Advice needed for aggressive behaviour

[decembergirl12]

Hi,

My Mum has early onset Alzheimers (she is only 59) and has recently developed some very aggressive behaviour - shouting, swearing, throwing things, purposely slamming doors and just generally trying to aggravate myself and my other family members. It mainly occurs at night which is obviously the worst time as we're all tired but can't sleep until she does- recently she kept us all awake until 2am until we somehow managed to get her into bed.

I wondered if anyone else has dealt with this successfully and has any tips on how best to cope with it, how (if it's possible) to calm her down?

Any advice would be appreciated!

 

[Izzy]

I wondered if you have discussed this problem with your mum's GP. It might be helpful to keep a diary to show what concerns you then share that with her GP before any appointment.

There society has a couple of factsheets about behaviour. You might find them useful -

http://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=96

http://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=159

 

[decembergirl12]

Thank you for your response Izzy- have downloaded the factsheet and will read it through now.

We've spoken to the doctor and it seems Mum has depression also- she has been put on anti-depressants but I honestly can't see a difference, her behaviour hasn't improved at all. I understand it can take a while to settle but myself and my family are at breaking point- it's horrible 75% of the time and we are all at the end of our patience.

 

[keane]

Your mum needs something to stop her agitation. My mum used to have trazadone which really helped. This is an anti depressant but also a sedative. My mum wasn't depressed - she was agitated due to changes in her brain. She also used to have diazepam when we were washing her. It needs careful management to ensure the correct dosage is given and as your mum's needs change so the dosage changes. I think this type of drug therapy is essential at this stage of Az and more discussion is needed about the most effective approaches. I have to say we found it difficult to get really good advice on how to deal with agitation / aggression as there is a reluctance to talk about the positive benefits of sedatives. I really wish we had used them sooner as seeing mum so agitated was like watching somebody in hell. This is a stage of this awful disease and is probably the most difficult for the family. I remember it nearly breaking us too so you have all my empathy. You are dealing with the emotional heartbreak of losing a loved one and the awful consequences of the disease. But you need practical advice and mine is to use an appropriate drug as I would argue that nothing else really works.


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[marionq]

My husband is not at all aggressive but was getting very agitated about his need to go out to work. He is on Trazadone twice a day and I had to try different times to get the balance just right. For him that is 2.30 and last thing at night. He still talks about this very important job he had to do but can be dissuaded much more easily.

I agree that sometimes you have to go down the drug route for all concerned. No sane person can live with extreme behaviour and not crack up themselves.

 

[sinkhole]

Can I ask everyone how you go about getting them take their medication, particularly if it's something they haven't had before or at a time they don't usually take anything?

My aunt is refusing any medication right now, but I know there will come a time when she will need to take something, even if it's just antibiotics. I just don't know how we're going to convince her, other than disguising them as krill oil capsules, which she's convinced cures all ills!

Any tips?

 

[keane]

Hi - you need to be really careful here and make sure that any decisions you make are written into your aunt's care plan - see below for why. However, we used to crush my mums tablets and disguise them in Lindt Lindor chocolates. My mum loves chocolates and this was the only way we could get her to take them. So my advice would be to do something similar.

However, this can be classed as COVERT medication and can be a red flag of abuse. So you need to make sure that you involve everybody - social worker etc in a BEST INTEREST DECISION. When people are judged as no longer capable of making a decision you need this in place and need to record all such decisions in care plans. This is because of the Mental Capacity Act (2005). There are good reasons for this act to be in place but it can be problematic and create some tensions when you are dealing with somebody who has Az. For example, you can ask somebody with Az if they would like a drink and they would often know how to reply to this question. However, it can be much more difficult to rationalise with Az patients about why they need to take medication etc. I think that this has to do with the difference between instinctive responses (based on learnt behaviour over a long time) and rationale responses that require reasoning. (These are my own thoughts based on my experience of looking after my mum over the last 15 years and trying to make professionals aware of this very important distinction.)

So Az patients (depending where they are at in terms of disease progression) have mental capacity to make some decisions but not others. My advice is always discuss with the appropriate professionals, make a note of such discussions and their outcomes.


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[sinkhole]

Thanks, that's useful. Maybe I should have started a new thread as I didn't mean to hijack decembergirl12's thread!

 

[keane]

It's all part of dealing with this awful aspect of this disease. Hope you and your family are coping ok. Xxx


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[marionq]

My husband trusts me and when I say this is prescribed by your doctor he accepts that it is the right thing to do.

I have thought a lot about the degree of sedation but frankly he has a better quality of life slightly sedated than behaving like a raving lunatic packing tools, making sandwiches, and trying to go to work in the middle of the night.

My life is better too and that matters - for both of us.

 

[keane]

I totally agree Marion x


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