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 Coping with Violence: If Your Loved One Changes 
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Joined: Wed Aug 06, 2008 2:24 pm
Posts: 40
Post Coping with Violence: If Your Loved One Changes
Geri Hall has written an excellent article on coping with violence in dementia.

It can be found here: http://www.centeronaging.uiowa.edu/archive/pubs/Newest%20Versions%20-%20pdf%20format/Coping%20with%20Violence.pdf


Fri Oct 17, 2008 11:14 am
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Joined: Thu Jul 03, 2008 11:05 am
Posts: 150
Location: Raleigh, NC
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Thanks for posting this link. It is a great article. I only wish I'd read it before I had to deal with such situations!

Garnet


Fri Oct 17, 2008 12:48 pm
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Thanks Angela,
I posted it to the caringspouses group as I know some are dealing with violence now and has been a topic as of late!


Fri Oct 17, 2008 2:31 pm

Joined: Sat Oct 27, 2007 9:16 pm
Posts: 165
Location: tennessee
Post violence
Thanks, Angela. The reminder to be vigilant is helpful. My spouse is in a facility, and even there when we go to his room, I see that he is seated in the corner and I sit in a chair close to the door. One way of looking at it is that you are not doing your loved one a favor by denying them your help in preventing behavior that is against their best interest!

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Wed Oct 22, 2008 5:07 pm
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Joined: Mon Oct 20, 2008 11:04 pm
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Location: AZ
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Thank you for posting this link. My dad had a very scary outburst at night. My mom was having a difficult time deciding whether to bring him home from the hospital or place him in assisted living. I sent her the article and asked her to please, please read it. You may have saved a life.

Dad is doing okay in assisted living, just wondering why he's there with all the "old people."

Anne


Thu Nov 20, 2008 10:50 pm
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Hi Anne,
It is very difficult to decide where the LO should be, in our hearts we want them home but in our minds we often know they belong in a facility, it really depends on the help we have at home and if the LBD'er can be controlled when they get into their delusions.
In our situation these Hallucinations were really difficult earlier on, I often thought I would have to place him and we had a situation where he needed to go into rehab for 3 weeks they were probably the worst 3 weeks of his life, with that I didn't get to pick and choose where he would go it was on first come first serve basis, I was really scared to bring him home but I did and as time went on the hallucinations became more mild delusions and more or less controllable but before his rehab stint he was at times extremly combatable and violent but again I am also 15 yrs younger than he was and that was in my favor too, so it really depends on the home situation.
I sent good thoughts out to your Mother while she is making the decison.


Fri Nov 21, 2008 8:41 am

Joined: Thu Aug 30, 2007 6:15 pm
Posts: 231
Location: Charlotte, NC
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I have kept a journal since Aug. of 2007 and it has been invaluable to me in making decisions like this. My LO can go weeks with no delusions or hallucinations and then completely flip out. When he is good I say, Hey, I can do this. Until he has a bad period, and I know I cannot. Last night he was saying that there was a gas in the facility that was going to kill everyone and we should evacuate, was upset that everyone was just sitting around. He had ahold of me and was racing around...finally believed one of the caregivers had taken care of the problem. Seroquel calmed him down eventually and he went to sleep, but I knew if he was at home he would have been out the door with me in tow. It comes on so quickly with no warning...I would be living in fear and dread...just my two cents.....Nancy Salvadore


Fri Nov 21, 2008 10:38 am
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Joined: Sat Oct 27, 2007 9:16 pm
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Location: tennessee
Post violence
Anne, I don't know if this is pertinent, but I made the decision based on what triggered my spouse. As long as he was engaged in activity he enjoyed or at least didn't object to, he was sweet as can be, but, as you know the patient simply can't have his way all the time for his own good. And maybe they really want to go upstairs, but the threat of a fall makes that too dangerous. When that sort of thing is the trigger, there's an impasse. Redirecting, distracting, etc isn't the solution. I also investigated and found out that even if I hired round-the-clock caregivers, they would have the same limits I had, which was basically do my best and then run and dial 911 at the same time. I have faced enormous criticism from friends and family who have only seen him sweet. And I understand that. I just know that in the very good facility he's in, when he starts going over the line from being resistant to combative, his seroquel has to be increased. So far that's working. I pray he doesn't hurt anyone. He would hate that when the episode passed. I pray he doesn't have to leave there. And I am very, very glad he is not at home with me. This way he gets the best of me, we don't have to fight, and we are both safe.

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Fri Nov 21, 2008 9:56 pm
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Post Re: violence
melinda wrote:
. I have faced enormous criticism from friends and family who have only seen him sweet.


Melinda,
These people should walk a mile in your shoes before they give their opinions, no one understands what it is like to take care a person with this type of illness unless you have been there , done that!


Fri Nov 21, 2008 10:35 pm

Joined: Mon Oct 20, 2008 11:04 pm
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Location: AZ
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Melinda-

I told my mom that whatever she decided I would support her. It took her many, many weeks and much heartache to reach the decision and thankfully she decided to place dad this week in assisted living. I have seen my dad go from his usual kind nature to this man who I could fear if I didn't know it was the disease talking. Well, actually it's pretty frightening when he gets delusional- logic or not. Luckily he's not hallucinating and delusional the majority of the time. I spent the night with my dad a few times, and he could sneak up on me faster and quieter than a church mouse! Freaked me out the first time and I learned to sleep with one ear open.

Anyone who would dare criticize you knows not what they speak of. This is a cruel and strange disease. People don't understand, even when you give it to them straight. I have to believe they can't understand how something can take such possession of another individual so rapidly.


Anne


Fri Nov 21, 2008 11:20 pm
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Joined: Thu Jul 03, 2008 11:05 am
Posts: 150
Location: Raleigh, NC
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Anne, your mother should earn respect for her decision, and Malinda, that respect -- not criticism -- is what you deserved as well. I'm sure many people wondered whether it was necessary to place my mother in a dementia facility, but even this small, meek and seemingly weak lady could turn violent at the drop of a pin and even trained staff could be caught by surprise and injured as a result. Thank goodness we finally found a drug that helped her tolerate the delusions and hallucinations better.

And thank goodness we have this forum, where people really do understand.

Garnet


Sat Nov 22, 2008 10:38 am
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Joined: Thu Aug 30, 2007 6:15 pm
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Location: Charlotte, NC
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I realize everyone is different....which drug did you find worked well for your mother with hallucinations/delusions? Nancy Salvadore


Sat Nov 22, 2008 10:45 am
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Joined: Thu Jul 03, 2008 11:05 am
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Location: Raleigh, NC
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What has worked for us is Risperdal. Seroquel was not effective for Mom. It made her groggy and even more unsteady on her feet (she could walk then), but did not calm her at all. She could even fight through it when she was really aggitated. Abilify was better, but she still had breakthroughs with violence. That was when she wound up in a geriatric psych facility for a couple of weeks. The docs there put her on Risperdal. It has worked very well with just one low, daily dose.

Robin seems to have serious reservations about Risperdal. I'm not sure if that's because it simply isn't as effective for many people or if it seems more likely to cause side effects. We have not experienced any side effects that I can tell.

You are right that each patient is different. I know we'd all prefer to avoid antispychotics, but I believe Mother is much better off on Risperdal than with those extreme outbursts, which seemed dangerous for her as well as for her caregivers, and I'd rather have her on a low dose of this than ever-increasing doses of Seroquel, which was what we had tried at first.

Hope this helps.
Garnet


Sat Nov 22, 2008 12:37 pm
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Joined: Sat Oct 27, 2007 9:16 pm
Posts: 165
Location: tennessee
Post violence
Nancy, again with the usual disclaimer, when my spouse was at his most violent, he was in a psych facility for 3 weeks. At that time he was given abilify injections. Finally he graduated to abilify pills which worked well for a time, then what seemed like "suddenly" but probably wasn't, he became more and more rigid, till he could barely move. At that time he was put on seroquel 25 mg nightly which again worked for a while, then had to be increased twice. He's now on 50mg 3 times a day. I wouldn't be scared to try something if you have a educated and responsive doctor. There's always a risk, but what if we had no medication resource? We'd be back to that nightmare of straight jackets. I'm grateful for the meds, and even if we should have a disastrous, even fatal result, we're doing the best we can. Most of my life, I've been chickensh..
With Lewy, I've become a fighter. And I've had lots of help and support, for which I am till-the-day-I-die grateful! We support you and Anne and everybody with our experience and our prayers. Melinda

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Sat Nov 22, 2008 3:57 pm
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Joined: Thu Sep 07, 2006 1:02 am
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Wow Melinda,
I can so relate with everything you say. Nobody knows what it is like to walk in our shoes except other LBD caregivers! I am so glad my husband is living in a facility now. Not to mention I still had two teenage sons in high school and they deserved to have a mom at least. I had my husbands daughter criticize my every decision but she didn't live with us and see what I saw every single day. I am praying that the facility doesn't kick him out for his violent behavior lately. He is back in the psych hospital for the 2nd time in 5 weeks due to violent behavior. I cannot even imagine dealing with this violence at home. He used to be the kindest, most gentle sweet man and now this disease has robbed him of so much. I just take one day at a time, pray a lot and I sure hope the doctor can come up with the right medication.
God Bless.
Shawna

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Shawna
Caregiver for 59 year old Husband w/LBD


Fri Jan 09, 2009 1:43 am
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