Challenging Behaviour - medication ?

Discussion in 'I care for a person with dementia' started by CarpeDiem, Dec 8, 2016.

  1. CarpeDiem

    CarpeDiem Registered User

    Sep 21, 2013
    My mum has Alzheimers and my Dad is her 24/7 carer - he is 79 and shattered :( !!

    He eventually took the plunge and arranged a weeks respite - put my mum in a lovely Dementia Unit near home for a weeks rest. After just 4 days she is back home - full of bruises on her hands and arms where the staff have had to restrain her from lashing out at them - we do believe that as she is known to lash out at home and is on aspirin so bruises very easily. She has come home in a foul mood. She gets very angry - and the voice and looks at people are almost venomous ! other times she is all sweetness and light ! So back to square one and I am very worried about my Dad.

    The Unit Manager has mentioned the Mental Health Team and anti-psychotic medication to calm her - not sedate her - but calm her...... has anyone any information or experience of this and involving the Mental Health Team ?


  2. Maldives13

    Maldives13 Registered User

    Feb 4, 2014
    My Mum is in a care home and has same issues with aggression. Heartbreaking as this is not her nature at all!
    She sounds exactly the same as your name - all smiles one minute and then changes!
    Doctor prescribed pregrablin which she is currently on with a tiny dose of respiridone! I have to say I am currently asking them to take her off some as the pregrablin has made her much more Incontinent and her aggression is still there.
    It's awful as in our childhood she never once hit any of us.
    I will follow this thread with interest to see what others say and good luck x
  3. smartieplum

    smartieplum Registered User

    Jul 29, 2014
    Oh poor you. And your poor dad. I'm sorry but people should not just be left to deal with this. The various agencies are just washing their hands of older people with dementia. As long as there is someone at home, no matter what the age, they just leave you to it.

    You have pensioner age children looking after parents and partners looking after aggressive partners. It's just not right.
  4. la lucia

    la lucia Registered User

    Jul 3, 2011
    #4 la lucia, Dec 8, 2016
    Last edited: Dec 8, 2016
    In my experience, the Community Mental Health Team are very good - they have specialist dementia knowledge way above GPs. My mother was prescribed medication for agitation that made her have extreme nights of sundowning. I would definitely get them involved.

    Our local team came to the house and that included a consultant's visit. You may have to trial different medications to find one that suits but I don't know what I would have done without their help.

    You should be able to self-refer - try Googling the CMHT for your area to get contact numbers. Make sure you have a detailed description of everything that happens with your mother. Maybe a diary format would be useful and don't play anything down. Best of luck.
  5. la lucia

    la lucia Registered User

    Jul 3, 2011
    Yes and no...... They're not psychic, medical professionals need to be informed if there's a problem and in our area they are really on the ball if you ask them to visit.

    The Community Mental Health Teams are generally excellent and in our area so are the reablement services.

    This morning we had a visit from an Occupational Therapist at 7.00am who gave myself and a domiciliary carer a training session on techniques for getting my mother out of bed. She decided it was the best time because later in the day my mother is more agile. That's pretty fine service no?

    There's a lot wrong with social care and Dementia support and things vary regionally but considering how the NHS has been stripped to the bone the last few years, their community services are generally good.
  6. Ludlow

    Ludlow Registered User

    Jul 20, 2016
    SE England
    Hi, Sorry to hear about your mum and dad's situation. So difficult and wearing for your dad - and not good for your mum either as there is obviously something causing her anxiety for her to lash out in this way.

    I know a lot of people are very against anti-psychotics but I'll give you my views so you can consider what to do.

    My mum has got the idea that a neighbour is coming in at night to blind her. No amount of compassionate listening, reassurance, distraction, changing the locks, sleeping in her room, putting chairs against the door and so on did any good. She just gradually got worse. Getting her to bed at night became a nightmare for both of us. She refused to get into bed, wanted to call the police, begged to be taken somewhere "safe". She would sleep in an armchair some nights, or pace around half the night. I'm in my 50s and took early retirement to look after her, but I was still exhausted by the mental effort of dealing with this.

    The mental health team have been slow to get involved (I suppose due to higher priority cases) but have now tried various anti-psychotics, starting at tiny doses. The first two drugs had no effect but in the last week, the third drug they have tried seems to be having a small effect. She has gone to bed with no undue fuss the last 3 nights. She is still talking about the neighbour and worried about him but she is not so panicky at night. It is early days and it could be coincidence, but I am cautiously hopeful. She does not appear "sedated", if that is what you are worried about.

    Yes, there are risks. The doctor estimated her risk of having a stroke at about 2%. On the drugs this increases to 4%. However, I see this as a risk worth taking if the upside is that she is no longer frightened and angry. After all, who wants to live their life being afraid all the time? I can honestly say that if I were in her position I would want to take the drugs if it made my quality of life better. And there is the plus that it makes my life less fraught too - and that's something you also need to think about for your dad. If your mum is too difficult then your dad may not be able to cope and she will have to go into care permanently. It sounds like your mum did not react well to being in a home, and your dad may well feel that he had let her down in not caring for her (not that he should, of course), so that may not be the best solution for either of them at the moment.

    I would definitely say talk to the mental health team and have an open mind about any drug treatments they suggest. Dementia is a physical illness so it is reasonable to think that the right medication can help. Think of it not as controlling bad behaviour but reducing the bad feelings that are causing your mum such distress that she behaves like this. The effects do need to be monitored closely. I don't know how well your dad is able to do that, or how often you can see your mum. I find keeping a diary of incidents and behaviours helps me to look back and see if there has been any change. If you don't see them, perhaps your dad could phone you each day with a "daily report" and you can keep the records.

    Sorry, I seem to have wittered on rather a lot. Hope it is some help - and good luck whatever you decide.
  7. Amy in the US

    Amy in the US Registered User

    Feb 28, 2015
    I'm in the States so can't comment on the mental health teams, but my mother has dementia and has been on a variety of medications since her diagnosis almost 2 years ago. In her case it was anxiety, sleeplessness, and pain needing to be controlled. It took time (a few months) but once the right combination of medications was found, there was a huge improvement in her behavior.

    I would encourage you/your dad to ask for help, a medication review, and more support. Carers coming in, day care, et cetera. Best wishes.
  8. MrsTerryN

    MrsTerryN Registered User

    Dec 17, 2012
    On your dads side. He needs the breaks:(... so having assistance with medications is a good idea.
    My dad hid a lot with mum and he passed away. The weird thing was once mum went into care , the day after dad died, mum improved for a few months. Mum had medications ... personal care.. regular eating.
    Dad and carers oh and us did that but mum would become aggressive and .. we didnt deal. The staff at the home did deal.
    I wish we had given dad respite

    Sent from my SM-T810 using Tapatalk
  9. Frederic H

    Frederic H Registered User

    Apr 1, 2015
    My O/H is in a nursing home now, the first care home she went to said she had challenging behaviour so I had to move.Now she is quite relaxed and quiet in the nursing home so I asked the nurse about her resperidone she was on half a tablet a day now on two a day but it seems to work and doctor is checking after 15 days

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