care home was good, now changes in mam's mood

Discussion in 'Middle - later stages of dementia' started by fizzbomb, Sep 27, 2015.

  1. fizzbomb

    fizzbomb Registered User

    May 10, 2014
    47
    lancashire
    My mam has quite advanced mixed dementia. She couldn't cope at home, breaking vases, mirrors, chairs,coffee tables and finally a small window, and constantly shouting slamming doors and crying( her neighbours even put a noise complaint in to the council!).Even with her care package we realised she would be safer in a care home. Within hours of being there she became aggressive, and the ch had her sectioned for assessment on her first day! She was in the assessment unit 8 weeks. While in the hospital she displayed tendencies to grab at people,get in their faces,and sometimes hit out if she was angry or upset, but they said this was in part due to the pyschiactric hospital environment and she would do better in a nursing home.
    4 weeks ago we moved her to specialist dementia nursing home, which seems really good. It's on the ground floor,so everybody has access to a lovely secured garden. The staff are great, and we are really happy with it. For the first 3 weeks, mam was really happy, laughing and dancing all the time and it couldn't have gone better( although she had a few outbursts, the staff siad it was fine, and they were able to cope with them and calm her down). The staff love her and said she is a joy to have around. She walks round with the staff ' helping' them to do their cleaning etc,keeping busy and loves doing this. She is very active physically, though she is in her own world now, and understands very little of the world around her.

    My brother had a meeting with the ch a few days ago, and they said however,she has started hitting out at people again, and has started crying a lot now.They have her on 10 minute watch, every ten minutes somebody will find her(she spends all day walking round, and doesn't sit still!) and check on her to see how she is.They said she is so active she is in danger of falling.(she sometimes walks very fast and we do have to slow her down to stop tumbling sometimes) and they said she is not sleeping which they are worried is making her ill (before she went into hospital she hardly slept, and this is continuing). They said when she hits people they are obliged to tell that person's family,(which I completely understand) and are looking at her meds to see if they can help settle her a bit, as if it does continue it could become a problem if she continues to go for people.

    We had difficulties finding somewhere for her in the first place, due to her aggressive tendencies I believe, and I am really worried that the nursing home she is in will ask her to leave if they can't calm her. We really believe this place is good for her, and she does seem to love it there.

    When my brother went to visit last, she was sobbing her heart out( a member of staff was there trying to calm her) and said ' oh my eldest son is dead' he said 'no mam, I'm here' and she said 'ooh are you? '. then she said ' my only daughter is dead'( that's me) to which he said' no, she's doing fine mam' etc and she said ' oh thank god!' He managed to get her happy and laughing again, but I'm so upset by this change in mood, and it just breaks my heart to think of her crying again,after seeing her so happy, and it worries me that she is being aggressive again.
    They also said she has defecated in somebodies room during the night twice,the door sensors alarmed the staff, and they think it was just due to confusion about where the bathroom was, but this too is such a shock to me.Although my brother said the staff didn't seem phased by it.

    Sorry for my long post but this illness is cruel and devastating, and sometimes I just need to get it all out of my head(hence the long post)
     
  2. Onlyme

    Onlyme Registered User

    Apr 5, 2010
    4,999
    UK
    I know that it's probably been done but has the home got her checked out for a urine or chest infection?

    Can you arrange to be there when the home's GP visits and get an emergency medication review with the psychiatrist? Mum was put on Memantine and respiradone when she was at that stage. It seemed to switch off the aggressive behaviour.
     
  3. fizzbomb

    fizzbomb Registered User

    May 10, 2014
    47
    lancashire
    thanks for that, onlyme. She's been tested for infections.And there was a gp with her a few days ago, (they were doing a Deprivation of liberty on her)when my brother was there. I live over 120 miles away, and rely on public transport, and can't get up for at least another couple of weeks. There is a care review meeting in 2 weeks So I'm hoping my bro will make it to that.
    The home did say they are looking into her meds in the meantime. She is on donezepil, and was on citalopram for depression but I am unsure if the hospital put her on anything else(crikey I feel so guilty even saying I don't know what meds she may be on, I was putting my trust in the hospital as I know so little about the different meds, and didn't ask. I do hope that doesn't make me sound like a bad daughter!! I feel it!)

    She was diagnosed with alzheimers and vascular dementia, 18 months ago,( I am shocked at the rapid decline over these 18 months!) but the hospital she was in recently was unsure if she had lewy bodies dementia,due to an increase in some of her symptoms. although they then discounted LBD, and said as she suffers from constipation intermittently, the toxins that build can make symptoms worse. But she isn't having issues with that at the care home, and is able to 'go'. (I'm just glad the poor bloke whose room she used as a toilet was asleep and didn't know!:D) I know if it was LBD, they would have to be careful, as giving her some types of medication is dangerous with LBD .
    I will contact the CH this week and see what they say
    thanks again, and apologies for anybody reading this, that I haven't learnt how to do short posts:eek:
     
  4. AlsoConfused

    AlsoConfused Registered User

    Sep 17, 2010
    1,958
    fizzbomb, on TP we should all feel free to "say it as it is" without worrying too much about prettying things up, being concise and all the rest of it!

    Hope the situation resolves itself.
     
  5. fizzbomb

    fizzbomb Registered User

    May 10, 2014
    47
    lancashire
    I've come back from my trip to see my mam and the care review meeting. Unfortunately things aren't going well. She has slapped a couple of people hard,round the face, in her nursing home,grabbed somebody by both wrists and dragged her round a corridor, tried to hit somebody with a spoon and even went to grab a knife to go for somebody( but was stopped by a carer)
    They have her on one to one care, she isn't left alone, and often isn't near the other residents as she tends to lash out when she is around them. If she passes somebody in the corridor she will sometimes go for them. They have her on meds to help with limited effect. When I went to see her she was in a lounge with other residents and staff, quite calm, but I could tell she was on medication and I could see agitation in her face. The visit went without incident, thankfully, even though part way through the visit she punched my brother quite hard in the chest. He flinched,and then she was pretending to be angry, punching the palm of her hand,then grabbing her hair, and almost growling,then laughing. I know it's the illness causing it, but it breaks my heart

    They want her readmitted to hospital, hopefully short term, for them to look into it.They said her place will remain open in the home as they want her back.They have seen the happy mam, (she was lovely and very happy the first couple of weeks and they all loved her).
    She is having auditory and visual hallucinations, although the hospital had previously said she wasn't,and was just making up stories( confabulations, was the word they used). Though my brother told them that he had seen her have a conversation with relatives who weren't there, shortly before she went into the hospital unit. She even went to hug the people and was replying to them. In an empty room she will shout out shut up, shut up, and the care staff said she is frightened by things that are not there They said her quality of life is not good at the moment as she can't be given the freedom to participate as much or be on her own, and she is under constant watch.
    I am just praying that something can be done to help calm her aggression and anxiety as I just don't know what will happen if they can't sort it.
     
  6. sleepless

    sleepless Registered User

    Feb 19, 2010
    3,232
    Female
    The Sweet North
    I am so sorry to read of your mother's downturn, fizzbomb. The bit where you describe her almost punishing herself for punching your brother is truly heartbreaking, as it implies she cannot help herself even though she knows what she is doing is wrong. There are several instances on the forum of this sort of behaviour and it is so sad to read of how this cruel symptom changes people and torments them.
    I do hope something good will come of her stay in hospital, and she will be returned to the care home.
     
  7. fizzbomb

    fizzbomb Registered User

    May 10, 2014
    47
    lancashire
    thankyou so much for your post.I hadn't even thought of her punching herself for that reason but it makes sense. It was as if she was trying to make a joke from it, to say 'look I didn't mean it, I'll do it to myself, I was only joking'. It was like a child who hits a friend and then realises what they have done.It is so different from her behaviour,I'm just hoping that she doesn't realise too much what is happening.It would break her heart
     
  8. AlsoConfused

    AlsoConfused Registered User

    Sep 17, 2010
    1,958
    The nursing home's reactions to your Mum are a credit to them and to your family (for finding such a caring environment for her to be in).

    It does sound as if the hospital discharged her too soon, doesn't it?

    I so hope matters improve for all of you.
     
  9. fizzbomb

    fizzbomb Registered User

    May 10, 2014
    47
    lancashire
    Thank you for your post. We are very happy with the home and do feel as if they are doing their best. And we too are just hoping that things improve. I think you're right about the hospital too.
     
  10. jasmineflower

    jasmineflower Registered User

    Aug 27, 2012
    335
    Given your mum's extreme behavioural problems you should ask for a CHC assessment
     
  11. fizzbomb

    fizzbomb Registered User

    May 10, 2014
    47
    lancashire
    Thanks for that jasmineflower. my mam is on a section 117 after being in a psychiatric hospital under a section 3 due to her aggressiveness. However we did attend a CHC meeting the other day , the man who led it said her behavioural and psychological issues were covered by the Section 117 but he wanted to see if there were any physical issues that needed looking into.
    However, part way through the meeting he cancelled it. He said it was unfair on us all to continue as the picture that he was being given was not how she was a couple of weeks ago, and he wanted her readmitted to hospital.She has been tested for infections etc, and they are all clear. He said the way the meeting was going, was heading toward a challenging behaviour placement,which he didn't want, and he is hopeful that they can settle her down with intervention, so she can then return to the care home again. So another meeting is planned in just over month, to see where we are, unless she is still in hospital . We are waiting for the psychiatrist to re-examine her to see if she needs re-admitting.
     
  12. sleepless

    sleepless Registered User

    Feb 19, 2010
    3,232
    Female
    The Sweet North
    So sorry you are still somewhat in limbo Fizzbomb.
    I hope your Mum does settle down enough to be placed back in the care home.
    It must be so worrying for you.
     
  13. fizzbomb

    fizzbomb Registered User

    May 10, 2014
    47
    lancashire
    thanks Sleepless, it is an awful time,and I too am just really hoping they can settle her down. I would love to see her dancing, as she was up until a couple of weeks ago, she was dancing everywhere! But I realistically know not to expect this, so just to be more settled and less combative, that would do me absolutely fine!
     

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