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  1.  
    I found this article from American Family Physician, and it may be useful to others, as we seem to be hitting open season on our LOs experiencing psychiatric behavior problems.

    This report is from '03, but I don't suppose too much has changed. Maybe what has changed is all the things you encounter on the web warning of the slightly increased risk of death in elderly AD patients who use antipsychotics. On the other hand, it is useful to read this, which fairly clearly delineates the various drugs likely to be considered, and how effective they may/may not be.

    I must say that given the untenability of managing agitation and aggression when it becomes severe, I am probably less concerned than I ought to be by warnings that some people may have increased odds of death on antipsychotics.

    As demonstrated by a recent local case in which the 86 year old wife of a 92 year old AD patient, while trying to stop him from taking off, was thrown to the ground, thus breaking her hip and subsequently dying of complications related to that...sometimes agitation can't safely be left unmedicated. If not, I am probably not in great danger of hip breakage myself, but that doesn't mean I'm looking forward to more wrestling moves.

    http://www.aafp.org/afp/2003/0601/p2335.html
  2.  
    Emily--I remember discussions here years ago about the use of anti psychotics and the Black Box warning. I think those of us who had experienced strong agitation in our spouses were unanimous in our belief that the benefits far outweigh the potential risk.
    • CommentAuthorcarosi*
    • CommentTimeApr 14th 2012
     
    in 2006 when DH was Dxd,we had to make med changes and I was infomed of the warnings. I was also told the reason for the warnings was not because the meds would cause earlier death but rather because,since that group wasn't part of the screening testing done, they couldn't say those meds were safe for them. After that, who would do a trial on that specific group, just to seeif they were fully safe?

    IMHO, the chances are immaterial, since our LOs are terminal already. If a med released them a bit sooner, it would be a bit less suffering under Dementia's rule.
    •  
      CommentAuthorJudithKB*
    • CommentTimeApr 14th 2012
     
    You all make such good sense in your comments. But, just the fear that I would give my dh a drug and he would "drop dead" was really frightening to me on top of how strange he was acting. To read all these strange behaviors from other spouses on here is so informative to us, but then to actually experience the behavior for the first time that seems really bad is so frightening.
    • CommentAuthorwoeisme
    • CommentTimeApr 14th 2012
     
    Dealing with aggressive behavior
    https://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=96

    a more current evaluation of anti psychotic medication


    http://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=1191&pageNumber=2
  3.  
    Yeah good. The article at that link is all about trying not to use antipsychotics and managing behavior by giving people the kind of life they need. Well, since Jeff needs to take off down the street looking for imaginary buildings, and throw people who seem to be thwarting him, I guess I'll just bring him home and let him run away.
    The Zyprexa is giving him the jerkies anyway.
    I am discouraged that this is ever going to become manageable so it looks like letting him do whatever he thinks he wants might be the best option.
    • CommentAuthordonna L
    • CommentTimeApr 15th 2012
     
    the best thing for bobby and his anger moments is in the good weather kick him ou in the yard with the care givers. i have told them to stay away from him and only interfer if he is going toward the road . just keep him in eyesight and let him walk it out. they don't like that too much because they are afraid he will fall and get hurt. we everything bobby had done dangerous over the years i don't see fallen as being one. i do know the reality is that is could put us in a worse place then we are at but so could the motorcycle , hunting in tree stands, the scuba diving , the love of snakes, turtle grabbing etc. he does not care for the caregivers when he is stuck in the house. and he has put his fist in their faces but i tell them not to get in a corner and keep one eye out it is not a constant thing, but never hurts to be on your toes
    • CommentAuthorandres
    • CommentTimeApr 19th 2012
     
    Belligerent behavior got DW booted out of day care. There goes my hope for respite for awhile. Got a few of the punches myself so I know they can't have her there as it would endanger other clients. Will have to retreat and think about what to do next. I can see her behaving this way with any prospective caretaker so would not be easy with a home caretaker. Is on Seroquel and has overall done ok with it till recently. Am working with her MD to find some med,any med, to make her more manageable. I guess these behaviors really mark a turning point in what we'll have to do.
    • CommentAuthorandres
    • CommentTimeApr 19th 2012
     
    SIGH.
    • CommentAuthordivvi*
    • CommentTimeApr 19th 2012
     
    ativan works pretty well here in a pinch.

    andres, sorry she got the boot. i know it makes it difficult. but they will find something. keep trying.
    •  
      CommentAuthorJudithKB*
    • CommentTimeApr 19th 2012
     
    andres....my dh's neuro just took him off the seroquel and put him on Risperidone. Probably too early to tell the final result of the change of meds. But, on seroquel he was like a zombie and at least yesterday he was so calm and not zombie-like at all. This is a result of the melt down he had on Sat. when I had to take him to the ER on doctor's orders.
    • CommentAuthorandres
    • CommentTimeApr 19th 2012
     
    Thanks, I'm hanging on to that sliver of hope. Medicine! Must find that medicine! One day at a time,right? The "funny" , dark humor part of this is that the belligerence is sooooo out of character. She's always been the sweetest, friendliest most tenderhearted person I could have imagined. In years past she (and I too) would have been totally shocked to think that she could behave this way. Judith, good luck with the Respiradone.