My husband's anger and aggression has gotten progressively worse even though his anti-depressants were increased a month ago. Our two grandchildren spent 2 nights with us and he was mad at me over something and yelled obscenities in front of them. When I asked him not to do that, his response was, "Oh you guys just need to grow up!" He told my granddaughter (age 5) that I didn't have time to hold her (she ws getting over the stomach flu and still was experiencing some pain) because I had things to do. To which she said to me, "Papa broke my heart." The day was a nightmare. When he left for a hockey game with his family I called my daughter and we talked about the day. When she came over to pick up the kids the next day, she confronted him about his behavior to me and to the kids. He just got more angry and railed back at her. Now he says they are not welcome in our home and he is NOT going there.
We have an appt for him to see a psychiatrist on Wednesday. I want him to evaluate him, and I am wondering if it is time for him to be in an assisted living situation. We have two nice ones in our city and we have long-term care insurance and I have POA. I have taken off 7 weeks from work to monitor him and his increased meds and when I ask him if he has taken his meds, he tells me it's none of my business. He told me he hates his life and one of these days when I come home, he will be dead. When he went over to his sons this pm to ask if he could rent a room, I hid his guns and bullets. Still have not found the pistol.
My kids are encouraging me to think about assisted living. Any thoughts?
If the increased meds have still left you with all these behavioral issues, let the Dr. know BEFORE the Wed. appt. And tell them of the suicidal talk and that there is a pistol unaccounted for. Remember, the rational button is broken. There is no reasoning or explaining going to work with him. Placmement may be advisable, or maybe a more extensive med eval./change. Above all, keep yourself safe. You can't take care of anyone if you are injured.
Loretta I assume this is a second marriage. How does your husband's family feel about this. Are they aware of their dad's problem and will they be there for you. My husband went the same very belligerent route against his own kids (and mine) this is our only marriage. If your husband's psychiatrist isn't willing to help and if you think your husband is a danger to himself and others a hospital admit for med adjustment may be in order. Even With a POA if you don't have legal guardianship you can't force your husband into assisted living. If he becomes aggressive they won't keep him.
Thanks for the responses ladies. Yes, we've both been married before. His kids are on the same page with me and my kids. I'm thankful for that. Legal guardianship ~ hmmm, basically, he wanted to rent a room from his son cause he says he can't live with me. He told me he needs to find a place but the problem is that he knows he can't take care of himself. Like carosi said, the rational button is broken.
First of all, make sure all of the kids fully understand that the reasoning button is not only broken, it can't be fixed. Never argue with an AD patient. It only get them more worked up.
I personally know of two spouses who recently went through what you are experiencing, except their situation turned physical. In one case, the right combination of strong anti-psychotic drugs calmed him down so he was manageable. In the second case, the Exelon patch was causing all of the trouble, and once he came off of it, he calmed down (He has FTD, so the meds. and their reactions are different than AD). My own husband was raging, arguing, and screaming so much, I thought I was going to have to be committed. Not him - ME. The stress almost killed me. Once he was put on Risperdal, the problem was solved.
I agree with everyone who said a medication adjustment is definitely in order. Carosi is absolutely correct - make sure the doctor knows the situation BEFORE you see him. Document each incident and be as specfic as possible. Either call him or fax him the information.
Loretta, you mention anti-depressants. Is he on any other mood-altering drugs, such as Seroquel or Risperal? Ativan to decrease anxiety? With the behavior you're describing I would think he'd need more than anti-depressants. Good luck, and please stay safe.
First, he is on Clonazepam for REM Disorder, then Aricept for AD, and then placed on Fluoxatine for depression. Now that it is Saturday, I won't be able to reach the psychiatrist until Monday.
sounds like you need to be prepared with a list of all the observations about his behaviour for the appt wed. there is a gap between the rock and hard place, when they arent willing to cooperate with meds or reasoning. if it were me, my choices would be simple. aggression and or unwillingness to take medications would tell me that it may be time to leave myself or allow him to find other living arrangements. you cant stay in an unsafe environment and if there are weapons unaccounted for you should notify his kids to come find it now. any and all weapons should be removed from the home and locked away. having small children around someone who is in that aggressive frame of mind is not healthy and can leave permanent emotional scarring. sometimes it becomes necessary to do for them and yourself first if the spouse is unwilling to get treatments that will allow you to become his ally- not foe. i also had to give potent antipsychotic meds for about 4mos to keep my DH at home during early yrs. calling 911 if he becomes violent to you or himself may be another option and at least that could get him placed into a hospital for evaluation. its never easy with AD but when they are violent and offensive its just so much harder. i sympathize with your situation. be sure the dr knows how YOU feel about your spouses actions. i wish you the best outcome. divvi
Lorretta--If your husband has been having anger and aggression problems, I wonder why his doctor increased the antidepressants instead of prescribing antipsychotics? They are different drug families that address different problems. Does the doctor specialize in the treatment of patients with AD?
My two cents worth...............why are you going to a psychiatrist ? I didn't realize that PSYCHIATRISTS treated neurological diseases. THE ACTIVE WORD here is disease, not disorder. Maybe I'm misinformed, (and it's too late to change anything we did for my husband)...but from the "get-go", we were directed to Neurologists...specializing in Neurological DISEASES. (Some neurologists work with strokes, others with cerebral pallsy, and similar deficiencies...LOOK FOR Neurological DISEASE Specialist).
I may be wrong about Psychiatrists...but it just thought it was odd that he was going to a "shrink" to treat a disease.
Nancy--Steve's doc is a neuropsychiatrist who only deals with AD patients and does AD research. Hopefully, that's the specialty Loretta's husband will be seeing. I agree with you that a regular psychiatrist would not be the best choice. This disease is tricky enough to manage, even if you're seeing the right kind of doctor!
For yoour OWN PROTECTION and his well being, make sure he does more than "deal" with them. If he is not up on the difference between tranquilizers and anti psychotic drugs, he won't be the best choice for your husband's care.
My husband regularly sees a neurologist at the University of WA, she wanted to refer him to a colleague who is a psychiatrist and deals with AD patients, but she couldn't take us. So his GP found one who deals with AD/dementia patients. I just want to see what he offers us. If he tries to "counsel" us, it will be over for me as he is way past listening to the right thing to do. And as you all know, they don't retain ~ hello? The referral from his neuro was because of his anger.
Oh by the way, he's 68. Thanks for all your coments. much appreciated.
It would be a wonderful thing if talk therapy could do anything to help an AD patient. From everything I've read, because of the memory/reasoning/judgment problems endemic to the disease, and the lack of awareness of what is happening to them (anosognosia?) traditional psychiatry just won't work. Please keep us posted on what the psychiatrist says or prescribes.
Loretta, does your husband have a neurologist? The reason I ask is that no one here in over two years has had a successful encounter with a psychiatrist and have wasted a lot of money on them. Unless it is a neuropsychiatrist who deals with Alzheimer's. Dementia in general is different, though Alzheimer's is dementia related, it is different. Medication has to be found and quickly....the right medication. Keep the grandchildren away until his medication has leveled him out. And many spouses have been threatened with divorce, and some even convinced their children to help them get a divorce! Even with AD!!
AD spouses can't deal with stress, with arguing, with anything disagreeable, no matter how wrong it might be. They can no longer reason; and trying to tell them they are doing wrong is trying to reason with them, and it just creates more problems. They can not understand. They can not help the way their mind is working, and what they say one day, they may or may not remember the next day.
Like the others, I recommend you find a neurologist Monday morning and get him in there quickly and take the time tomorrow to type up everything you can remember about how his personality has changed; instances of horrible behavior; any threats, especially with the guns; and memory; visual or written perception problems (reading, writing, bumping into things, dropping things) - these will help the neurologist. Also get your attorney to see about your obtaining guardianship so that you can have him committed, if you need to, if medication fails.
The others have given you excellent advice...I hope we have been able to be of help. Please let us know how the appointment with a neurologist, not the psychiatrist goes....remember, Alzheimer's is a disease, not a mental disorder.
My husband sees a psychiatrist who keeps a check on his anti-depressants and his seroquel. He doesn't do "talk therapy" with him. My husband sees him every 6 months, but our situation may be different in that my husband was seeing this doctor for depression years before FTD raised its ugly head so he knows my husband well. I sometimes think the appointments are more for me because he asks me if I need anything or what my observations are on my husband's behavior. This doctor does listen to me and has raised my husband's dosages upon my request. So for us this psychiatrist is helpful.
Loretta-in a perverse way you are fortunate to have found us. I know I had to wing it alone for too long because I didn't know such web sites existed. I didn't know that other spouses were out there and feeling so alone. It is so different losing your life partner rather than an old relative. The combined experience of the group will get you through this monster.
Oh boy, today has been a doozie. My husband woke up crying and angry with me all over again. As the day progressed, he just got angrier. I listened to his side of the conversation on three long phone calls as he berated me and I heard him tell his son that he will divorce me because if he shot me he would go to jail, and HE IS NOT GOING TO JAIL!! His only problem (as he told it) is that he doesn't know what he's going to do because he knows he can't take care of himself.
So far, he's looking forward to going to the psychiatrist on Wednesday so he can tell him all about me. I know that he is sick, but it still hurts.
I have emailed his neurologist again today to let her know things have escalated. She has been out of town, but is back in the morning. She'll have 2 emails from me.
UPDATE: So much has happened in the past 5 days. Monday ended up with me calling 911 for help. Wednesday we saw the psychiatrist and he is now on Trileptal which is a mood stabilizer. I hope this works. Both the neurologist and his GP were involved by phone to us. We go back to the psych in 3 weeks. I have not felt much like writing. The emotion of the past several days has been overwhelming.
Loretta--so sorry to hear of all you've been going through. When I looked up Trileptal, it said it's for epilepsy and prescribed off-label for bipolar. I was wondering if you were told why it was prescribed for your husband as opposed to something like Seroquel?
Loretta find your own level of comfort. Our site is a place where you can express very negative feelings and be understood. Sometimes it helps to vent-and sometimes not
Loretta, thanks for the update. I'm not sure if I read through correctly but sure hope the Trileptal works especially if he is there with you. If not for Risperadol, we were on the brink of admitting to a psych ward for evaluation etc. Sometimes its hard to wait out that 3 weeks to see the psychiatrist if the medication isn't working. In fact I hope you won't wait if things aren't leveling off now. Good that your GP and Neuro are handy. I sound like a preacher who doesn't heed her own advice..But we do have a plan and if the agitation overpowers the Risperadol..we'll have to do something more drastic. Fortunately for us, his doctor is fully on board and will help in any way he can.
Marilyn, It's also prescribed for AD aggression. I looked it up on an Alz site also. The pharmacist carefully explained it to us as well, and his GP looked it up as we were in his office on Thursday.
The psych explained that often AD patients are in a state of depression and some then go into the aggression stage. (as you know, some don't)
Thank you for your concern ~ as you all know, if you've met one AD patient, you've met one AD patient. It is true that no two are alike, nor is their behavior alike. My friend's mother has AD and she is the same sweet little lady, just extremely forgetful.
Loretta, There were two things in your original post to jumped out when I read it. The first was that his daughter confronted him about his behavior around the kids. We all know that confrontation does no good, it only makes things worse. The second was that you ask him if he took his meds. Does he take his meds on his own? I know I had to give DH his meds or he wouldn't take them. Not only give but make sure he swallowed them. Then crushing them and mixing them with apple sauce or some other food, because he would not swallow them.
Other than that, I fully agree with what everyone else has said. He may have to be hospitalized to adjust the meds. Take care of yourself and keep yourself safe.
I found it interesting that Loretta's DH doc prescribed Trileptal. My DH has taken 300 - 900 mg daily for YEARS to treat his "on again, off again" trigeminal neuralgia (neuropathic pain). For the past year or so he's been on only 300 mg each morning as a preventative.
Loretta, at this point my husband still takes his morning meds on his own. They are in an organizer in a very visible place. I do check that the day's container is empty each day, and most days I actually am in the kitchen while he is taking them, so I know he isn't just dumping them somewhere. I hand him the evening pills, currently only two of them but soon to be three as we are changing him from a capsule to a pill on one med.
Finding the right balance between letting them do as much for themselves as they can for as long as possible, and keeping them safe isn't easy.
Loretta: I can't help you, but, I wish I could. You are getting some good advice here and these are your friends.
On the meds, I have to get them ready and tell my DW when to take them. She couldn't possible handle that chore by herself. However, I don't mind. Also, Starling hit the nail on the head (as they say in the South and as she often does), when she commented about 'Finding the right balance'. At our house, this is a never ending chore.