My husband is displaying a new form of agitation--banging his head against the walls. The ALF had him evaluated by PT and gave me the info to order a soft helmet, which I did last night. I emailed the psychiatrist to alert him and to ask if a change in medication is warranted (he is already on several anti psychotic and anti depressant meds).
I did a search here and didn't find much about the topic--there seems to be more about caregivers metaphorically "banging their head against a wall", etc.
Just wondering if anyone has experienced this with their spouse and how it was resolved. When the staff tries to stop him, sometimes that agitates him even more. They do give him a PRN (as needed) dose of extra anti psychotic med when this happens, but it would be great if we could eliminate the behavior. So far he has cut his forehead and caused a black eye.
I have always dreaded the thought of Steve in a wheelchair or bedridden, but being very ambulatory and having advanced AD does present its own challenges.
geez marilyn, it never ceases does it? just when we think we have caught a breath of fresh air and things are going ok. i havent heard of the head banging but would think it would be helped by the helmet. i know kids do this and they recommend the helmits. not sure if its a neurological issue or a frustration one but that sure cant be good for him since its causing physical distress. we do know over time the meds that work in one cocktail tend to fade and we need to re tweek them after a while. the body absorbs them and becomes more tolerant. i hope they can get him under control. best of luck friend, i know its exhausting to be going thru this once again. let me add that yes being bedridden/non ambulatory has its deterrants but i found that when dh was a pacer all the time, it wasnt in his best interest either. even now in late stages, my dh is bedridden but so much more calmer and overall happier than earlier times. but it does present with another miriad of difficulties to deal with. maybe they can get him compliant and it will only be temporary while he adjusts. divvi
Hey, Divvi, good to hear from you! I am thankful he had an 18-month plateau and I knew that the other shoe would drop, sooner or later. Yes, we'll get through this. I have seen from the past that Steve seems to have some of the more, shall we say, "unusual" symptoms. This too shall pass.
Tour guide explaining things taking people on a tour through our house. Lectures to audiences on the other side of the mirror. Double reverse Houdinis trapped in sweaters over the head with pants around the arms chanting (ok moaning) Ripping a door off the kitchen cupboard, the bathroom cupboard, the china cabinet, wait... Grazing on the carpets on all fours picking unseen things out and eating them (vacumn said the specialist) Awake marathons (61 hours straight was our longest run) Sitting on wooden chairs suddenly to pee Wrestling her nemesis the christmas tree into headlocks cheered on by the cats (yes it's still up) Rocking back and forth on the couch the way she did as a child (I'm told)
I was close to ordering what they called a soft helmet just months ago with her now in the NH. Unfortunately she can't keep her balance enough or use her legs well enough to fall down anymore.
I'm sorry Marilyn. I know how it hurts and as bluedaze said we don't know what's next.
I'm sorry that this has happened. I've seen it a couple of times in the care facilities, and it is distressing for all. Here's a prayer going up that a solution will be found. Practical Divvi has come up with a probable one, a readjustment of meds.
marilyn, so sorry to learn of this new behavior; it seems we never get a break sometimes. We haven't faced that behavior yet, but who knows? Sorry I have no meaningful info to offer but please know I am here for you and pray he gets through this phase quickly and unharmed.
In the rehab hospital my husband did something along these lines. He was mostly confined to a wheelchair because of agitation and throwing a cup (paper) of water at another patient. Additionally his orders included keeping him where the nurses station could monitor him.
He was enraged at all of this and would direct his chair to the end of the hall- this was kind of like the station being the hub of a wheel with the hallways directing out on a diagonal. Well, despite the advanced FTD he developed a strategy to motor himself to the end of the hallway and would choose different ones. He would configure a way to get out of the chair. Then he would stand up and bang his head and hands on the very secure exit door. He would also scream "done".
It sounds like a lot of activity but it really did not take too long. I have been told this could not happen but it did.
He would also become enraged by the wooden wainscotting along the halls and would bang his head against it and try to tear it out.
Among his medications were keppra and ativan and these were increased. The facility doc, who did not know him at all, added atenolol (tenormin). Apparently (it is primarily for hypertension and some cardiac conditions) the slowing of the heart rate can also calm the banging and screaming which the doc had labeled "frustration rage". I was also told that the most common unwanted side effect is brady rate which is very easy to monitor. Aricept had already been discontinued at the hospital.
He was transferred to the ALF within a week or so and it was with these meds. The physical layout at ALF didn't support his access to a length of wall space and was much more homey. Everthing then happened so fast and he was transferred to hospice so I don't know how long he was given those meds.
Thanks to all for your support. Psychiatrist increased Zyprexa today. Helmet should be here in a few days--my guess is--it will not be an easy thing for him to accept. Several weeks ago, the nurse suggested I bring in sippy cups so Steve could hold his own beverages. One of the caregivers said when it was given to him, he said "What the heck is this?" and didn't like it. Just when you think they're pretty much out of it, they do recognize that something funny/new is being introduced. I expect the same response to the helmet, but it's worth a try. Shame he never rode a motorcycle, maybe then he'd like it!
I have never heard of this and my search didn't find any answers. But I did come across this "Reasons for aberrant behavior Aberrant behaviors such as self-injury and aggression can be indicative of physical pain. Head-banging is often associated with dental pain or upper respiratory tract infections causing sinusitis or otitis."
Thought it was worth sharing, perhaps he is in pain and isn't able to articulate it.
OMG Nikki, I think you are a great detective! I am so glad you posted this. Steve has started to have some mild swallowing issues and I called in a dentist last week to inspect his teeth, gums, etc. He said Steve needs an extraction, but he didn't think that was the cause of the banging. Based on your post, I'm wondering if he is wrong about the connection. However, he identified tooth 3, which is the upper left canine tooth. It looks like Steve is only banging the left side of his head, because that's where the cuts and black eye are. The increased Zyprexa seems to be working to keep him calmer. I need to speak to the dentist because he wants to do the extraction right there at the ALF--I can't imagine how he will sedate Steve enough. Novocain seems an unlikely solution because it would be hard to get it positioned correctly and to keep Steve still. I have heard of putting dementia patients to sleep for dental work, but clearly, that couldn't be done at the ALF. I'm going to see if they can give Steve Tylenol until we can get the tooth out. Thanks so much!
Wolf - is this what I have to look forward to? Oh my gosh, I can't believe you went through all of that. Sometimes the stories just seem to sound worse & worse - but at least I might (I repeat might!) be a little more informed & possibly might not be caught off guard because of reading of the experiences of others. Frightening, though.
marilyn, DH has the same issue. a broken off tooth and our mobile dentist came and said an extraction if it gets to that point of pain or infection. and they wont do it here a tthe house either, but would want him transported via ambulance to the oral surgeons office just to have that incase of complications. and they would use a type of twilight anestheia verset maybe. i know its not ideal for the use of drugs but mine would not be able to cooperate either. i use oragel on the gums and around the tooth just in case. at some point i am sure it will need extraction too. best of luck!! let me know how steve does if you have to go thru it= divvi
Hello Marilyn, Been a while and a half since I posted, but the head banging did remind me of a similar situation. In my FTD support group (yep, I still go after all this time) a member's spouse has been doing this for about three years. He is in a foster care situation, wears a helmet, but that didn't protect him enough so the caregivers lined the walls with bubble wrap! He has stopped getting injuries, and is mellowing down a bit. All the meds seemed to agitate him more, but the situation is running it's course now. They have never found what created the problem...just another "bene" of the damned disease.
Well, today (in the midst of a snowstorm) the mobile dentist is scheduled to extract Steve's tooth. IF he is successful, we'll see if that stops the head banging. Otherwise, I have the helmet on hand. I probably won't be able to get to the ALF because of the snow, but the nurse there will help the dentist by holding Steve's hands down. Thanks, Kathi, for the anecdote on the bubble wrap. Steve still wanders all over the ALF; I had to smile thinking of an image of the whole place covered in bubble wrap!!!! Gives new meaning to "padded cell". I must try to see the humor in this, it's so wretched! Please, everyone, keep your fingers crossed that things work out today.
Well, the tooth is out. I must admit, it wasn't as bad an experience as I had expected. Steve was sleeping from the extra Ativan they gave him as a pre-medication. He wriggled a little when the dentist injected the needle (was still lying in bed--Steve, not the dentist). One of the caregivers held his arms down and I held his feet. After about 5 mins. he was numb and the extraction was pretty simple. Less thrashing around by Steve than when he has his teeth cleaned. The downside is, the tooth was not on the side of the head that Steve has been banging. We'll see what happens now.
Marilyn, I had a horrible toothache on my lower jaw on the right side. It was over the New Year's holiday weekend couldn't get to a dentist until Monday. The bad tooth turned out to be on a molar on the upper left side....so maybe it will work for him.
redbud--that is encouraging. The dentist doesn't feel the head banging is due to the tooth--but that may be a CYA thing--he saw Steve 4 mos ago and didn't mention any problems with the one he just extracted.
hoping the recoup period goes well marilyn. its true sometimes if a tooth is absessed the pain can travel to other sides of the jaw and mouth. i hope it helps with the banging. if not you are ready with the helmet.:)
I'm following along...this is hard stuff to deal with. Steve always seems to be just a step ahead of Jeff in terms of what trouble he gets into. I hope we can skip this one, and that it resolves for you quickly.
So far, so good on the banging issue and the tooth healing. The head nurse has taken a special interest in Steve and is feeding him as much as he will eat. Today for breakfast he had bananas, 4 pieces of French toast, oatmeal and eggs, plus several large cups of OJ. Her theory is that it makes him calmer if his tummy is full. He walked around for a while this a.m. and when I got there around 10:45 he was back in bed sleeping (no wonder, with all the food he had eaten :) They have also put the helmet on him and he seems to be adjusting to it.
Glad to hear the extraction went smoothly.. whew! One never knows with how their poor brains work, the pain could be on the opposite side of where he was banging. At any rate I hope he stops, that has to be heartbreaking to deal with.
Divvi, have you tried straight oral lidocaine? My neurologist gave it to me and it works on the nerves in the mouth better than any of the others.