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Medicating/ alleviating agitation and frustration

Huckleberry

Registered User
Nov 27, 2017
15
My mum is showing increased physical aggression and agitation in her care home, which is no doubt linked to her inability to communicate via speech, and also witness the terrible physical state of those around her who have advanced stage dementia.
She has slapped several other residents and has been refused placement at some other establishments due to her challenging behaviour. Tonight she has been hit herself by another resident and responded by striking back. I really feel there must be some type of medication she could take which would reduce her agitation/ frustration.She is stuck in a semi secure setting with other residents with severe needs and cannot wander anywhere so I’m thinking this is also something which adds to her sense of frustration. I am going to see if I can find a way to get her out for a walk to see if this will improve her mood but also feel she could do with a mood medication or otherwise. Does anyone know of similar situations which have been improved through medication? Obvs any change would need to be done through medical oversight but I would like to build my case for her to receive GP review with this in mind.
Many thanks
 

Cat27

Volunteer Moderator
Feb 27, 2015
11,463
Merseyside
Personally, I’d have a chat with the GP. Every case is different as people take other medication which may interact.
 

Helly68

Registered User
Mar 12, 2018
663
My Mum is in the dementia wing of a CH and has issues with aggression against the staff, when having personal care or refusing to take medication.
When they can get her to take medication (given covertly as liquids, agreed with MH team) we are trialling Mermantine and Lorazepam to try and reduce her hitting, kicking ,spitting etc. We have tired various other behavioural approaches as well.
At the moment it is early days, so she is very tired with the new drugs. She still has outbursts, but we hope with careful drug administration (i.e. an hour before personal care) that we may be able to reduce aggression without her becoming a zombie. I am very lucky in that my Mum's home has a liaison mental health team who visit and review those whose behaviour challenges and they are better than a GP, and can prescribe, in cases where the resident has a long history of mental health treatment (as Mummy does) or where drugs associated with mental illness are used.

Good luck, I hope your GP can help.
 

Huckleberry

Registered User
Nov 27, 2017
15
Thank you both. Hoping the drugs help your mum Helly. I can see mine is on the same trajectory, behaviour and all, and your care home and liaison team sound great.
The social worker has referred to the community mental health team to progress the assessment for meds but apparently the waiting list may be several months long. The social worker feels the GP won’t want to medicate due to the other blood pressure meds she is on. I’m wondering as I type this whether it might be appropriate to get a private psych assessment to hurry this up. I’m fearful that the home might not feel able to manage this behaviour going forward and she is moved to an even more extreme environment. If this is the reality there is more of a time pressure to get the meds on board.
 

Helly68

Registered User
Mar 12, 2018
663
Huckleberry, it seems we've had a lot of the same issues.
GP won't prescribe for Mummy as she is on a number of medications now, including one for Bipolar disorder and a number for pain, dementia, mood etc. I think the community health team is the way to go though that wait time is very worrying, but not surprising - I work in the NHS and mental health services have never had proper investment.

In terms of a private assessment - I haven't done this so am not sure how it might help. I think your problem would then be getting a regular prescription via the NHS (which I think you would need) as a result of whatever is recommended. NHS and private referrals don't always work well together, which is annoying but a reality. I think I would contact the community MH team, explain the issue and time constraint and see what they say. If you had a private assessment could they then work from that?

I would also say, keep in contact with the CH and emphasize that you are active in trying to resolve this. Often CH are just left to deal with challenging behaviour and as a relative it is hard to know what you can do, but if they know you are chasing up referrals, that might make them feel that things are going in the right direction and they may be more prepared to deal with behaviour while this gets sorted out. I have to say that Mummy's CH have been brilliant, even whilst she is hitting the staff, they keep working with the medication and want her to be able to stay. I am very lucky. Also, it is worth bearing in mind that homes often sadly have to deal with this behavior so it is worth talking about your fears with the manager as good homes will have dealt with these issues before.

The last thing I am going to add, may sound a bit extreme, apologies if you feel it is not appropriate.

In the past, Mummy's bipolar disorder became so bad that she has to be "sectioned" several times.
Sectioning is used when someone's behavior presents an immediate danger to themselves or others and leads to the person being placed in a secure psychiatric environment. Obviously, this is not an outcome that anyone would want, but as I understand it, it may be an environment where a drug regimen could be established and stabilised with more mental health input than a CH or nursing home might have. If Mummy's current drug regimen isn't successful, we may have to consider this. I am aware that this is not an option to consider lightly, but it might, as I understand it, lead to quicker access to mental health support, in extreme circumstances.

I hope this helps and that you get some progress.
 

Helly68

Registered User
Mar 12, 2018
663
Great advice, thanks very much Helly xx
Hopefully you will be able to get some support from the mental health team. Challenging behaviour is very hard. Mummy also kicked another resident but on further enquiry, I was told that the resident approached and tried to help her up. She would have found this frightening so context is important in understanding why aggression happens. It isn't always only about one persons actions and homes are good at monitoring interaction and separating where necessary.
 

MrsV

Registered User
Apr 16, 2018
169
Northamptonshire
My mum is showing increased physical aggression and agitation in her care home, which is no doubt linked to her inability to communicate via speech, and also witness the terrible physical state of those around her who have advanced stage dementia.
She has slapped several other residents and has been refused placement at some other establishments due to her challenging behaviour. Tonight she has been hit herself by another resident and responded by striking back. I really feel there must be some type of medication she could take which would reduce her agitation/ frustration.She is stuck in a semi secure setting with other residents with severe needs and cannot wander anywhere so I’m thinking this is also something which adds to her sense of frustration. I am going to see if I can find a way to get her out for a walk to see if this will improve her mood but also feel she could do with a mood medication or otherwise. Does anyone know of similar situations which have been improved through medication? Obvs any change would need to be done through medical oversight but I would like to build my case for her to receive GP review with this in mind.
Many thanks
Hi Hucleberry,
We had similar issues with Mum. She attends daycare a few days week. The Manager of the daycare center rang to tell us Mum was aggressive, kicking the doors,. walls, people, generally being disruptive and shouting at everyone. No amount of consoling or reasoning would stop her. They sent her home in the end. We spoke to the GP who upped the Risperidone, and shes much better now. Speak to your GP. All the best