4th full day at JH Bayview geriatric psych unit for Jeff. One thing I was afraid of was--what if he is perfectly mild-mannered and cooperative, then goes back to the ALF and is crazy again?
I guess that fear won't come to fruition since he was utterly uncooperative with the aide trying to give him his meds and take bp this morning. So he got the IM version. I'm not really sure how they do that...a surprise jabbing? I got this info from the aide when I went in at 11am. I will ask for more details when it's not the weekend and more "business" is being done. I also noted that he had a bed alarm and some posey belt thingies in his room...so I am sure he is not under control, or anywhere near it, yet.
I guess I should take this as reassurance that they will understand just what kind of pharmaceutical effect is needed. It also provides me with a clearer rear-view mirror understanding that his difficult-at-home behavior, and times of almost manic agitation, were not figments of my imagination which I should have been able to deal with better. Rather, they were just parts of an escalating stage of the disease.
So, I would not say things are improving yet...but at least the professionals know what they're dealing with.
I remember thinking along the same lines--like when you take the car into the shop and it won't make the noise? I don't think dementia works that way--Steve reproduced his behaviors that he'd been having at home, like Jeff.
Not familiar with the IM version--do you think they tried mixing pills with ice cream or pudding first? Maybe he refused that? Steve never refuses food these days--if it's not nailed down, he eats it.
Well, I do know now how the IM injection alternative to pills works in an uncooperative patient. Apparently on Saturday morning he refused medications, bp, etc (anything resembling cooperation, really,) and staged a sit-down strike on the floor against the closed lower Dutch door of the nurses' room. So the aide had to call security. Guess security helped make things secure for a shot. Hmmm. He doesn't seem to have any particularly traumatic recollection of this event, but I hate that it happened.
The psychiatrist on his case is supposed to be in on Tuesdays, so I hope to get a more thorough word on progress or lack thereof tomorrow.
emily, I know your concern and distress...my DH wouldn't cooperate eiher and the psych dr told me they had administered drugs to control him. They never mentioned IM but I am sure they gave him IM drugs because they work faster to controll the behaviors. At the time I decided that what I didn't know wouldn't hurt me. Probably a bad decision but I was in SO much distress at the time I don't think I could have handled knowing. God bless you.
I just remember that when Steve was at Lakeside, he did get one shot to calm him down. I think it was when he first got there, they were trying to do a bladder scan, he hit the NP. So apparently, it's not so unusual. Emily, I know it's upsetting to hear about things like the security guard, but it's actually better for them see Jeff displaying tough behaviors and address them, so that once he's back at the ALF, he'll be medicated properly. It is a bit surreal, though. Years ago, could you ever have imagined this scenario? I know I didn't.
And now they're getting more of the right impression. After being cooperative for days, (and after I was just there today, helping him with lunch and shower,) he went berserk again. The nurse on charge called me. "Would it help if I came in?" she wondered.
No. Because when I got that very same call from the ALF I DID go in, whereupon he did not believe I was me and tried a couple sumo wrestling throw you off balance moves on me.
In this case, instead of threatening to break windows he was starting to pull cords out of the walls. And blocking the nurse's movements because she was not a nurse, he said, she was a robot. Utterly paranoid and aggressive.
In a 5 to 1 play, they did get a shot of Zyprexa into him. Then the nurse called me back, The Zyprexa, apparently, had a magical effect. He calmed right down and actually apologized for his behavior.
Apparently only Seroquel has been made a regular part of his regimen. Let us hope that Zyprexa does NOT have the terrible side effect on Jeff that it did with Diatron's wife, because I think the psychiatrist may need to take a serious look at making this a regular part of his diet. I know it plays a role in the cocktail prescribed for many such patients.
((Emily)) I am glad to hear the medicine helped him, and will pray that the side effects are minimal for Jeff.... it does seem surreal, even when it is happening to someone else. How are YOU holding up Emily?
How am I holding up?...hmmm. Well, it's been an interesting 2012. One thing that's happened is that the traumatic events of this year, and the need to seek outside help, have kicked down the emotional wall that enabled me to spend 8 years being caregiver without having to feel the heartbreak on a daily basis. So I've been processing a lot of grief that was hiding under the rug. In some ways having that stuff surface has made me, well...more like you Nikki. I'm sort of clinging to the moments, and whatever I CAN get of Jeff instead of self-imposed emotional numbness.
ahhhh, I remember well when the walls came tumbling down.... leaving in its wake a blubbering bundle of misery, whom I was shocked to discover actually turned out to be me. It was good too though, rediscovering myself and my true emotions. If it is of any consolation to you Emily, I truly am happy now. Every tiny thing that Lynn CAN do, I liken to the joy one would experience in finding a pot of gold. It is good to live in the moment and take the time to treasure what we have.
When one is faced with such life altering changes as you are facing now Emily, it helps you focus more clearly on what truly matters. Doesn’t mean it doesn’t hurt like hell… I know it does. But it does help change ones perspective. You have been in my thoughts so often, and remain in my prayers ((hugs))
If he's the same guy as last year, he was pretty good. I used to ask for more recent music, so maybe Steve would recognize something. The recreational therapists should be able to tell you what the schedule is.
Seroquel stopped working for Steve in 2011--had been on it for about 5 years. Zyprexa worked at first, but then other drugs had to be added to supplement it.
emily--be patient. It's trial and error in a geripsych unit--there are lots of drugs to try and different dosages. I know it's a pain to have Jeff in that setting, but he's in the right place. Can you tell if Diatron's wife has ever come back--he hasn't posted in a bit.
Options! How loaded is that? I feel the same way and that has what has contributed to me going from lawyer to lawyer.
I had posted to you last night but saw that it was not recorded here. I just want to send you regards and best wishes.
Are you considering taking Jeff home after this hospital stay? I have also wondered about Diatron and his loved one.
I think sometimes that those of us who post here are what fraction(?) of those who are living this?
In my past life I worked as a stand-in on cbs soaps in ny. Being still under hot lights while they and backgrounds were adjusted; well, I thought that showed me patience. Clearly this is patience of another kind.
Thanks y'all. (that's my Virginia heritage showing.) Abby--I am not exactly considering taking Jeff home. My plan is to move him back to the ALF from the hospital. It's a lovely place, very close to my home, with a good staff, and I feel that hospital ---> homey ALF should have the feel of a positive change, insofar as he is even able to process his surroundings appropriately.
On the other hand...given the unpredictability of his eruption of acute crazy episodes, I am fearful that if another severe one occurs, he will get the boot. Hence, I am scoping for plans b, c, d, and e to have in my pocket. One of those would have to be home, with a heavy schedule of in-home aides. I would also like to be able to ascertain whether any other facilities in my area could accept him if plan A falls through. I know that eviction from one ALF is a bad mark, but I'm not sure whether (for example) the one that is STRICTLY dedicated for dementia, or one that is classified in the nursing care category would have the wherewithal to manage him if his current one doesn't.
I'm not sure how one gets answers to those questions ahead of time, for preparation. I feel like calling them and saying "my husband MIGHT get kicked out of Place A...if so, is there any chance you could take him?" might set off all sorts of sirens prematurely. I need a general knowledge person, who knows the ins and outs of all the local places, to answer that for me. Don't know who that person is.
(this is why I joked on the Facebook page that any place could handle him provided their rules permitted the use of a sharpshooter with a tranquilizing dart gun on a PRN basis. Nora tells me it needs to be managed with the daily regimen. I'm hopeful. ish.)
emiy--the general knowledge person you described above would be a geriatric care manager. I know a good one in Baltimore, she may be able to recommend a colleague who works in your area, if you'd like.
Thanks Marilyn--I actually attempted to contact a local one by email and got no response. I should try again by phone, because it could have been a glitch, but not having a contact returned makes you wonder.
emily dont get too flustered. they should be able to find a cocktail that will help curtail his symptoms. it takes a while and some will work while others wont. even in a locked down dementia unit, they would need to keep him medicated and compliant enough to live safely among the other residents and staff. so its best to iron it out now however long it takes. if hes not under control there is surely no way to bring him home either. that would be a nightmare, aides around the clock or not. he isnt the only one with this type of scenario happening. many here have gone thru were you are now, and they eventually found a place for them after all was sorted out. patience is a virtue we all need more of. divvi