Quetiapine - Again

[BeckyJan]

Hello:
David had a review with his Consultant today She felt things had not changed

She was pleased that the pressure pad was worthwhile. At least the carers now knew when he was out of bed during the night and he is not reaching the top of the stairs.

I explained he was very irritable today - all to do with toileting. (I have had a blow up twice this week and have written to CH Manager to express my concerns).

End result is that quetiapine is to be increased and also citralopram (? spelling).

Aricept to be continued for the time being but some concern that it is not helping as deterioration may be 'vascular'.

Jan

 

[Grannie G]

I get the feeling you think David has deteriorated Jan. How do you feel about the consultant believing David`s condition has not changed.

 

[Helen33]

Hello Jan

It sounds like you have been going through a very rough time Jan - blowing up twice I certainly hope things get sorted and that you feel satisfied with a response from the Care Manager.

Like Sylvia, I was wondering how you felt about the consultant's viewpoint? Do they ever say what they base their opinions on?

Love xx

 

[BeckyJan]

I blew because each afternoon I seem to be responsible for the 6 - 10 residents left in the lounge. There is a shortage of carers at that time (maybe holidays, maternity leave or whatever). My David always seems to want toileting around 3.00 - 4.00 - never anyone around lately!!!! Sunday he was drenched and I blew!!!

Today when I arrived one lady wanted me to take her to bedroom, another wanted me to take her cardigan off, another fellow wanted a whisky (should have had one with him . My husband wanted the loo - no one responded so I took him myself and when a girl arrived to take over - I blew yet again. Yes I am tired and anticipating being 'out of action' for a few weeks from Monday, and, like you Helen, want to be sure everything is in place. Anyway put my feelings in print to CH Manager (strangely this lack of care in the afternoons corresponds with his absence!!). I generally am on very good terms with most of the carers - I think they are just pushed for time and underpaid.

The Consultant seemed to change her mind after meeting David again, and being in the mood I am, I pulled no punches. She had based her first opinion (in writing by letter) on the MMSE test When questioned she still had him at 19!!! (ridiculous cos he does not know where he is at any time, does not know what month, day or season! He probably can do the arithmetic and spelling World backwards and he can draw an octagon!! However she seemed to change her mind when she heard how incoherent he is and heard how irritable and depressed he is. Hence the change in medication.

She noticed his swollen foot - he smartly told her that had been that way for at least 2 years (how clear he was then). She put it down to his vascular problems

Rambling now. Love Jan

 

[Helen33]

Hi Jan

No Jan, you're not rambling, you are clearly telling us what has been going off!!

I will ring you tomorrow.

Love xx

 

[sue38]

Hi Jan,

What dose of quetiapine is David to be on? My dad is currently (back) on 25mg twice a day. We had stopped the evening dose, but as the recent aggression has occurred at night, it was felt that the mornig dose was wearing off, so this has been reinstated.

I agree with your concerns about the lack of carers available. Some of the residents at my dad's home will occasionally ask me to take them to the toilet, but there is always a carer I can hand them over to.

Citalopram is an anti-depressant used to control agitation? Is this new, or has David been on this before?

I have to say our consultant is conspicuous by his absence and it is the GP who now seems to be in charge of his care.

When is your op? If I don't catch up with you before that, I hope all goes well.

 

[Margaret W]

Sad to say I only dip in and out of TP since mum died last November, though it is all still raw with me, and still lots of unanswered questions.

Yep, Jan, I remember the scenario at certain times of day, usually when the staff are having an afternoon break, probably having been on their feet since 7 a.m. and people are needing assistance. I was often up and down the stairs to tell them so-an-so needs the toilet, or so-and-so feels sick, or so-and-so is shouting obsceneties that I felt were out of character. To be fair, the staff did always react instantly to my message, but I felt that someone should have been there in the room.

What Op Jan? If you don't mind me asking.

I am not suprised that you blew at David being drenched, it is so undignified.

You are quite right to put your concerns in writing. I did so with mum on a couple of occasions, and it did result in improvements as the manager was not aware of the shortcomings I described.

Hope it works for you and David.

Love

Margaret