I have recently started giving DW this med. She has been getting very agitated in the afternoon. She is only taking 0.5mg and I have not been giving it every 6 hours, only as needed. This works great for her except, she is more unstable, and has fallen a couple of times. She will stand up and loose her balance. I have always thought how terrible it is to medicate the elderly in order to make it easier to care for them. I now find my self thinking about using the med more, just to make her not so combative. I feel bad about doing this but I see no other way to make keeping her at home doable.
Bob, never feel bad about what you do to cope. I give my DH Seroquel for his aggression. I’m thankful we have these meds to help us through. Keep up the good work!
Bob, you do what you gotta do! I would be worried about her falling for sure. My DH is bedridden, he also sundowns. I give meds. You have different situation with her being mobile, can you wait til bedtime to give meds?
Moorsby---Among his meds DH takes 5mg of Lorazepam a day--spread into 4 single gm doses and a double toward night. This solved the agitation issues we were having, but when he started sundowning and fretting about not being able to lay down and sleep, we added a dose of Seroquel (200mg) around 3-4pm. It takes from then until about 8-8:30 to work a nd he's gone to bed to sleep.
Lorazepam doesn't linger a long time in the system, but he was more unstable on his feet early on when he started with it. The .5 mg dose is small and using it only as needed, is a beginning point for using it.
I would, I think ask the Dr. what other options you might have for the combativeness, reserving the Lorazeopam for the occasional times when a bit more is needed. Other meds last longer inthe system too.
this is the one thing that you should not feel guilt over. medicating them is the only way for us to help keep them calm controlled and able to function at home or in a facility. if we dont give it at home they will give them something in a facility to be able to control them if they get to an aggressive state and non compliant. its also not in their best interest to have them upset and anxious and abusive and we all know they would not want to put us thru this if they had a choice. so yes, we need to use what we have to to make it thru this disease. we have said it before pharmacology is our BFF under these circumstances!
I agree with Divvi. Before my DW passed I would give her 1.0mg of lorazapam 4 times daily. While it cause her to sleep more the anxiety was kept to a minimum and she could actually relax when she slept. At the end that was the only medicine she was taking and it continued to help her until it was over. Do NOT feel guilty about the medicine you are using to help her in those final days. Remember let your conscience be your guide and be relieved that there are meds available to help her cope now that the end is nearer. Always keeping in mind that the first lesson of learning about AZ is that IT IS NOT CURABLE . Therefore anything that helps her rest and remain calm is a good thing. May God bless you both now that the end is nearer.
DH's doc prescribed lorazepam but I'm not sure how/when to give it to him. The doc's assistant said to give it to him when needed. I said, when he's agitated, he most certainly will not allow me to give him another pill. So, she said to give it to him 3/day and I'm not sure what that will do for him. He's raging around tonight because I challenged him on his drinking again. He opened a new bottle of wine at 8 pm tonight - totally out of routine for him and that really concerned me and we got into a big row about it. I told him I was going to pour out the whole bottle and he told me he'd hit me in the face if I did. I guess that kind of amused me, but, I guess I should have been more concerned. Anyway, now would be a good time for this drug if I could only get him to take it. What happens if I put it into his tea??
put it in anything that you think will work and if he is to objectionable don't tell him that his drink is medicated. Second rule of caregiver DO NOT ARGUE WITH PATIENT. His reasoning button is broken. Just do whatever it is you have to do to to keep him/her manageable. I am so sorry that you are going thru this but remember it is the disease not the person that is causing the problem.
mothert-- If there is a time of day that he generally starts having problems, get the med into him a little before that--if it's evening after supper, put it in with his late afternoon or supper meds. That will give it time to be digested/ab sorbed and start working to calm those agitated/anxious times. Kind of put a stick in the spokes of his behavior.
Thank you bruce d and carosi for your advice, I'm really thankful for all of your comments and experience. He doesn't take any meds in the afternoon, just am and pm, but I think I should be able to slip him something around 3 or 4 - I'm learning to be sneaky.
I do think he must get a bit anxious in the afternoons - maybe that's why he can't wait for a drink. Often he's asleep on the couch right up until 4:30 or so, but he hits the wine bottle as soon as he awakes. Usually, he will drink until dinner is through and stops - tonight was a departure from that routine, although he didn't actually drink any of the wine he opened at 8 pm as I made such a fuss. So, perhaps I should try and get the drug into him with that first glass of wine or an hour before, if possible. He's usually good at night, I think it's in the afternoon/early evening that the drug might be helpful. I'll see how it goes.
I am not sure what is going on. It seems that her balance is at the worst in evening. I now have a bedside potty chair and she could not balance getting out of bed. I had her sit on the edge of the bed while I got the chair in position. She starts sliding off the bed. I grab her and push her back on to the bed. I then have to stand her up and turn her to sit on the chair, while I am pulling down her underwear and gettting the chair behind her. This is all because she will not use the depends. She will wear them, but will not use them. She will start saying she is in pain when she has to go and will not wet herself. I guess this phase will pass once she slips a little further away and does not care.
Bob My DW was the same way when I first tried using depends, but I told her that it hurt me to have to lift her onto the potty and then back into bed. Then she allowed me to put the depends on her because she was afraid that she was hurting me. She still was not happy about going in them but nature took it's course and soon she was using them whether she knew it or not. Just be patient and give her a little time to adjust to the fact that it is ok to wet yourself and that takes some getting used to. Good luck and God bless. bruce
My dh has Lorazapam as well for agitation. He is bed bound so I don't have to worry about falling. I did realize that when he was having issues with bowels, he was very agitated. Could this be an issue with your dw? The nurse also told me that the medication does not stay in the system and build up. But you do have to take it a couple of days on a regular basis. It would be best if you could give it at bedtime. So many meds make them unstable on their feet.
One thing that was causing my dh to be agitated was news on the radio or TV. So I found a music station with no commercials or news which really helped.
I think the sleeping pill she takes at night plus the lorazapam is too much, so I plan to cut out the trazidone and see if she is better in the middle of the night.
Have any of you been on trazadone? When I took it in the 80s within a half hour I was so sleepy and dizzy. I learned to take it and go to bed. I would have to wait at least 4 hours before getting up to not be dizzy. Weird anti-depressant - it caused the big weight gain - before AD added to it.
Trazidone afected my DH the opposite. Instead of solid sleep, he was cat napping 'round the clock--1 1/2 hour here, 2 hours there. No real rest in that.
DW is now constipated, it has been 3 days now, and I see that is also a side effect of the drug. Do you have to give them something else too for their bowels?
senokot S has been a good choice for us with bowel issues. its not hard on the stomach or causes cramps and you can give up to 8/day in extreme cases. the S in it has a stool softener which alot of them dont. usually with hospice folks the cutoff day is the 3rd day. if they havent gone they need help. medications can cause constipation but sometimes its not a choice so just add a laxative into their diet. i also give seeded prunes and lots of apple chunx as snacks. the laxatives melt in applesauce well and can be spoon fed if they cant swallow them