My DH has been in an ALF for 2 months which is 2 hours drive from our home (the closest facility since we live in a very isolated area). I visited him Thurs and he was initially very happy to see me, then he got quite angry and told me to leave, then told me to sit on his lap, then again told me to leave. We were going to go out to lunch but he didn't want to see me. I left and was talking with the admin when DH came with his jacket and hat on and demanded to go outside. I managed to leave without his seeing me leave and parked a block away. I got a phone call a half hour later saying that he started breaking up the plastic outdoor furniture and they had to call the team to restrain him after he wouldn't respond to requests to talk. They all fell down and my DH got a gash on forehead. They then called local police to transport him to the ER attached to the largest hospital in the area (which has a psych unit). I went over and waited for him (yep, he was handcuffed behind his back) but by the time they called me into the ER room, the doctor had already interviewed him and said DH was rational and said DH told the doc he would go back. We were assigned a social worker who knew barely enough to call local ALZ.ORG and print referrals off their web page. The ER wouldn't admit him to psych unit because they don't admit dementia or ALZ patients. The ALF was willing to have him come back as long as he he had stronger meds. My family and family doc all feel he needs to be there as do I because I too couldn't handle the 24/7. The explanation my DH gave was he thought he was able to leave whenever he wanted and had "often" walked around the block alone. Of course he was never alone when he was out, but can't tell him that.
Any suggestions on a backup plan in case this happens again? Any suggestions on finding a doc in the new city? Should I take the recommendation of the ALF (all family docs). It appears that there are no gerentologists in the area. Nearest psych hospital would be 300 miles away.
DH is currently on citalopram and trazadone. With this episoid he is now on low dose of Seroquel which sedates him. They will want to take him off of Seroquel. I felt so alone at the hospital with our 2 kids living at opposite ends of the USA and my friends 2 hours away, with ER doc not caring and SW totally untrained.
My DH hates it at the ALF, but the ALF staff says he does ok at there (he does nothing and calls it his jail room). Most residents are further along in their own dementias and it is not the best situation for him, yet he has a private room which is not available in the few other ALFs in the area.
Any ideas on "Plan C", what to do if the ALF can't handle him. He is certainly not ready for a nursing home. My only thought at the time was I would have to bring him home but I can't manage him.
Where do you live? City and State. If you don't want to write it on the message boards, e-mail me - joan@thealzheimerspouse.com If I know where you live, I may be able to better direct you as to where to seek help. How old is your dh? Does he have an official Alzheimer diagnosis from a neurologist?
Joan, Sorry you are going through some problems now too.
I live in Moab, Utah population 5,000 nearest city larger than Moab is 100 miles away Grand Junction, Colorado, population about 150,000. Denver is 350 miles away from us and Salt Lake City is 250 miles away.
My husband is 72, diagnosed 3 years ago at the Alzheimers Clinic at Univerity of Utah in Salt Lake City. The diagnosis in Nov 2008 and reaffirmed in Nov 2009 was "This patient has Alzheimer's disease with visuospatial predominance" from the neurologist in charge of the clinic.
I have alway been a take charge person, but this has just wiped out my ability to make plans or decisions.
The only answer that I can come up with is to get his medication adjusted. This is a tough balancing act between sedation and some level of function. You want the highest level of function and the least amount of sedation goes without saying, so that is why I said it. It is going to take a doctor willing to spend the time to get the balance you want, and it may not be what you want but what you have to live with.
hikergirl--is your husband in a dementia unit of an ALF? Is there a psychiatrist who sees the residents there? Generally, it is the psychiatrists who are the most familiar with medications like Seroquel. I'm not clear on why you said "They will want to take him off of Seroquel." It is a anti psychotic that is given continuously to calm patients and help prevent anger and the type of meltdown you described. Giving it on a sporadic basis, after a problem occurs, will not level out his mood.
Is he a vet by any chance. My husband was like this after his bleed and the sent him to the phych unit at the va hospital. He is also on Citalopram , Trazadone and Seroquel They kept him there till and switched his meds until he was clamer. They wanted me to admit him to a nh but I talked them into letting me try it at home.
Hikergirl: My DW was having untrollable episodes and they put her on Seroquel and Citalopram. She was on them for quite sometime, and then they quit working. We were at the Dr's office and he sent her to the ER at a large hospital where they had a psych ward. They changed her meds and she is doing good at this time. She was there for two weeks and then went direct to the Altz Unit of the nursing home. I'm sorry I don't remember what she is on at this time because I don't buy the medicine anymore, but, whatever it is, it sure works. That two weeks in the psych ward was time well spent.
I don't know if you are interested, but, since Seroquel is very expensive, there is help (or was) thru Astra-Zenica. I paid $800.00 for a prescription one month and got it for $25.00 the next. I hope this plan is still available.
I don't want to take up much space because I can't really add much.
Moab! The site of Best Friends Animal Sanctuary. OT, I know, but what a remarkable place!
Even though I am in a medium or medium-large city, there is still the issue of what insurance will cover, (not medicaid or medicare) in terms of placement or meds.
H has had little benefit from lorazepam, which started out doing quite well for him. He has had no favorable reaction to ambien er. Lunesta is recommended but is not on the formulary.
I am hopeful for the day when H will accept AFL. I wish you the best.
Thanks for your help. Yes DH is a vet. Good suggestion. I have been away from the internet past day. I have to switch doctors which means switching insurance, in the meantime family doc is very helpful. I am overwhelmed by the continuing need for decisions even with placement. I can understand now why family doc urged me to move near family a couple years ago even tho it would mean giving up my entire life and local friends. I thought I was handling everything well but ALZ certainly doesn't seem to cooperate. My family is urging me not to see DH for at least a month. Placement was supposed to help me get a life and right now it just seems like its still just as bad as before placement. I know I must disengage. Thanks to Wolf for timely comments in separate posts.