Hallo. My husband has vascular dementia, and is so variable it’s a nightmare. Some days he just sits and sleeps. Unable,to,stand,or,walk, but this can change,hourly. other days he talks, and fiddles, nothing I’ll hold his interest, and whatever I am doing, all I hear is my name constantly. This can change from irritating to suddenly aggressive.Plus aggressive shouting, throwing things, cushions, sweets, the worst so far, a cup which shattered.
He now has hallucinations, has lost language skills, and cannot process anything, talking, understanding, or moving.
He shuffles in a Parkinson’s like gait, although our Consultant insists he has not got Lewey bodies,
So my question is there any medication which can keep him calm? Or at least on some sort of plateau, which will stop me getting that awful stomach dropping feeling,when he changes persona at the drop of a hat,
Hi Katy,
It sounds like you have an awful lot to cope with here! I’ll try to address your individual questions but, overall, I’d say that you need help from someone properly trained to investigate these kinds of situations – particularly the volatility issue. You should already have access to a community mental health nurse through the local Memory Service. I’d strongly recommend you contact them and ask for assistance. It’s what they’re there for.
The main reason why I’m suggesting this route, rather than dealing with it entirely by yourself, is that the symptoms you describe might be a sign of an underlying medical condition (aside from the dementia) that needs treating. This could be a recent unnoticed event (such as a mini-stroke) or a new emerging condition, infection, pain (e.g. toothache, backache, arthritis), depression/anxiety, or perhaps the side effects of recently changed medication. If so, then a thorough clinical examination might reveal it and allow it to be resolved without having to resort to antipsychotic drugs or mood stabilisers, which tend not to be very effective in such situations anyway and have serious side effects and risks. Antipsychotic drugs tend to only be used by doctors for very short periods in dementia, and only a last resort when a person’s safety is at risk.
Aside from medical conditions, it’s possible that your husband may be struggling to either understand or communicate an ‘unmet need’. This can include being physically uncomfortable, bored/under-stimulated, overwhelmed/over-stimulated, scared (particularly with hallucinations), anxious, lonely, tired or frustrated. Each of these has a potential solution (perhaps not a perfect one, but at least something that can help).
Try to put yourself in his position as much as possible, taking into account his pre-dementia personality and the cognitive difficulties that make processing thoughts and feelings so much more difficult for him, and then look for clues as to what might be causing the problem. Once you’ve identified a potential cause, try to come up with a solution and try it out. If it works, then great. If not, then try something else or look for another potential cause. It may take several attempts before you find something that makes a difference, so patience and perseverance are key.
I’d recommend reading our factsheet on
'Changes in behaviour' (pdf), which sets out some of the typical reasons for these kinds of problems and how best to manage them. It’s a really excellent resource (I didn’t write it!) and may suggest some solutions you’ve not yet tried.
There is also a good factsheet on coping with
sensory difficulties (pdf), which includes how to deal with hallucinations.
You can also make good use of the Alzheimer’s Society National Dementia Helpline (0300 222 11 22) while you’re waiting to see the consultant or community mental health nurse. The main thing is that you shouldn’t feel you have to do this alone. Get expert help.
Best of luck,
Simon