The Story So Far

  • I'm a writer, photographer, consultant. Age 51. My father was a reporter and editor. Then he became something other than that. He died February 8, 2010 at 87. He was widowed in 2003. His decline started a little earlier. His sister died of Alzheimer's.

May 2011

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Comments

julie

Hi Alan,
I'm just wondering if your father has been tried on Lorazepam which is for the agitation and anger? We have found with my husband that 25-50 mg of Seroquel and 0.5 to 1mg of lorazepam works wonders in maintaining a more even temperament. I talked with a lady that operates an assisted living home here and that was her recommendation also. We got the lorazepam RX from our primary care doctor when he was becoming violent with me. He does sleep more with the two drugs but a little more sleep is an improvement over raging man. And when he wakes up he is all smiles and pleasant. It is a generic version of Ativan. I'll be curious to know.
We toured our first nursing home and I couldn't stand the thought of leaving him so I have hired some private care CNA's to come in and help me with his care to try to keep him at home a little longer, at least till I'm ready. So far he is on his best behavior with the gal and she can get him to go for walks and get up in the morning for breakfast so she is doing better than me at this point. So we carry on and we will see how it rolls.

Alan G. Ampolsk

That's a great suggestion... except that we've had to list him as allergic to Lorazepam. There was an episode when he was hospitalized almost three years ago. He had his usual sundowning episode, and someone on the staff decided to dose him with Ativan. The result was three days of full-blown paranoid hallucinations. They were so persistent that on Day 3, I finally had to tell him he was hallucinating - a level of truth-telling that I almost always try to avoid. For the record, he was pretty cheerful about it - actually somewhat amused that the big fistfight in his room and his subseqent abduction weren't real.

I remember also the extremely condescending young house staff physicians. On the first day, when my wife and I told them we'd never seen him like this before, they smiled and said, "Oh, okay..." In other words, let's humor the family, they're obviously in denial. At the end of the day they came in looking sheepish and said, "We've just looked at his chart and it seems that somebody gave him Ativan..."

So ever since, we've kept him off it. Maybe it's worth revisiting at a low dose, but I'm reluctant to go there. Makes me think we're stuck walking the line on Seroquel and trying to keep him between the low-dose rage and the high-dose rage...

I'm glad to hear you've got some help in. Your reaction to the nursing homes is understandable, though it may also be a reaction to particular nursing homes. I'm guessing you don't have too many choices in your geography, but if you do, it might be worth looking at more. I'm feeling OK about my likely choice - but couldn't imagine leaving him at some of the others.

As always, hang in, and keep us posted.

julie

Oh......well then, that sucks! I wonder if there are any other drugs of that nature that might be
tried? I'm hearing that Seroquel is a very strong drug and is good for what it is good for. Perhaps, though, that is not your fathers issue. I'm just throwing out ideas here but if I'm not wrong, I believe Seroquel is an antipsychotic. I wonder if his episodes could be handled with more of a calming type agent. I think we are all just bumbling about in the dark here trying to find some way to smooth things out for our persons and perhaps we make a lot of mistakes in our attempts but at least we keep trying, eh? Sorry there are no easy remedies for your dad or you but, as I say, carry on like you do.

crella

"actually somewhat amused that the big fistfight in his room and his subseqent abduction weren't real."

God love him...

MIL could probably use a tad more medication, she's really paranoid about the "thieves who come in my room when I'm asleep" but she can't tolerate anti-psychotics. When she was first diagnosed a few years ago she was put on Aricept and one other medication (which I can't remember now) and she had a severe electrolyte imbalance, crazy reaction, she was hardly conscious for 5 days, had to be put in diapers, she was almost completely non-responsive. We don't dare try and give her any more than she's on right now, which is too bad, because she must be miserable thinking that people are stealing from her all the time. Her doctor is afraid to give her anything to calm her down.

Alan G. Ampolsk

Julie -

Interesting. A calming agent sounds right, an antipsychotic sounds, on the face of it, like overkill. I don't know enough to judge - but it's something to put to Dr. B when she gets back. Definitely worth following up on.

Crella -

We've had the hallucinatory episodes, but run-of-the-mill rage seems to be the bigger problem. My father doesn't seem to be all that drug-tolerant, so it's hard to figure out what works. I sometimes think that we might be able to get at some of this nutritionally, but no one in the caregiving establishment is all that versed in nutrition - and then, of course, there'd be the problem of getting him to eat. Not looking for cures, of course, just something to smooth the path a little. We'll keep looking for what might work...

Flouncy

Risperdal is an alternative to Seroquel and is often used for severe anger and agitation.

Some people do NOT respond well to Seroquel. Your dad sounds like one of them!

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