anti pyschotic medication

[mickeyblueeyes]

Hi all

I am new to this website and posted an introduction a few days ago. I was touched by the kind responses. I do understand the illness and that confrontation with my mum is not the answer, however I find myself challanging her and trying to explain to her that I KNOW she has not bathed etc which only frustrates her more! One of the replies I had talks about 'the facility to edit out all the evidence' and thats what I continue to struggle with. Mum states she baths everyday even when last weekend I put my hand in the bath and loads of dust flew up! How can she continue to fight this evidence when she is NOT unintelligent?
Mum has also said that there is a convent opposite her that she has visited. Of course this is not the case. Her Dr recommended yesterday that due to this and her levels of anxiety (she is not settled and rings us constantly throughout the day asking to be taken out) that she go on a mild dose of anti psychotic medication ! This really frightened myself and sisters yesterday and we have refused this - have we done the right thing ?

 

[sunshine13]

Hi all

I am new to this website and posted an introduction a few days ago. I was touched by the kind responses. I do understand the illness and that confrontation with my mum is not the answer, however I find myself challanging her and trying to explain to her that I KNOW she has not bathed etc which only frustrates her more! One of the replies I had talks about 'the facility to edit out all the evidence' and thats what I continue to struggle with. Mum states she baths everyday even when last weekend I put my hand in the bath and loads of dust flew up! How can she continue to fight this evidence when she is NOT unintelligent?
Mum has also said that there is a convent opposite her that she has visited. Of course this is not the case. Her Dr recommended yesterday that due to this and her levels of anxiety (she is not settled and rings us constantly throughout the day asking to be taken out) that she go on a mild dose of anti psychotic medication ! This really frightened myself and sisters yesterday and we have refused this - have we done the right thing ?

Oh Mickey, my heart goes out to you. There is no 'right thing' unfortunately. This disease is, unlike most others, not straightforward. I was very resistant to the use of antipsychotics with my mum but have now accepted it, because she was becoming increasingly distraught.

My mum is in a secure unit and, from observing the staff there, the best thing usually is to agree with the patient whatever they say. In my mum's case she was worrying about not getting the "baby fed" when of course there was no baby. We just agreed with her - humouring her, I suppose, which sounds awful, but there is no way you are ever going to win an argument with someone who has dementia. I know it's different because your mum needs to keep clean - maybe a carer could call and help her to wash/bath, whatever is needed.

I hope this helps a bit. I know it's really difficult and anything I say is only based on my experiences with my mum who is a very long way down the dementia path, unfortunately. Just remember, whatever gets you and your mum through is probably ok because there are no simple answers - this disease is horrible and even the professionals struggle to deal with it.

Take care.

x

 

[loveahug]

I can't comment on the anti-psychotic drugs as I have absolutely no experience of them, we keep mum calm by being non-confontational and my brother and I are now with her 24/7 between us. I can only suggest you fully research the drugs and their side effects, esp on the sex and age range of the patients.

To present your mum's side of the case, if you looked in the mirror and saw blue eyes looking back at you but everyone around you insisted they were brown, what would your reaction be. Your mum either has an absolute memory of showering or is terrifed to admit she doesn't remember any more in case 'they come and take her away', so you will not convince her.

My mum will only change her clothes regularly when I sneak into the bedroom in the morning, while she is having her first cup of tea, and swap her dirty clothes for clean ones, leaving them in a heap on the floor just as if she left them there the night before. Although she does change her underwear every day (ingraned daily habits seem to hang on much more). She will shower when prompted it's just that it's so much effort to do it every day, then she forgets how long since she last showered.

I hope this has helped a little.

Lots of hugs

 

[jenniferpa]

It's difficult to be sure if you've done the right thing about the anti-psychotic drugs, but I think on balance it's probably never wise to make a decision like this out of fear. For many people these drugs are inappropriate, true, but for others they can be a vital part of treatment, particularly if they are closely monitored. I personally would be inclined to try anything that might alleviate anxiety - this is such a disturbing thing for a person with dementia.

About the bath issue - you are going to have to try to stop thinking of this as something that can be addressed by logic. It has nothing to do with intelligence either - as far as your mother is concerned she always bathes everyday, so confronting her with (what you see as) evidence to the contrary, is only going to distress her not persuade her that she is wrong. Imagine if you were the person who thought they bathed everyday and were confronted with this evidence: do you really think you would say "Oh I must be mistaken" when you are convinced you were not? I doubt it. You'd be more likely to think that someone was playing tricks on you.

 

[stanleypj]

Hi all

I am new to this website and posted an introduction a few days ago. I was touched by the kind responses. I do understand the illness and that confrontation with my mum is not the answer, however I find myself challanging her and trying to explain to her that I KNOW she has not bathed etc which only frustrates her more! One of the replies I had talks about 'the facility to edit out all the evidence' and thats what I continue to struggle with. Mum states she baths everyday even when last weekend I put my hand in the bath and loads of dust flew up! How can she continue to fight this evidence when she is NOT unintelligent?
Mum has also said that there is a convent opposite her that she has visited. Of course this is not the case. Her Dr recommended yesterday that due to this and her levels of anxiety (she is not settled and rings us constantly throughout the day asking to be taken out) that she go on a mild dose of anti psychotic medication !

Is there such a thing as a mild anti-psychotic?

From what I've read, on here and elsewhere, I doubt it if only because no-one can be sure what effect any drug can have on a person with dementia.

There do seem to be some suggestions as to what you could try first. It's usually best not to try and prove someone wrong but just stick to the idea that she needs a bath or good wash, offering to help. Try running the bath, using bath salts etc if she likes them.

A drug might stop your mum phoning to ask to be taken out. But 'be careful what you wish for' is always good advice. At present, your mum can use the phone (a big plus!) and she would like to be taken out (like many people who live alone - and another big plus that she shows interest in something).

It's very hard, no-one can deny that.

Take care

 

[zeeeb]

My step grand father in law, is similar, but no dementia. He says he bathes everyday, but he doesn't. I've given up worrying about it. I dont have to live with him, so if he wants to stink, too bad. Has was given anti psychotics, they worked very well for his depression, anxiety and general feelings of fear. Of course he took himself off of them once he was feeling better, and will go back down hill again, but I'm all for them. He was constantly in fear of dying, calling the ambulance etc. He needed something to chill him out and calm his fears down. At this point, whatever gives them a bit of peace and happiness. Why should they feel stressed and anxious? I don't believe they should feel it, any more than they should have to tolerate pain without medication to dull it. A lot of people are against anti psychotics, but what ever works, they don't need to be sharp as a tack, they just need to be kept as comfortable as possible in body and mind. Someone else will/should take responsibility for the other things, money, bills, daily grind.

 

[Highland]

try things

My mum was talking about all sorts of things that were unreal but to her they were true. You cannot convince her and should not try. try to imagine someone telling you you had just been to the shop. When you knew you hadn't it is just the same. Don't try logic that doesn't work. Does she need a bath in reality we all bath too much once a week is fine unless there are other issues or body odour is a problem. I just try to work it on is she happy. The anti-physcotic drugs worked a trteat for my mum she was happy and bit less wonky.

Try them. The thing is shes not going to get better so whatever helps in the moment is worth a try.

x

 

[marsaday]

My step grand father in law, is similar, but no dementia. He says he bathes everyday, but he doesn't. I've given up worrying about it. I dont have to live with him, so if he wants to stink, too bad. Has was given anti psychotics, they worked very well for his depression, anxiety and general feelings of fear. Of course he took himself off of them once he was feeling better, and will go back down hill again, but I'm all for them. He was constantly in fear of dying, calling the ambulance etc. He needed something to chill him out and calm his fears down. At this point, whatever gives them a bit of peace and happiness. Why should they feel stressed and anxious? I don't believe they should feel it, any more than they should have to tolerate pain without medication to dull it. A lot of people are against anti psychotics, but what ever works, they don't need to be sharp as a tack, they just need to be kept as comfortable as possible in body and mind. Someone else will/should take responsibility for the other things, money, bills, daily grind.

I'm with Zeeb on this. My Mum has just started on a mild dose yesterday. Her anxiety /agitation was getting to the point where she would have to move from her lovely supported living environment. So if this brings a modicum of peacefulness-so be it. I wait anxiously to hear how it affects her in the coming days.

 

[Pepper1066]

Is there such a thing as a mild anti-psychotic?

From what I've read, on here and elsewhere, I doubt it if only because no-one can be sure what effect any drug can have on a person with dementia.

There do seem to be some suggestions as to what you could try first. It's usually best not to try and prove someone wrong but just stick to the idea that she needs a bath or good wash, offering to help. Try running the bath, using bath salts etc if she likes them.

A drug might stop your mum phoning to ask to be taken out. But 'be careful what you wish for' is always good advice. At present, your mum can use the phone (a big plus!) and she would like to be taken out (like many people who live alone - and another big plus that she shows interest in something).

It's very hard, no-one can deny that.

Take care

hi I am new to here aswell my mother is getting anxiety , I rang the GP and he prescribed a low dose of Valium ,which we give when anxious ...I feel maybe an anti depressant would help my mum ...it's difficult I can't tell whether her dementia drugs help or not! Like the other lady said when dealing with suffers explaining and using logic ...just doesn't work! Does your mum have plenty of help going in to ease the load on you ? Take care x

 

[CraigC]

Her Dr recommended yesterday that due to this and her levels of anxiety (she is not settled and rings us constantly throughout the day asking to be taken out) that she go on a mild dose of anti psychotic medication ! This really frightened myself and sisters yesterday and we have refused this - have we done the right thing ?

My personal view based on experience is that a mild dose of anti psychotic can help in some circumstances. It is important to ask a lot of questions and to ensure that a clear review process will be in place. Very important to monitor reactions to any drug. There are some very strong anti psychotics (e.g. haloperidol), but these are rarely used for dementia patients now. A lot depends on your GP and how informed she/he is.

There are some useful old threads if you search for 'antipsychotics'. You may want to check the following to help with an informed decision.

http://forum.alzheimers.org.uk/showthread.php?19633-Today-programme-Radio-4-07-22

I think that is your chance to discuss changes and a detailed plan. My argument would be that then need to adopt a plan and not just say that they will review this in another year.

Best to go forewarned and forearmed.

Some useful reading here:

http://www.alzheimers.org.uk/site/sc...p?serviceID=49

http://www.alzheimers.org.uk/site/sc...documentID=548

http://www.alzheimers.org.uk/site/sc...php?fileID=322

Since it has been in the news recently, dad's care home has been asked by the GP to provide a list all residents who are on antipsychotics. They are on the ball to be honest but I expect the new approach has rattled quite a few homes. Good news as far as I am concerned.

Good luck with being heard and makes sure you write everything down and make everyone aware that you are writing it down

Kind Regards
Craig

And here is a direct link to a useful factsheet 'Drugs used to relieve behavioural and psychological symptoms in dementia'

http://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=110

Mickey, these decisions are difficult and emotional, so just best to get us much information as possible in my opinion.

Kind Regards
Craig

 

[SussexDave]

Hi there,

My sympathies this is a really difficult one.

What follows is a description of my own experience and my personal opinion. I would emphasize this is only one view and others may have more or different experiences. In particular close family care is not always possible.

My mum was diagnosed with AD when she became very distressed and had symptoms associated with psychosis such as hallucinations. At the time she was living alone but receiving regular visits from care workers. The doctor prescribed first risperidone and later olanzepine, I was very reluctant to allow this but the reasons for treatment and the risks of using the drugs were explained to me (if you are concerned I would try to get the doctor to describe the risks as simply as possible). I was also reassured by the enrollment of mum into a day care centre with medical overview for the duration of the treatment. The drug therapy extended mum's independent existence for a while but had the effect of dulling her mental state.

The doctor did not want to continue the treatment for long (a great relief to me) and by the time it had stopped I had come to stay with mum and was able to provide the kind of care mentioned by "Loveahug" I believe that the reassurance provided by the company and support of a trusted individual has proved more effective in the long run than the anti-psychotic treatment. Mum has continued to improve and is currently almost free of the symptoms requiring treatment.

 

[stanleypj]

SussexDave, I think you've hit the nail on the head. But, as you suggest, such care is not always possible.

This is perhaps the ideal. It will not work with everyone and there are situation described on TP where medication seems the only answer. But it's also clear that some medications that, it is generally accepted, should be a last resort are still used too casually.

 

[marsaday]

Yes Stanley, such care is not always possible. My Mum is suffering from extreme anxiety and delusional thinking and is being disruptive when she is left alone in fact even with the carers one to one attention. She is in a great place (not a care home per se but highly supported group living for dementia) where the care couldn't be better so I'd hate to see her leave but the reality is they can't provide constant 1-1 atttention, and neither could I, so we are trying risperidone in the hope that it will put off a move to a nursing home. My feeling is that some will suffer from this type of distress and some won't no matter how good the care.

Is it their character? Somehow I knew deep down my Mum would be difficult to manage in a care environment.

 

[LadyA]

My husband had/has me caring for him all the time, 1 to 1. When his paranoia and hallucinations were very bad, no amount of calming or reassurance made any impact on him - understandable, as in his "reality" we were under attack, he was going to be killed/kidnapped/tortured, or my daughter was (regularly) tortured horribly to death -acid being poured into her eyes was a regular occurance - by men who lived in her bedroom. It got serious when in the space of a couple of days, I twice found him hiding outside her room, having armed himself with on one occasion my kitchen shears, and the second time, a rather lethal barbecue fork! He was waiting for "the men" to come out! - good thing my dau didn't! So he has been on anti-psychotics since. Sometimes, you have to weigh up risks of meds against risks of not being on meds! Since being on risperidone, Wm is calm, happy and content - as long as I'm nearby!

 

[3littlepigs]

A Blessing.

My dad was prescribed a mild dose of anti-psychotics, just half the normal starting dose. It had amazing effects without any adverse side effects. The relief was amazing. Leading up to this decision dad was convinced that there were little black bugs everywhere and that they buried into your skin. It could be fluff, grit, soil or crumbs but to dad they were bugs. He began squeezing them out of his lower legs and started to get big bleeding wounds on his shins. I did not want to agree that they were bugs as this would exacerbate the problem. Things came to-a-head when he picked up a black bead outside one-day. I just lost it, (I still feel guilty even after a year), I fiercely told him it was not. He then shouted and swore at me, telling me not to speak to him that way. Understandable. But then he aggressively pushed me so that I nearly fell to the ground. My daughter, 11 at the time, witnessed it and was upset.
The anti-psychotics worked amazingly and the bugs have never appeared again. His legs healed, just scarring now. Other obsessions also disappeared too.

The main thing is to not let fear be your judge. We all hear horror stories about such drugs, being used inappropriately, being used to subdue people, don't let this cloud your decision. My theory is - if something is enhancing quality of life then go with it. If it is not, then don't.

 

[stanleypj]

My dad was prescribed a mild dose of anti-psychotics, just half the normal starting dose. It had amazing effects without any adverse side effects. The relief was amazing. Leading up to this decision dad was convinced that there were little black bugs everywhere and that they buried into your skin. It could be fluff, grit, soil or crumbs but to dad they were bugs. He began squeezing them out of his lower legs and started to get big bleeding wounds on his shins. I did not want to agree that they were bugs as this would exacerbate the problem. Things came to-a-head when he picked up a black bead outside one-day. I just lost it, (I still feel guilty even after a year), I fiercely told him it was not. He then shouted and swore at me, telling me not to speak to him that way. Understandable. But then he aggressively pushed me so that I nearly fell to the ground. My daughter, 11 at the time, witnessed it and was upset.
The anti-psychotics worked amazingly and the bugs have never appeared again. His legs healed, just scarring now. Other obsessions also disappeared too.

The main thing is to not let fear be your judge. We all hear horror stories about such drugs, being used inappropriately, being used to subdue people, don't let this cloud your decision. My theory is - if something is enhancing quality of life then go with it. If it is not, then don't.

I'm so glad things worked out for you and your dad.

However, things are not necessarily as black and white as you suggest in your last sentence. One small dose of a 'safe' antidepressant had an alarming effect on my wife which continued for months.

Anti-psychotics have been, and continue to be misused, as is now generally accepted.