Hello everyone,
This is going to be a long one. My mother lives in a long term care facility. She is 69 years old and is considered to be late stage Alzheimer's. On January 12 it was decided by the AD specialist to make a few changes in my mother's meds. She was taken off the Ritalin - generic name methylphenidate - (which she had been on to combat lethargy & it worked) because Ritalin is known to increase suspicion and paranoia and my mother was more so of both. She was also switched from Zyprexa (generic olanzapine) to Seroquel (quetiapine) because Zyprexa is implicated in weight gain and increase in blood sugar. At 5'3" & 190 lbs with erratic blood sugar levels, this was a concern.
I agreed with this as I felt these were legitimate concerns, particularly the weight issue. However, over the course of a few weeks my mother became more & more aggressive & much more easily worked up about things. Her suspicion & paranoia didn't change at all which didn't surprise me, as she had always been a suspicious, mistrusting person. She became aggressive with staff and residents. I'm not too concerned about the staff as they can run. We were starting to use Ativan (lorazepam) prn when she was too difficult to calm down. She continued to escalate; little things were setting her off.
St. Patrick's Day it came to a head. She wasn't given a St. Patrick's Day hat by the recreation staff & apparently wanted one. She took one old gent's hat off & when he took it back from her, she grabbed his cane & hit him in the face.
I walked off the elevator to find Thomas on the floor, bleeding from several cuts around his eye, people milling about & my mother a little back from Thomas. More Ativan of course & they started Haldol (haloperidol) as the Ativan didn't calm her down enough.
Big uproar, I'm talking to the general manager, the charge nurse, the dementia nurse, everybody & his dog for the next two days. They did understand she is not responsible for her actions but we did need to find some sort of solution for everyone.
A week later I received a call on my mobile (while I was at a funeral for another resident of the home) to tell me that my mother had been involuntarily committed to hospital because she was deemed to be a danger. So off to the hospital we went, chats with the police (in Ontario, it's the cops who have the lovely task of picking up demented people & bringing them into hospital when it's a Form 1 committal), talking to the medical people. The only psychiatrist on call was a child psychiatrist & he kept referring to the nursing home as a group home. He also needed new glasses as he couldn't read her meds sheet properly & thought she was on anti-seizure drugs (no - cholesterol drugs) and kept saying she was over-medicated & on a soup. She's not - I'm careful to pay attention to that.
But he didn't feel my mother should stay at the hospital. No big surprise there, as they had given her an injection of her old drug Zyprexa & she was settling down.
It's been just over a week, she's back on the Zyprexa & still taking a low dose of Seroquel. I'm meeting with the specialist on Thursday this week - it's amazing how quickly you get to see a specialist when you're hauled off to hospital by the cops!!
She's settling down a bit but she is definitely sundowning (forgot to mention that earlier). Now her day has become night. Her moods are better but she is definitely declining - not due to change in meds, just a general decline, I think.
There's no real point to any of this - I just needed to tell the story. We'll see what happens with the specialist.
She looked so pitiful at the hospital. They had given her the shot & put her in the "quiet" room - a small 6' x 8' or so cell. A couple of chairs & a foam mattress covered in vinyl on the floor. It looked like a prison cell, not something in a modern-day hospital.
At least now I finally put my foot down with my aunt and have forbidden my mother going out of the nursing home. Until 5 days before the hospitalization and AFTER my mother was physically violent with Thomas, my aunt was taking my mother out to the restaurant around the corner and/or bus rides. Now I have written a letter to the home forbidding anyone taking her out (I have power of attorney). I had to do this because when I asked my aunt not to, she chose to take her. Her take on it "I know when I won't be able to take Doris out". So my husband finally told her off & my sister (who lives 300 miles away) sent my husband a thank you email. My sister said somebody had to tell my aunt off, as obviously I wouldn't.
I'm just rambling now. Thanks for the ear.
This is going to be a long one. My mother lives in a long term care facility. She is 69 years old and is considered to be late stage Alzheimer's. On January 12 it was decided by the AD specialist to make a few changes in my mother's meds. She was taken off the Ritalin - generic name methylphenidate - (which she had been on to combat lethargy & it worked) because Ritalin is known to increase suspicion and paranoia and my mother was more so of both. She was also switched from Zyprexa (generic olanzapine) to Seroquel (quetiapine) because Zyprexa is implicated in weight gain and increase in blood sugar. At 5'3" & 190 lbs with erratic blood sugar levels, this was a concern.
I agreed with this as I felt these were legitimate concerns, particularly the weight issue. However, over the course of a few weeks my mother became more & more aggressive & much more easily worked up about things. Her suspicion & paranoia didn't change at all which didn't surprise me, as she had always been a suspicious, mistrusting person. She became aggressive with staff and residents. I'm not too concerned about the staff as they can run. We were starting to use Ativan (lorazepam) prn when she was too difficult to calm down. She continued to escalate; little things were setting her off.
St. Patrick's Day it came to a head. She wasn't given a St. Patrick's Day hat by the recreation staff & apparently wanted one. She took one old gent's hat off & when he took it back from her, she grabbed his cane & hit him in the face.
I walked off the elevator to find Thomas on the floor, bleeding from several cuts around his eye, people milling about & my mother a little back from Thomas. More Ativan of course & they started Haldol (haloperidol) as the Ativan didn't calm her down enough.
Big uproar, I'm talking to the general manager, the charge nurse, the dementia nurse, everybody & his dog for the next two days. They did understand she is not responsible for her actions but we did need to find some sort of solution for everyone.
A week later I received a call on my mobile (while I was at a funeral for another resident of the home) to tell me that my mother had been involuntarily committed to hospital because she was deemed to be a danger. So off to the hospital we went, chats with the police (in Ontario, it's the cops who have the lovely task of picking up demented people & bringing them into hospital when it's a Form 1 committal), talking to the medical people. The only psychiatrist on call was a child psychiatrist & he kept referring to the nursing home as a group home. He also needed new glasses as he couldn't read her meds sheet properly & thought she was on anti-seizure drugs (no - cholesterol drugs) and kept saying she was over-medicated & on a soup. She's not - I'm careful to pay attention to that.
But he didn't feel my mother should stay at the hospital. No big surprise there, as they had given her an injection of her old drug Zyprexa & she was settling down.
It's been just over a week, she's back on the Zyprexa & still taking a low dose of Seroquel. I'm meeting with the specialist on Thursday this week - it's amazing how quickly you get to see a specialist when you're hauled off to hospital by the cops!!
She's settling down a bit but she is definitely sundowning (forgot to mention that earlier). Now her day has become night. Her moods are better but she is definitely declining - not due to change in meds, just a general decline, I think.
There's no real point to any of this - I just needed to tell the story. We'll see what happens with the specialist.
She looked so pitiful at the hospital. They had given her the shot & put her in the "quiet" room - a small 6' x 8' or so cell. A couple of chairs & a foam mattress covered in vinyl on the floor. It looked like a prison cell, not something in a modern-day hospital.
At least now I finally put my foot down with my aunt and have forbidden my mother going out of the nursing home. Until 5 days before the hospitalization and AFTER my mother was physically violent with Thomas, my aunt was taking my mother out to the restaurant around the corner and/or bus rides. Now I have written a letter to the home forbidding anyone taking her out (I have power of attorney). I had to do this because when I asked my aunt not to, she chose to take her. Her take on it "I know when I won't be able to take Doris out". So my husband finally told her off & my sister (who lives 300 miles away) sent my husband a thank you email. My sister said somebody had to tell my aunt off, as obviously I wouldn't.
I'm just rambling now. Thanks for the ear.
