1. daughter

    daughter Registered User

    Mar 16, 2005
    824
    Just back from visiting Dad in hospital and pleased to report he's looking and sounding much better. Yes, I did say "sounding" better. The improvement in his speech (he hardly says a word now usually) is remarkable. His head is straighter (he's not so hunched forward) and he's the most alert he's been for ages, in fact since he came back from his last assessment in hospital in May 2006.

    Just to clarify, the hospital where he had his assessment for the agggression was a Mental Health hospital, whereas at the moment he is in a Physical (for want of a better word?!) hospital because he collapsed on Sunday.

    We saw a doctor today who was not only dishy, ;) (just as Alex has been finding!), but also very friendly and informative. (Although, once again, we were asked if Dad had any mental health history and I found myself saying "he has Alzheimer's"!! :rolleyes: ) Dad had about 5 different medications on the list sent from his Home, and he is only on two of these at the moment.

    The main one that I'm pleased they are only going to administer as and when Dad needs it, (like it says in the notes), is Haloperidol (for his aggression). I have a feeling that he was being given this as a matter of course each day in his Home. I felt even happier when the doctor said they do not like to give medication for behavioural difficulties if it can be avoided. OOh! how I agree!

    The other good thing is that Mum has seen this sudden change for the better in Dad herself, because she thought his decline was just the Alzheimer's progressing. Well, I wasn't sure either, but now I'm almost convinced the medication is the cause of (most of) Dad's rapid decline over the past 6 months. I haven't dared search the Internet about this drug before but, now I feel Mum's on my side, I have been looking and have not found many glowing recommendations!

    What should I do now? Dad is meant to be in hospital for another couple of weeks, so we'll monitor the situation, but I guess an appointment with his Psychiatrist is the next step to discuss a possible change in his aggression medication? The other problem is going to be how to approach the Home to ask/suggest/tell them not to administer this unless it is really needed? I don't want to appear ungrateful or meddling, I realise it is they who have to deal with Dad on a daily basis and it can't easy getting the aggression under control, but it is heartbreaking to see him so drowsy on this medication all the time. What should I say/do - if anything?

    P.S. I can't tell you how good it is to see him looking a little brighter. :)
     
  2. Skye

    Skye Registered User

    Aug 29, 2006
    17,000
    SW Scotland
    Hi Hazel

    So glad your Dad is so much better. Has he shown no signs of aggression while he's been in hospital?

    I would have thought that if the doctor puts on his notes that Haloperidol is only to be dispensed when necessary, the NH would have to abide by this?

    I would think the psychiatrist would be the one to make this clear.

    Good luck
     
  3. Grannie G

    Grannie G Volunteer Moderator

    Apr 3, 2006
    69,595
    Kent
    Hi Hazel, What a good post about your dad. We are so programmed only to expect deterioration, it is cause for a double celebration when we see an improvement. It just shows how medication should be continually monitored. Hope his speech continues to stay as clear and he remains as sharp.
    I agree with Hazel [Skye] about your dad`s notes clarifying when he should and shouldn`t be given medication. I would definitely check it`s recorded properly.
    Love Sylvia x
     
  4. Cate

    Cate Registered User

    Jul 2, 2006
    1,370
    Newport, Gwent
    Hi Hazel

    What fantastic news, it is soooo very good to hear about an improvement, such a rare thing to hear about.

    I agree, I would ask the Psychiatrist to write to the NH stating clearly the dose and frequency, if required, for any of his medication...........I think I would also be inclinded to ask to see his medication chart now and then............you could just say to see how things have been going!!

    Hope dad continues to stay alert.

    Love
    Cate
     
  5. glyn

    glyn Registered User

    Nov 23, 2006
    30
    Hi daughter ,,,,,,just a note to say mam was prescribed Haloperidol ......early on in her demetia ....and she seemed to be getting worse ....after taking her to see the Dr at the hospital he suggested mam stopped taking haloperidol as the side effects were starting to show ,,,,,,e g .....shuffling her feet ,,,,shaking of her hands ....and slurring her speech ....all those side effects have now gone ....I think sometimes the medical staff play around too much with the elderly ....Its a lovely feeling isnt it when you see the improvements in your loved ones ,,,,no amount of money can compensate for the feeling you have for them ......Just keep your chin up .....theres lots of people thinking of you ......Glyn ,,,,,,
     
  6. daughter

    daughter Registered User

    Mar 16, 2005
    824
    Hazel, Sylvia & Cate , I'm sure you are right about the psychiatrist being the one to approach, and Glyn, glad to hear your Mum has been taken off the Haloperidol. I still can't believe Dad's been kept on it for over six months. Thank you all for your good wishes.

    Latest news is that the hospital thinks that Dad has had a bad cold but also that he's been over-drugged (although they were careful not to say those actual words). He has not shown any signs of aggression, but then he's still not mobile. They are still giving him an anxiety-reducing drug and will eventually ask Dad's psychiatrist to visit him at the hospital.

    It will be interesting to see the outcome after all the various parties have had their say. Will the psychiatrist agree with the hospital's way of handling Dad without so many drugs? Will the Home then follow what the psychiatrist decides?

    Worst case scenario is that the psychiatrist disagrees with the hospital, puts Dad back on the Haloperidol and the Home administer it every day - back to square one.

    Happiest outcome for Dad, Mum and I would be that the hospital find Dad stabilises on his anxiety-reducing drug, and/or a weaker neuroleptic form of drug (dangerous thing a little knowledge - I've been searching the internet!), that he/she will continue to monitor the effects of this and the Home only give him it in moderation.

    Thanks again and I'll keep you posted!
     
  7. CraigC

    CraigC Registered User

    Mar 21, 2003
    6,630
    London
    Hi Hazel,

    Dad was put on haloperidol for a short while and it definitely made him worse. It made dad very anxious and confused and he ended up pacing up and down incessantly. He was not the same man. After a bit of battle, his medication was reviewed and then he was put on a low dose of quetiapine. This worked out much better and dad is still on quetiapine 8 months later - he seemed happier in himself and lest anxious. Like all drugs it has his side effects, dad seems a lot more sleepy for example.

    Haloperidol frightened the hell out of us so make sure they are clear about side effects etc. If you run a search on quetiapine, you will see some threads discussing its use and side effects

    Kind Regards
    Craig
     
  8. Nebiroth

    Nebiroth Registered User

    Aug 20, 2006
    3,518
    Like all these things what suits one person doesn't suit another. Very often a process of trial and error is necessary to find a treatment that achieves the desired result without undesireable side-effects. The trick is to gain the maximum positive effect whilst minimising the negative effects.

    From what I have read Haloperidol (amongst others) is one of the older class of "conventional" antipsychotics whilst Quetiapine (again, amongst others) is one of the new class of "atypical" antipsychotics. I believe that the former are still the first treatment of choice, unless there is a reason not to use them - for example if you have not responded to them or have experienced "extra pyramidal" side effects.

    Before my Dad got diagnosed with AD I never thought I'd have to be finding out about all this stuff!

    I think the important thing it to keep on trying, and to keep on going back to the doctors when you get side-effects to try and get an alternative.
     
  9. daughter

    daughter Registered User

    Mar 16, 2005
    824
    Thanks Craig, I will definitely be looking more closely at Dad's medication in future.

    Thanks Nebiroth - I agree that it has to be trial and error but this drug was started at the same time as Dad's Excelon was stopped - so this is another reason why Mum kept saying (and therefore I was unsure too) that the deterioration must be down to the Alzheimer's. Surely it wasn't just Mum and I who noticed the bad effects. I'm just a lay person with no medical knowledge to back up my suspicion that the Haloperidol was doing this. If he's quiet and compliant, do they care even if they do notice these effects?

    Then again, at the last visit Dad seems to have slipped back to the "normal" state of not acknowledging us, dribbling and staring into space. So I just don't know any more.

    I'm taking Mum for another visit today, and I know I can admit this to you all, I just don't want to go. Seeing my Dad like that, seeing my Mum suffering because she's worrying about him is almost as bad. Ho hum.
     
  10. Grannie G

    Grannie G Volunteer Moderator

    Apr 3, 2006
    69,595
    Kent
    Dear Hazel, I`m so sorry your dad has reverted back to where he was. It`s so upsetting when you get your hopes up, only to have them dashed a day or two, or even an hour or two later.
    Even though you are a lay person, you and your mother know your dad better than anyone, certainly better than the medics. So continue to observe and report even though the outcome might be very disappointing and upsetting.
    I hope he has another good spell soon. Love sylvia x
     

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