to work out the meds. > [quoted text clipped - 4 lines] > become fully effective because the level in the blood needs to > build up to a therapeutic level. |
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