Is it Live or is it Seroquel?

The same symptoms over the past few days - on the phone he's incoherent, genial, somewhat dreamy.  I wind up inventing my half of the conversation since there's nothing to respond to - vocalizations that sound like words and have the rhythm of sentences but aren't.

Last night he was a little more focused - very concerned that he had to write something about Roosevelt, but "what can I say that hasn't already been said?"  I think I've mentioned before that in 1945, he wrote a press release for the Coast Guard about their participation in the Roosevelt funeral.  A very old circuit suddenly kicking in.

Sunday night was an exception - he was very clear and also quite paranoid.  Kept telling me that "the house is full of women" and "they're no good" and "you need to come up here and see what's going on."

I've been wondering whether the new incoherence is the result of the Alzheimer's, or a side effect of the new drug regimen (higher-dose Seroquel and melatonin).  My current guess is it's the latter.  He had a substitute attendant Sunday - E is off every other weekend - and she probably forgot to give him his dose.  Or she didn't give him the dose because, strictly speaking, she's not allowed to - this is custodial care and the attendants can't pour meds.  If he missed the dose, and suddenly got articulate and unhappy, that tells us something.

I'll mention it to Dr. B so she can check into it when she sees him next week.

Strange - a couple of months ago I was indignant at the prospect that the Medicaid establishment was going to drug him instead of caring for him.  I think I was wrong.  The drug effects aren't bad - if the result is that he's less agitated and calmer and quieter and more peaceful, that's OK.  And if he's less conscious - well, at the risk of repeating, consciousness isn't his friend anymore.

I'll head uptown shortly and see what's on tap for tonight.

Comments

[Flouncy]

I agree - awareness/consciousness is not necessarily our friend.

On the money situation - if your dad is even barely ambulatory (can stand for a few seconds unassisted), you might consider a residential care home. In my state, RCHs are licensed just like ALFs and can be certified for Alz/dementia. There are also unlicensed facilities, and many of them provide very good care as well and are much more affordable.

(The only reason I mention the "barely ambulatory" requirement is because that's usually a regulatory requirement to move to a licensed ALF or RCH.)

The cost averages about $4300/month in TX.

If your dad is a vet, the VA's aid and attendance benefit will help pay and the asset test is much less stringent than Medicaid.

I recently placed my mom in an RCH that is certified for Alz/dementia and staffed by CNAs. The skilled nursing is provided by home health, paid for by Medicare, so residents can age - and die - in place, even if wound care, IV meds, feeding tubes, etc., are part of the care plan. They work with hospice.

Not all ALF/RCH will keep residents through end of life, but many do, esp. if they specialize in Alz and dementia.

[julie]

I also agree. My experience with the drugs has been very similar in the dreamy, almost incoherent genial type chatter,which is much better than the paranoid accusations of trying to steal all his assets by marrying him and then divorcing him. It is better for both of us as the stress of that was killing me and he was on the verge of a stroke in my opinion with all of the upset all the time. I'm going to suggest that it is the Seroquel as I have seen that exact change when upping the dose from 50mg to 100mg. But it all settles in after a while and becomes normal again after perhaps a week. The melatonin, well, not so much. I have seen no change with or without. I have taken it myself to see if perhaps it would help me sleep but I didn't notice anything.

I think the operative word here is paranoia. Everything must be scary in this world where nothing is the same anymore for the AD victim. Everything must be questioned and the understanding is no longer possible. I shudder to think how it must feel inside the head of our loved ones. That is the only reason I'm still here trying to take good care of my husband but I feel very much like we are all going down with the ship.
Carry on like ya do.

[Alan G. Ampolsk]

Flouncy - good suggestion. My local care manager, the one who's helping with my father's relocation, has good things to say about a couple of the local ALF's. I was initially skeptical given how advanced his dementia is, but I'm willing to have a look. Costs in the DC suburbs aren't quite as low as they are in Texas, but they're a lot better than nursing home costs. As to his veterans status, he served, but not overseas, so I'm not sure he qualifies for benefits. I'll check, though. I have his discharge papers handy in case they're needed.

Julie - I think you're right. The paranoia is a way of trying to build rational explanations for things that seem incomprehensible, sort of like the people who can't accept that JFK might have been killed in a random act by a crazed lone gunman. I can't begin to imagine how things seem to the person with Alzheimer's, but I keep trying in the hope that I can follow along.

Dr. B, his gerontolgist, seems to think that the dreamy wandering state is in fact the result of the Seroquel - but that the progressive speech failure and the ravings and loss of focus are the disease itself. I'll provide a few more details soon.

Thanks for your good wishes and for keeping up...

[Ajlouny]

There has been studies made on the effect of Seroquel and on to be avoided effect is Type 2 Diabetes. I would get some information on the medication before he takes the drug for much longer.