I am really kind of frightened. My dh became paranoid and agitated on Wed. and continued to get worse. Last night I gave him one Seroquel (25mg) which he had taken for several months a year or more ago. At that time the drug helped him and he didn't seem to have any real side affect.
I gave him another one this morning. He isn't talking, he has gone into a deep sleep, he seems totally out of it when he wakes up now and then and he is almost sombie like. I called his neuro and their office is closed on Friday afternoon. He has an appt. on Monday.
Is it better to be zombie like or be agitated? I feel so stupid writing this post, but I don't know what to do now This is the first time I have ever been really frightened about his condition and how he is acting.
Judith--I don't exactly have the answers to your questions, but I CAN say that it has been the changes since New Year's--increasing agitation, delusions, and paranoia--that were pushing Jeff's behavior into the bewildering and frightening category. Obviously this is an essential problem that needs to be addressed at the upcoming appointment. I hope you will be able to manage over the weekend.
Maybe you will be lucky and the neuro can recommend a medication strategy that will prevent this from escalating. Jeff's behavior continued to escalate on a low dose of Seroquel, then still popped out in occasional psycho episodes when his dosed was raised, so as much as I am sorry to have him hospitalized for med adjustment, it seems to be necessary in our case, since the answer (and I hope there IS an answer) would seem to be some combination of meds that isn't quite nailed down yet.
As for which is better--zombie or crazy? I am having to vote for a little zombification in our case, if it's what's needed to keep him from being a danger to himself, me, the care staff at the ALF, the other residents.
have you given the 2 doses like this before on drs recommendations? sometimes like nelson says you have to restart off on a minimum dose and increase slowly. maybe it was a bigger dose for him since he hasnt taken it before. i dont think i'd give any more until you see him aggitated again. and there should be an emergency number for a dr over weekends. it should begin to wear off fairly quickly i would think. last resort is take him to the ER if you get too concerned and they can call his neuro or a dr on call. i think others here will have more input on dosings of seroquel. but yes most of these drugs say to increase and decrease gradually to avoid withdrawals or side effects. but i also know some go off them cold turkey without too many issues esp if they havent been on them too long.
If you do not take quetiapine for one week or longer, you should call your doctor before you start taking the medication again. Your doctor will probably tell you to start taking a low dose of the medication and gradually increase your dose as you did when you first started taking quetiapine.
Quetiapine may help control your symptoms but will not cure your condition. It may take several weeks or longer for you to feel the full benefit of quetiapine. Continue to take quetiapine even if you feel well. Do not stop taking quetiapine without talking to your doctor. If you suddenly stop taking quetiapine, you may experience withdrawal symptoms such as nausea, vomiting, and difficulty falling asleep or staying asleep. Your doctor will probably want to decrease your dose gradually.
Thanks for the response.....Gezzzz...on top of this we are having a thunder storm in Ca. which is rare and my dog is have a fit...had to give her medication. She is running around panting and driving me crazy. I feel like I am Nurse Ratchet...whatever her name was in "One flew over the Cookoos nest" or whatever that movie was called.
I am beside myself also. DH has been very delusional with everyone taking his stuff, money, etc. People come during the night and steal his tools out of the basement and leave just crap. Put up a sign on his drawer that reads "no stealing". Today he decided he was going to work. Retired for 11 yrs. I said he couldn't, no ID. First he said I had to drive him. If I wouldn't, then he would drive. Finally I called my son 1,000 mi. away and told him to talk to his Dad to create some diversion. I called the dr.'s office to please prescribe something to calm him down. Phone call with son helped a little but he is still determined to leave. Until now DH hasn't needed any meds but today really frightened me. He is bigger and stronger than I am so I can't physically stop him from anything. Like Emily says, maybe we better be satisfied with a little of the zombie state than worried for our safety.
unfortunately for alot of us, once these paranoia, and delusional behaviors start they dont go away on their own, unless its caused due to something physical like pain or uti or such. its part of the progression of the disease, it usually hits all of us at some point. i dont know of anyone here? that has made it thru the stages to the end with no medications to adjust the circumstances that can crop up at any time for one reason or another. emily was literally thrown into it very quickly and her spouse was relatively calm before the storm too. once these ideas begin to occur they are irrational and yes can change quickly and we have to be very vigilant to the changing demeanor. you have to trust your instincts, if you become fearful its usually sound intuitions. if nothing else you can call 911 and have them transported to the hospital for evaluation. but most of us will be able to get them into an appt for a reevaluation. its why we always say here its necessary to address this issue if any change is happening to try to avoid a bigger issue. i also would agree a bit of zombiness is acceptable if it keeps them/us safe for the time being.
Sounds good to me...but, since I am the chief meds nurse on this floor and I took an Ativan about an hour ago I don't think I better beef it up with the juice right now.
I know this sounds really off the wall...but, what keeps going through my mind is: What if I gave him a drug that will kill him. Now is that way out there in left field or what? Guess I should give up the thoughts of ever becoming a nurse.
Dear Lord what did I do to deserve this today. My canine patient who is frightened by the thunder storm... just went in my bathroom and pooped all over the floor.....Very smart patient using the bathroom...but, I didn't need this.
Judith. Correct on both the Nurse Ratchett and the movie. My wife was up to 100 mg of Seroquil a year ago and was a zombie most of the time...too heavy a dose perscribed by the MD as it turned out and was meant to control her trying to leave the memory unit to wander..off the drug now..adjusted..more active...but still thinks she's an office nurse and working to help her doc...tries to help the other residents now and then..some things never go away, I guess.
Thanks Nelson...that makes me feel better..or is it the Ativan kicking in...probably both. Just having this wonderful site to come to and be free to express your deep thoughts and have someone tell you are aren't off the wall is worth a million. I know this is just another phase I am dealing with right now...but, I have no experience with this....and you get all those "what ifs" going through your head.
Ain't that the truth, bluedaze*. Judith, please get your canine a thundershirt. It does wonders for storms and other loud noises. Go to thundershirt.com.
Judith...I haven't exactly had the "what if I give him a fatal drug" thought, but I do have a similar reaction to the warnings you encounter about the dangers of atypical antipsychotics used for AD. There are always websites warning of the slight increased risk of death. And I think...so?
JudithKB...isn't this so scary...my Dh is doing everything like yours is. Paraniod about everthing, agitated, hides stuff then blames our son for stealing them. I started him on 25mg Seroquel a couple of weeks ago, but he went into a deep sleep for 12 hours, I had to wake him for meals..etc.. he seemed totally out of it when he woke up didn't know where he was, he talked a lot of jibberish and was almost zombie like. Scared me so much i stopped it after just 5 days..maybe i didn't give it a chance to work properly... i too was scared when he slept so much...I might have killed him.. Where's that corkscrew!..
Today was a good day: Start off going to Costco to get gas. Take card out of wallet, leave wallet on seat. Fill up, next stop Publix. They sealed their parking lot and parking required 50 yard walk, with dark clouds gathering. Find a spot, but there's a cart in the way. Ask DW can she move the cart. Silly me, she lowered her window opened her door got out and stood in front of the car. I get out move the cart and position her safely with a gentle " stay" and pull in. Note, I haven't said a word about my wallet which now has fallen between the seats or raising her window. Storm clouds now really dark. DW is like the Rabbi's wife always walking 2 paces behind and to the left. I only lose her momentarily she's walking in ghe wrong direction Really raining hard, thunder, the typical Florida weather thing. She wanders again while waiting for cold cuts, no big deal I know she's in the bakery innocently helping herself to a cupcake. Finally hit the check out counter, guess where my wallet is?? Jog back to car in downpour, wallet is under seat NP. DW's window wide open a minor flood. Jog back to store stressing the triple by pass plumbing a bit. Just wanting to get home, back out in the rain totally wringing wet now and head for home. I live on an island, naturally the draw bridge was up. Bridge goes down and there is chaos ahead, The trafic light is out and is just blinking. Floridians are not noted for their driving skills to begin with. I think the intersection was filled with Chinese Nuns and 90+ old men in old Caddy's. Finally after witnessing one minor feder bender we got to our condo. We were greeted by Juilo the maint. man who can smell a tip at 50yrds. He unpacks and heads upvwith DW in tow. I park amd find Juilo fiddling with the cart, a wheel came off, brand new cart probably an assembly issue. Where is DW??? Julio winks at me, she was in the elevator he keyed the doors to stay open. Finally we get to our apt., our cleaning lady is there, the reason we went shopping was to keep DW out of her way. she unpacks and puts away the groceries, The sun came out and DW and I went for a swim before lunch.. This was a " good" day!! No Ativan (for me, not her)
Julia & JudithKB, my DH is also getting paranoid again. He went through the stage over a year ago where he thought everyone (including me) was stealing from him. He also hid everything (I'm still finding things that I thought were lost forever!) I got him on 25 mg of Seroquel & it helped with that & his rages. However, like I said he is getting paranoid again, but I think that is just the progression of the disease. Along with the paranoia he almost doesn't want me to be out of his sight. It's very hard to get any alone time anyway, but when he practically won't let me out of his sight sometimes its enough to drive me crazy!
Have two drinks....you deserve it...make that a double for each drink.
What did you do in your earlier life that you are being punished for now?.....must have been something really bad. Being bad doesn't mean it couldn't have been fun too. But, now do you think it was worth it???
Your trip sounds like the typical trip with a spouse who has AD....it is so funny when it happens to someone else and they can tell a story as good as you do...I know, I know...you aren't laughing and if you were it would be just to keep you from crying.
Judith- I told the story tongue in cheek, compared to the grief on this thread, I had a great day...and evening :)
What did I do to deserve this: We Had it too good, married 52 yrs., 2great kids, both wife & I enjoyed careers successful beyond our wildest dreams (particularly) when married at 19 &17. We put each other thru college, She a BS me Ms. Travels round the world twice, Only thing missing from " bucket list" love and companionship that used to exist
I guess I'm being punished living life in the fast lane, making and winning too many of the risks one takes in a business and life. You can't win them all. The piper must be paid
So glad for you that you had so many of the things in your life that made it so great. My mother use to say..."Make good memories while you are young because when you get old all you have left are your memories."
Several years ago I use to think of that statement and how true it was and my dh and I did alot of traveling when he first retired. But, now I look back on what my mother said...and she was wrong....some (like our spouses) don't have very little of those memories left.
Things are worse here this morning. I called his neuro and he called me right back. He told me to take him to ER. I can't even get him to take a shower...OK..so I haven't been able to get him to do that all week. Guess I may have to take him anyway. He says he won't go any place...guess I will have to call 911 and have them come get him. He just keeps repeating himself and talks like he is out of it. He called his cousin in Ill. we live in Ca. said he was coming back to Ill. and she could take care of him.
I am trying to put off taking him to the ER...don't ask me why....I don't know.
JudithKB MD say go to ER, don't pass go, don't collect $200.00 pick up the phone and call 911 Do not, just in case you didn't hear me, do not attempt to drive your husband yourself, putting both of you and others at risk. Besides if you walk in you can wait for hours. 911 admittance will get your husband evaluated immediately and then you will wait for hours. Past experience, bring a cell phone charger with you, you'll need it
Back from ER.....They let Jim come home. They did all kind of tests on him including a Ct Scan of the Brain. They said everything was OK...whatever that means....I take him to the Neuro Monday and will know more.
They changed his medication from the Seroquel to Risperidone. He was on that once before and I don't remember why they changed that to the Seroquel and now they are changing it back.
I am exhausted. I pray that this will help because I can tell you point blank I cannot handle another week like this last week. Call me a sissy, whatever...but to me this week has been the week from hell. My hat is off to all you brave warriors that fight this for months and years....God Bless you All....I feel like such a failure. He was doing so good relatively speaking and then the bottom fell out and I fell with it. I just totally lost control of his actions. He had always responded to me telling him what he could or could not do and when he just needed to shut up and go take a rest or whatever was needed to calm him down....not this time. I totally lost control of him and the situation and he would not shut up about the people taking his stuff and laughing at him. And then he started on yelling he was going to kill himself, over and over and over. I don't know how he planned to do it....or I might have helped him. Oh...well I hope the new med. works.
OH JudithKB, you must not beat yourself up!! My God what a horrid thing having him threaten suicide! And the going on and on and on yes that is just too much for anyone to handle. You are DOING A GREAT JOB AND WE LOVE YOU!
judith i hope you get some rest. i know its hard in an ER all day. maybe the med will react favorably with him this time. good luck= we tackle each day at a time.
JudithKB--let me give you a tip--start a notebook on your husband (and one for yourself, too). Write down all the meds he is given and any other info that might help about symptoms, reactions, etc. I've been on the caregiver train for 7 yrs and there are so many meds--it helps to have a written record. It may spare you a bad experience at some point.
You certainly aren't a failure. Those of us unlucky enough to have spouses that have meltdowns need superhuman strength to endure. But we are just regular people and we get through it however we can. I hope you will still speak to his neuro tomorrow. Hoping today will be better.
DH has been taking Risperadone for a long time,due to angry paranoid behaviors at home. A minimal dose but it worked, fairly well I thought, UNLESS he wanted to do something he wasn't supposed to do. No way to stop him either. We ended up struggling through placement in ALF (2010), very nice environment AND as long as no one tried to get him to do something he didn't want to do.. the MEDICINE worked. For every misadventure there, my question was 'has he had his medication'? He is uncooperative, impatient and threatening to anyone who tries to help him change clothes, or take a shower right now. In January we moved him from the ALF to our local NH. I was going to have to hire sitters because he had begun to fall. They also got his medications mixed up AND at times u failed to give it. However, this topic reminds me of yesterday morning asking the nurses if they thought Seroquel would WORK better than Risperadone. They had struggled with him for nearly 30 minutes just trying to change his pants /socks/brief. He kicked and hit at them. It takes a team of rotating helpers to get him showered. It took our two sons over 2 hrs to get him showered and changed. IS there ANYTHING that will help him become COOPERATIVE? I don't know but he has become even more ATTACHED to his pants and underwear. I've wondered if they make snap on pants.
JUdith: Deep breath.. Think about what you're saying.. you're ready to give up...because you're spending your energy blaming yourself for non existent failures. "you lost total control of his actions." "He always responded to me" "you totally lost control of him" YOU DID NONE OF THIS... The disease has caused this to happen. This is not your fault or failure. Don't waste your energy blaming yourself, don't doubt yourself. You need every once of strength you possess to devise coping mechanisms. How am I going to deal with this the next time is your primary concern.
Suggestions: Just click on SEARCH at the top of the page on this site do a search for threads on "rage " and "anger" Learn how others are dealing with this with the help of medication. Just don't beat yourself up. That the most destructive thing you can do to you.
If you haven't already done so read "The 36 hour day. " other good sites to view http://www.veteranstoday.com/2009/05/19/caregiver-series-dementia-alzheimers-anger-and-aggression-1-in-a-series/ http://www.alzheimersreadingroom.com/2011/01/learning-how-to-communicate-with.html
Thanks Nelson for your suggestions and comments. The one thing I didn't mention in my post last night was his action regarding the beautiful watch I bought him on our last cruise for his birthday. When he refused to eat breakfast so he could take his morning meds. and then refused a shower, both actions of confortation for hours made me go into the mode of....."Who gives a ______" . Fill in the blank. I just felt so defeated and couldn't think right. I had already called his dr. and he had returned the call with instructions to take him to ER. But, I didn't want to take him there before he had his meds and a shower. (The shower I had been fighting for all week). Anyway, the final blow was before the guys came I told him to take his good watch off and he shouldn't be going to the hospital with it on. He refused..and refused and refused. Once again it was.... "Who gives a _______". Well guess what?? He no longer has a beautiful watch that I bought for his birthday.
This has really made me sad. I guess I do give a __________. He can't even tell time, but he was so proud of that watch and it was beautiful. Who knows what happened to it.....probably will never know. Now he keeps repeating...we will just get another one.
I have a sitter for him every Wed. morning so I can go and do what I want. But, now I am going to be looking for a day care center for a couple of days a week. I think he will hate it....but, I hate this daily routine...so why should I be the only one hating something?
Thanks divvi....I called both of them already and they said they didn't have it. Just makes me so sad. It was a beautiful watch and one of the new kinds where you never have to replace the battery.
Probably a good lesson for me...never again will I allow myself to get so emotionally out of control that I don't take full control of the situation.
Judy--you have accurately described my husband's behavior last year. What changed it was 2 stays in a geripsych unit for medication adjustment. During the second stay, he was put on a "cocktail" of multiple meds and his cooperativeness returned. The nurses at the facility aren't the ones to ask--is there a geriatric psychiatrist or neuro who visits the NH? It sounds like he needs to be seen by a specialist. If he is striking out at people trying to care for him, he may need a stay in a hospital's psych unit to fine tune his medications. But those behaviors can be controlled by the proper meds.
that would make me angry. if he left with the watch on and lost it between the ambulance and ER stay someone there took it. i would file a complaint with both ER unit and the ambulance carrier. it probably happens alot and nobody reports it. i know a friend lost her diamond studs when she was transported in an ambulance as well. it may be common practice but we try to hope people are beyond taking things from the sick when under duress. let it serve here as a hard learned lesson judith to YES take ALL valuables off our spouses before they are lost. substitute something of less value you can lose. ps if they did any xrays or tests they have to remove jewelry usually. i would ask if any tests required him removing it. and ask the techs who did the tests!
Judith - go on line and buy a" knock off" of that special watch. It will make him feel better, and you just tell yourself it looks just like the real one. We lost DW's Tenth Anvivery Rolex gift watch in much the same fashion. This was pre AD when she was hospitalized with Jaundice and ended up having 1/3rd of her liver excised. It was on her wrist as she was wheeled in for surgery and gone when she arrivied in the ICU. I've learned real fast as an AD caregiver In order to survive you've got to prioritze and rationalize everything. With me " I just said: "The real one always ran slow," and the "knock off" battery operated one runs perfectly. When her wrist starts to turn green from the tarnish, I just get her a new knock off, one for a few $'s and for her it's a thrill to receive a gift, A guarantied smile which in turn makes me feel good.
The way to survive as a caregiver is knowing what to overlook.
darn nelson. i would hope it we have the opportunity for a rolex we would insure it under homeowners:) that would be such a shame. but yes the fake ones work pretty darn well. oops off topic here.
divi, it was insured, a police and internal security investagation for Grand Larceny was lauched because the personnel with whom she came in contact with during that time frame were identifiable, all without results, This investigation took nearly 4 months it was only then did we receive payment from the insurance company. We didn't rush out to replace it immediately because a she didn't know what she wanted other than not the same one because it never ran properly and b: the oppotunity, like being in a tax free carib island to select an alternate, not just a replacement, just never happened.
DW was officially DXed with AD about 6 - 8 mos post op, she'd left her poketbook behind numerous times, more often than not. it was returned intact, It was only after she lost her way in a parking lot. (she had gone to one shop to pick something up, while I went to pick up the dry cleaning at a second shop) and she didn't recoginize our car even though I was right in front of her, honking the horn, did we seek a DX.
After the first five minutes of that exam when she failed to reply correctly to question afer question did my head start spinning and I continued in a state of shock and depression for weeks thereafter. I can assure you all thoughts of buying expensive trinkets disappeared from any rational thought; my wife was sucicidal, having watched her mother die of AD, knowing full well what fate held in store for her ..... until she asked one day about her watch... hence the knock off. End of off topic discussion
So true divvi: The watch is just a "thing". It can be replaced if I so decide. Today is a new day and trying to look at yesterday's problem as a huge learning experience. I will be better prepared the next time as well as controlling myself emotionally. As the saying goes...."this too shall pass". The one thing my dh and I cannot cope with is if I became ill or unfit to take care of him. This is what is important and what I will be working on in the next few weeks and mnonths. He has no one except me. So whatever it takes for me to continue to do my part in this terrible illness he has I will do to the best of my abilities.