My DH often gets agitated and angry with me. He is fine with his caregivers who take him for a walk, etc. He was an Aricept (since Dec. 08) and is now changing to Galantamine (starting about 10 days ago). I tried Depakote, but didn't help. Some days he is fine with a sense of humor, other times so upset. I just can't figure out what happens when he changes his moods so quickly. Today he started off already very upset and agitated. It got worse in the afternoon. He seemed in emotional and mental agony, kept talking non-stop. Getting himself angry, then chuckling over something, then he got upset at me, then saying he can't stand it any more. On and on. I felt so helpless. I gave him a 25 mg Seroquel, which I had tried months before and it made him fall asleep. I just had to do something. After 1 1/2 hours he quieted down. He said he felt better. We took a walk; however, his speech was slurred, he said nonsensical words and then kept falling asleep during dinner. His neurologist keeps suggesting different meds (we e-mail). Some of those have side effects that are scary. Some conditions he already has would be enhanced because it could be a side-effect. Do these doctors not check the medical records?
A few weeks ago, while I was chopping vegetables for dinner, my DH grabbed my knife by the blade and was angry about something. Another time he was upset at me pulling weeds in the garden. I tried to stay calm, suggesting he help me, but then he just kept mocking me and tried to throw all the pulled out weeds back into the garden. Othertimes he seems so sweet and loving. Where does a person get help. A friend suggested Dr. Amen's Clinic to get his brain evaluated. I personally don't think that would help. Anyone have experience with Dr. Amen? How about a Geriatric Psychiatrist? I dont' want to over-medicate; however I can't easily deal with these changing moods and aggressions.
My husband is only 68. He was diagnosed with AD in 2008. I believe he is in stage 5. Still dresses, (in layers) showers. He is on his best behavior with others; although easily angered. He loves me and tells me that and shadows me. He plays the piano and still plays beautiful music (his own compositions). He can't focus thoughts and shifts from one idea to another.
Some of these meds scare me -- however, now I'm happy he is sleeping in front of the TV, still knocked-out from the Seroquel I gave this afternoon.
Monika, I'm sure others will be along soon. We've had agitation here to nearly the same degree. UNTIL Risperadol was prescribed. The 'warnings' scared me too and no we didn't want DH to be a zombie..We just desperately needed him to stop the maddness! We live on a farm. Every day was a new awfulness. He was mad at everyone nearly all the time for various 'reasons'. We were ready to have him put in the hosp for psych eval..as that was the next step..but doctor wanted to try Risperadol. It has made a world of difference here. I will say that I think DH has declined more, is not as active. He was diagnosed in 2005 and is 71 now.We noticed something was 'wrong' 5 years before, so its been 10 years. I don't know if the decline is due to medication OR the natural progression of things. BUT more than once here, I've praised that medication..it has calmed the fury.
Monika, we have discussed your husbands condition (and ours) at length in the past discussions, because most of our spouses experienced the same things that you are experiencing now. The problem is all of his symptoms and stages are AD. Taking him to other doctors will only be expensive and not really give you any knowledge that will help you. It is what it is. Alzheimer's.
My husband was diagnosed in February 2007, and was 68 when I knew he had AD, and he's in the final stage now at 71. All you can do is make them as comfortable as possible through each stage and make certain that they don't hurt themselves. And come here for answers to any questions you may have. He's going to continue to decline, and you want to keep him functioning to some extent if possible.
While you might not like the fact that the medication makes him sleep too much, his brain needs it now. When he is agitated, the medication brings him relief. You may be approaching the time that he can't go on walks any more. It will come. We end up pulling back from activities until they are chair and bed bound. We learned not to expect them to be as active as they were. Flexibility is our new word.
"Pharmacology is our friend" was our motto. If you haven't read the discussion on Caregiver's Tips here, please do so.
AND WELCOME!!
More will be along with good advice soon. (((((HUGS))))
Monika, pharmacology is our friend. DH was violent for 2 years on and off. When wefinally got the initial diagnosis (pre-senile dementia) the neuro tried different meds to calm him. It wasn't until the 2nd stay in psych hospital that they got the med regimen correct. Risperdal didn't work for us - made him a zombie with tremors. Tried Depakote but had side-effects, Ativan,& Haldol (didn't work), finally put him on Seroquel, Clonopin and Neurontin which seems to be working. A geriatric psychiatrist would be an option. DH's geriatric psych told me it was a trade-off - calm the rages/violence with meds and take the health risks or let him rage and potentially injure/kill someone with greater consequences (such as jail). Yes, the drug warnings/side-effects scare me too, but they have enabled him to be non-violent and living at home. That is what I've chosen.
Kep in mind, the warnings are therebecause the elderly and the dementia patients were not tested when the drugs were safety tested, so they cannot say they're safe for those populations. Alsom they don't sa the meds will shorten life, but they could. Our LOs have diseases which are already shortening their life. Having some quality for what life they have left is more valuable than whether they might live a little while longer(in a worse hell)without these meds. IMHO
As others have already stated, drugs are our friends. Even though my husband showed absolutely no violent traits, he would become agitated and anxious. He would pace and pace, move furniture around (we used to say he danced with the chairs). He got to the place where is slept very little and walked himself into exhaustion and couldn't walk for falling, only to try to get up and go again. Many drugs were tired and finally Seroquel did the trick. Work with your doctor to find what works. You both need relief.
If you get the Az Dementia Weekly this week they have Richard Taylor, that psychiatrist with EOAD, answering the question from a woman with dementia: if I get agitated what should I do? I don't want to take meds. He suggests nice little things like eating, or playing with your grandchildren, and only in the last resort taking pills. Boy, I sure don't want any agitated spouse playing with MY grandchild!! Here we agree, meds are our best friends.. I agree with Carosi, ignore the black box warnings. As we go into the later stages I can't imagine avoiding anything that would help him even if it did slightly shorten his life!
Monika--You have already described an outright dangerous attacvk on yourself. I know you're planning to consult an attorney about taking Guardianship. That process will take some time. Even after that, there is a procedure to go through to make things happen. Until all that happens, establish a safe place to retreat to, out of harms way, and keep a phone on you. Don't threaten calling the Police--DO IT! Even now, as soon as you can, contact the Police at their non-emergency number and ask them how to establish with them the fact you LO has Dementia; could lose control and become a danger to himelf or others, and need to be taken to the hospital for a medication modification. Once he's at the hospital, the personnel will be able to act, and probably back you up in having him committed for medication adjustment and/or whatever else needs be done.
I was scary to see my husband grab the blade of the knife. I tried to stop me from chopping vegs to get his attention. I was worried he'd cut himself with the blade. He wasn't trying to attack. However, what is a concern are the unpredictable behaviors. One thinks, "if he grabs the knife blade, what else he might do." I have a couple of rooms with locks and can go in there, should the need arise. When he is o.k. it seems like a faint nightmare. Sometimes I wonder what I am contributing to his behavior. Sometimes caregiver advice doesn't quite work (i.e. distractions). Some people are had to distract. Othertimes one just has limits of one's own personality and energy.
Of course Ann, but that doesn't mean ALL medications have bad side effects for ALL people. I doubt anyone on this board (or their spouse) thrives entirely on sunshine and good food and exercise.
Monika, I was so afraid of giving my husband Seroquel because of side effects, but the agitation and the anger got so bad that I asked the good people on this site what to do and I received the same answers you did. I decided to give him the medicine. Since he has been on the Seroquel he has been much easier to deal with over the past 6 or 7 months, but in the last couple of months he has become very angry at times. When he gets angry he screams loudly at me. If I call him and he doesn't answer I'll call in a slightly louder voice. He answers with a shrill yell, "What????" It scares me half to death. He never shouted at me before he had his FTD diagnosis. He hasn't been violent and I sure hope that doesn't change. But he does have paranoia, which worries me very much.
His doctor told me to give him another 25 mg of Seroquel if the two 25 mg doses aren't enough, but I haven't figured out how to do that, since he always counts his meds when I give them to him or when he takes them out of his cassette and would be sure to ask me why he has two pills instead of one. Maybe someone could tell me what they do when they give an extra dose to their spouse?
I am trying extra hard to ignore the things he sometimes says that upset me and just walk away or take a deep breath. I know it's the disease and not him, but sometimes I forget.
Get your doctor to give him something to calm him down. I don't worry about the side effects anymore. Better that than have him agitated all the time.
Bev, hide the extra pill in yogurt or applesauce or even ice cream or anything else which would hide the pill. I'm lucky-when we increased DH's dosage I just told him the extra pill would make him feel better. He seemed okay with the explanation.
Bev, not sure since I have not tried this approach, but others here have. Perhaps they will let you know. I would ask dr. or pharmacist if the pill can be crushed (without consequences) and then try it in something. It's worth a try - what do you have to lose?
Mine just can't swallow even the tiniest pills - he does fine with real food, but swallowing with water doesn't work. So for a good while now I've been crushing the pills and putting them in yogurt in the morning and ice cream or frozen yogurt at night. Occasionally I've gotten a fleck or two on the spoon that I allow myself to clean after I've mixed it all up, and whatever, it's bitter. But it doesn't seem to bother him at all. If you decide to try crushing, go get a mortar and pestle at Bed Bath & Beyond, and use it. The "pill crusher" you get at the drugstore is no good.
briegull- remember that taste all too well. For a while my husband was still using his tongue on kisses. Well, one day he kissed me right after having his meds....... It is very good that their tastebuds go with this disease - there is no way you could hide a pill like that for a "normal" person.
Monika - when my husband would get agitated, I would often waltz with him. It was a soothing motion and he liked holding me close so that worked well for us.
Keep in mind that they are emotional baramoters. If you get upset or agitated even if you think that you don't show it, they will pick that up and react to it. So if you are calm and respond calmly, you have a better chance at calming him down.
Living better with chemistry is a very true thing for dealing with the disease. The warnings on the meds are frightening however, sad as it is, is it really a bad thing if the medication hastens death versus them ending up like zombies in a wheel chair? My husband is in stage 7 and almost one of those zombies - that is not his definition of life at all.
There is a thread somewhere that discusses which is better: living with agitation, anger, rage, etc. or taking meds that help it but have the black box warning. I think everyone concluded quality over quantity that includes the safety of the caregiver.
Monika--you said " sometimes I wonder what I am contributing to his behavior". I know that in the early stage, before I learned to control my emotions around DH, things were a lot worse. As Therrja said, they are emotional barometers. I even heard it described as "they have extra sensitivity to tone of voice, body language, etc." as if it is an attribute! I find that now I'm in the habit of smiling at my DH constantly, because I think it reassures him that everything is ok.
Thank you all for your helpful replies. It's not always easy to get to the computer and have some privacy. This morning I actually wrote a message, and it wouldn't send! I poured my heart into it (one of those emotional storms that just sweep over). I lost the message and I think next time I'll just have to copy it first before sending it.
I did try 1/2 Seroquel a couple of days ago (per discussion with Dr.). We were having dinner and I left the room for just a few minutes to get some fruit. When I came back my DH was eating the roses in the vase.
Now I have a prescription for Zyprexa. Another scary med. Haven't given it to him yet. He has been having some good days and I can't justify trying it out while he is in a good place.
I'm trying to reassure him that I love him because he has been so worried that I have someone else and that I don't love him. There are just so many things to think about and to be aware of.
It amazes me how one's own emotions can change so quickly. Sometimes there is so much sadness, heartbreak, grief. I try to stop myself of thinking too much of what will be. Sometimes I feel so much regret of not having been a better wife, of not having been more loving, not having spent more quality time together. It is easy to torture oneself with all of these thoughts of past events and what will be in the future. So often I got upset about when my DH retired of not being able to have a quiet house just to myself at times. Now, sometime soon, there will be too much quiet with him gone.
It's also so sad that many of my friends just seem to ignore us. They don't call, or even e-mail. In a way I can understand. Unless you really experience this path, not just theoretically, but with your heart and body, you can't truly understand what it is like.
So much more wonderful to see so many caring people on this site. Thank you