I could not locate a topic related to this. My DH has had aggression in the memory care unit. I had to find a behavior hospital for medicine adjustment. Has anyone had to do this and did it take long to get their LO stable on medication to help with the aggression. What types of medicine did they try. We have long term care insurance. They will pay to hold his room in memory care for 14 days. So there is a chance that they will stop paying for that and I have to give a 30 day notice to the facility.
I am more worried about how long he has to stay at the hospital and if they can even do anything for him. What will I do if they cannot.
My husband was in a geriatric psych floor of our local hospital. I was told the average length of stay when he went in was a week to 10 days. It takes at least that long to see the affects of the medicines. They want to make sure they are stable before they discharge them. They tried high doses of seroquel and IM Geodon on my husband. They switched to po Geodon because it made him drool. The only thing the medication did was get him to sleep at night. He passed 2 weeks after entering the hospital. The social,worker at the hospital told me that medication can control some behaviors but not all.
My husband has bvFTD, so his aggression was significant. He was committed to 2 geriatric hospitals for his aggression. The first stay was 1 month and the 2nd stay was 3 months. So in our case it took a while for the doctors to find the right med combo to calm him but not make him a zombie. In my opinion the shorter stays (10-14 days) are usually effective for less aggressive patients or to tweak the meds a person is currently taking which may be getting less effective over time.
The first hospital put him on Abilify for 2 weeks and then started to wean him off of it(I have no idea why) in combo with Aricept & Namenda. They used Haldol and Ativan to calm him after very aggressive outbursts.
The second hospital tried several med combos-Ativan, Haldol, Depakote, Risperdal, Seroquel, Clonopin, Neurontin. The combo we now use is Seroquel, Clonopin, and Neurontin. Ativan as needed which is not very often anymore.
As others mentioned, the length of stay can vary. My wife was kicked out of one ALF and the only program available was a 3 week evaluation (which can take longer) at another facility. I ended up keeping her at this facility since they can deal with her aggression (which has become much less frequent).
Ask the doctors what they are doing. You want to know how long the medications are expected to take to kick in and if they are removing any meds and how long it takes to get him off of them. My wife's neuropsychiatrist avoids drugs which take a long time to ween patients off of to avoid problems of side effects causing problems.
I did ask what medicines they were removing. I asked time frame for him to be there. The doctor said next week. That was 3 days ago. I will talk more to them tomorrow. I just wonder if this really makes them progresse after being there. The doctor said the medicines can only do so much. That they will still have episodes. One doctor told me this is part of a new stage and he will eventually get through it. We just do not know how long it will last. I just want him closer to home so I can see him more. This has been one of the more difficult things for me. I mean all is difficult. This is really taking a toll on my physical and mental health. I worry so much more with him there.
My partner went through three geriatric psychiatric hospitalizations for medication adjustment for behaviors, twice for nursing home eviction for aggression.In our case the loss of abilities seemed to bring about the behavior and it was one nursing homes insistence to use anti-psycotic drugs that made him aggressive. What was perceived as hitting was actually an attempt at communication with speech loss when their poor incontinence care caused skin loss in a very sensitive place. One period of aggression seemed related to losing continence, and losing ability to understand restrictions and general confusion. Once he became more disabled and unaware, he has no longer needed the anti-psycotic medication. For folks with dementias that have a lot of aggression, a nursing home that also has a psychiatric unit can prevent nursing home eviction as sometimes the person can be treated there. But those are hard to find. But they have more experience with dealing with those difficulties. His hospitalizations ranged from 10 to 20 days (insurance usually pays for 14). Having to find another nursing home is stressful while dealing with hospitalization, so I hope you can keep your placement. I hope to see the day that care facilities are set up to deal with medication adjustments on site - after all they are a part of dementia care. The disruption to the person who is dependent on routine is difficult, and the places we were in were considered the best in the area, yet there seemed to be no science as to what works - just trying different combos until results occur. I hope its just a phase and in time drugs that debilitate can be withdrawn. In our case, he is no longer on anti-psycotic drugs, and is not living in the psych unit or the dementia unit, but the main part of the nursing home as he perfers the quiet , and is experiencing no aggression and little agitation. He is mostly content, unless something is wrong, like a cold or headache.
My DH has Been in the Behavior Hospital now for 16 days. He is still all over the place. Climbing furniture, pushing furniture. If they try to stop him or redirect, he lashes out. He is in stage 7. I have contacted hospice. They say he qualifies. So my decision to get him from the hospital back to his facility, close by, is medicate to the point of out it or ECT. If he only has a short time to live, I do not want to put him through ECT. Still not sure about that. I did see the thread here for ECT. The aides at the hospital, said they have seen some really great results with ECT and some it did nothing for. He has been on so many meds to help with compulsive, agitated, aggressive behavior, I do not know what to do. The doctor said he tried marinol before with no results except increase appitite. All other meds knock him out. When I go see him he is knocked out by a PRN, because they cannot settle him. He is 1 1/2 hours away in Atlanta traffic. I can only see him between 12-2.
The hospice worker told me that my DH is in the stage where he is pushing to be here and when he gets tired this will stop. He also said that it will probably 6 months until he is gone. I know they are never sure. Please any advice or similar experiences.
ECT is not what it use to be. I heard light sedation and they are confused for a couple of hours. I also heard it can make agitation worse. His memory short and long is gone. He cannot say but a few words. He does when not knocked out, tell me he loves me too, when I tell him. He just seems so tormented.
jackiem29, My husband was very agitated in the end also although was not climbing on furniture etc as he did not have the physical strength. When he was discharged from the hospital, I had to put him into a facility that accepted behavioral issues. Not all facilities do as the one prior to the hospital admission would not take him back because of his uncontrolled behaviors. It sounds like he is at the end and if it were me, I would not do the ECT although that is just my opinion. I would allow hospice to make him as comfortable as possible although sometimes as I found out Hospice does not even know what to do in case of extreme agitation. Increased doses of Seroquel did not do much and they tried Geodon which is a powerful psychiatric medication. The hospital told me that with dementia they can control some of the behaviors but oftentimes not all. A facility that deals with behavioral issues can handle a situation such as this. Hospice told me that some dementia patients actually pass from something called terminal agitation. That is what I felt my husband had. I know if it were my husband, I would not want to subject him to any more medical procedures, not to mention the stress that a procedure such as this would put on you. I knew these decisions are so very difficult especially when the medical professionals do not have any answers. God bless.
My SIL had this problem. She spent six months in the psych ward trying to find a combo to calm her but nothing worked. She was violent and nasty, said nasty things to her daughters which she would never even think of saying in her healthy days. It hurt them terribly. Finally after about 6 months she collapsed from exhaustion and died within 2 weeks.
I forget who it was, but there is a guy here who had a similar experience with his wife.
It is a tough call. You are in a position none of us ever want to find ourselves. On one had with the raging their mind has to be in torment. Do we allow it to continue until they drop from exhaustion or do we sedate to at least give them some peace? But then the question is: is the torment still going on but they just can no longer act on it? What a hell this disease is.