Challenging behaviour with personal care

[Alfiefern]

Hi,
My father has end stage Alzheimer’s. He has lived with my mum at home and was admitted to hospital at the beginning of September.He is now in a specialist dementia unit.
He was admitted due to problems with his mobility and an infection.
3 months later he is presenting with very challenging behaviour when the nurses are attending to his personal care. He is bed wetting 4 or 5 times a night. He is on a low bed that means he is often found in the night crawling around the floor. He is looking for the toilet. He has been on Haloperidol some May 2018.They took him off the haloperidol and he is now on rispiridone.
I would like my father to be on some night time sedation so that he can sleep better during the night so that he can wee in his pad and be more settled and not be crawling about the floor looking for the toilet and therefore prevent these episodes of challenging behaviour. Just wondering if anyone has any experience of night time sedation in order to help him.

Thank you
Alison

 

[Kay111]

Hi Alison,

I'm so sorry to hear that your father is going through this stage. It's so very tough isn't it? I have no advice about sedation I'm afraid, what has the GP said about it?

When you say challenging behaviour, is it "just" (and I say "just" lightly - it must be distressing for him and for you to know he's doing that) the crawling on the floor? Or do you mean he is agitated when nurses change him too? My dad is currently very verbally and physically aggressive when he's being changed and cleaned and we're going through the process of working out how to best help him go through it all. The docs have slowly changed his meds (though if successful it might take weeks to work) but also we're paying close attention to what might trigger him. We've noticed some nurses are much better with him than others, so a part of it can be down to the carer's approach. I won't go through everything here in case that's not the issue you're wanting help with but let me know and happy to share one or two tips I've picked up (FWIW, everyone's different so your father might respond to different things )

Either way, sending you strength and support!

 

[Alfiefern]

Hi
Many thanks for your response. So sorry to hear that your Dad is distressed during personal care.

Sadly Dad’s challenging behaviour is verbal and physical aggression during personal care. He sadly has 4-5 bed changes aovernight.He is on a low bed so sometimes he gets onto the floor and is crawling around looking for the toilet.

He has Old age psychiatry looking into the overnight issues at the moment.

Any tips would be most welcome. Dad has 0,5 mg rispiridone a day split over 2 doses.

Again many thanks for your response.

Best wishes
Alison

 

[EdgsonW]

Hi,
My father has end stage Alzheimer’s. He has lived with my mum at home and was admitted to hospital at the beginning of September.He is now in a specialist dementia unit.
He was admitted due to problems with his mobility and an infection.
3 months later he is presenting with very challenging behaviour when the nurses are attending to his personal care. He is bed wetting 4 or 5 times a night. He is on a low bed that means he is often found in the night crawling around the floor. He is looking for the toilet. He has been on Haloperidol some May 2018.They took him off the haloperidol and he is now on rispiridone.
I would like my father to be on some night time sedation so that he can sleep better during the night so that he can wee in his pad and be more settled and not be crawling about the floor looking for the toilet and therefore prevent these episodes of challenging behaviour. Just wondering if anyone has any experience of night time sedation in order to help him.

Thank you
Alison

My Dearest has been prescribed Donepezil 1.75mg at night and she sleeps for 14 hours without having to change her pad. Alzheimer's for 4 years now and communication is deteriorating quite fast. Nobody has ever said there is an end stage for Alzheimer's as it seems impossible to assess?
Take care of yourself.
EdgsonW

 

[Alfiefern]

My Dearest has been prescribed Donepezil 1.75mg at night and she sleeps for 14 hours without having to change her pad. Alzheimer's for 4 years now and communication is deteriorating quite fast. Nobody has ever said there is an end stage for Alzheimer's as it seems impossible to assess?
Take care of yourself.
EdgsonW

Hi,

Many thanks for your reply. The reason that I wrote end stage Alzheimer’s is going by the 7 stages and my Dad is at about stage 6 I reckon.
Glad to hear that your mum has very settled nights on donepezil. I hope that my Dad will eventually have more settled nights,
Best wishes