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 Super aggressive behavior 
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Joined: Thu Sep 07, 2006 1:02 am
Posts: 14
Location: So Calif
Post Super aggressive behavior
My husband has been living at a dementia facility for over a year and was doing great and pretty stable. Then around Thanksgiving he suddenly took a turn toward being very aggressive and violent. He tried to choke the evening male nurse, he knocked over heavy furniture, he hit another resident. He is young and very physically strong and in good shape. He attacked a female caregiver that was redirecting him. He chased her and kept hitting her from behind. She was out of work for quite a while. I am devastated to say the least. I have involved new doctors. He does not have problems walking at all. He has no infection or any other obvious symptoms but the doctor decided to put him in the hospital and try to redo his meds. After 2 1/2 weeks he was sent back to his dementia facility but it has been a roller coaster every since. Yesterday he bit a male caregiver while we were trying to change his pants. Last night he charged another caregiver and hit him. I think everyone is afraid of him now. This facility is well experienced and equipped to handle all kinds of dementia. They have been amazing to work with us and do everything to keep him there. I go every single day to spend time with him and I am seeing a different person. I don't think any other place would have been able to handle him. Today the psychiatrist decided it would be best to send him back to the hospital. He usually responds well to me but lately I have been afraid of him. Saturday, he tackled me to the ground, while I was changing his clothes,. Before Lewy, he was the most gentle, kind, loving husband and would absolutely die if he knew what he was doing now. I have always believed that less medication is better but now I realize this is not safe either. I am so broken hearted seeing this terrible decline. I am not new to this forum, I read it almost everyday and I don't hear of many that are this violent. It is hard to say if it is the disease or the medications. He is completely unaware of where he is or of his surroundings. He can't talk very much or make sense. He still has some moments where he smiles but mostly he wonders aimlessly around the facility. He really can't participate in most of the activities. He was just 56 when diagnosed four years ago. He urinates everywhere. Has no sense to find a restroom. I guess I am just venting. I rode in the ambulance with him to the hospital tonight to help keep him calm. He kept trying to get out and to undo the seat belts. I'm praying that they can keep him safe. This is the most cruel disease!
Shawna


Wed Jan 07, 2009 3:11 am
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Joined: Fri Aug 11, 2006 1:46 pm
Posts: 4811
Location: SF Bay Area (Northern CA)
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Shawna,

I'm sorry for what you and your husband are going through. I hope the hospital can figure out his meds again.

Not many turn violent but some do. In our local support group, a gentleman with presumed LBD killed someone in a locked psychiatric facility. This is a very difficult situation; the right answer is not obvious (and probably doesn't exist).

Try to do something every day for yourself, even if it's only a 30-minute walk around the block.

Take care,
Robin


Wed Jan 07, 2009 6:01 am
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Joined: Sat Jan 03, 2009 2:59 pm
Posts: 1978
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Shawna,
I am so sorry that the LBD has taken a turn like this for your family, I do hope they find the right combination of medication for your husband, this is a hard illness for sure. Take care of you too!

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Irene Selak


Wed Jan 07, 2009 9:36 am
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Joined: Tue Aug 26, 2008 4:57 pm
Posts: 10
Location: England
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Dear Shawna,

I'm so sorry to hear of the situation you and your husband are in. It sounds like he is in a great facility and that you and they have been doing everything you could possibly be doing.

It's impossible to fully know what a person with LBD is experiencing and it sounds like your husband is feeling very scared at the moment, causing him to lash out.

Perhaps he has an infection that has not yet been detected that is effecting him and will settle when this has passed. I also read recently about a patient who was lashing out who later turned out too have a broken finger, staff had been bumping it and hurting him without realising.... I know things in Lewy land are seldom this simple, but I do wish you every good wish.

Mary


Last edited by soundmary on Wed Jan 07, 2009 11:23 am, edited 1 time in total.



Wed Jan 07, 2009 10:36 am
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Joined: Mon Jan 05, 2009 4:23 pm
Posts: 21
Location: the Netherlands
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Dear Shawna,

Im sorry that this is happening to you and your husband, this must be very difficult to deal with.

Take care.
Sandra


Wed Jan 07, 2009 11:09 am
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Joined: Thu Jul 03, 2008 11:05 am
Posts: 150
Location: Raleigh, NC
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Dear Shawna,

My sweet, gentle mother turned violent. On the day she hit, bit and kicked care managers (it was the third time she'd bitten someone), we had to have her admitted to a geriatric psych ward. It was clear that her hallucinations and delusions were what triggered the episodes. The hospital switched her antipsychotic (to the third type we'd tried) and reduced her other meds. She was in the hospital two weeks. Although she still gets agitated from time to time and shakes her fist, we haven't had any serious problem since then.

Probably the only thing that prevented the type of damage your husband inflicted was her smaller size and limited mobility. Even with those limitations, she can show amazing strength when she's upset.

All the best,
Garnet


Wed Jan 07, 2009 8:22 pm
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Joined: Thu Sep 07, 2006 1:02 am
Posts: 14
Location: So Calif
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Garnet,
Can you tell me what medication finally worked on your mother? What other ones did you try? I know that everyone reacts differently to the same meds but we have tried so many. The last big change is that we added Abilify & Clozoril. I am not sure what the next change will be. I am just praying that it works.
Thanks
Shawna

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Shawna
Caregiver for 59 year old Husband w/LBD


Wed Jan 07, 2009 11:24 pm
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Joined: Thu Sep 07, 2006 1:02 am
Posts: 14
Location: So Calif
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One of the reasons that I go everyday to see my husband is to check him physically and keep an eye on any change. One day his hand was so swollen that I thought for sure it was broken and asked for an x-ray which proved that it was not broken. I am always checking everything, even toenails that might get too long & could cause pain. I don't know what could cause this violence.

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Shawna
Caregiver for 59 year old Husband w/LBD


Wed Jan 07, 2009 11:29 pm
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Joined: Thu Jul 03, 2008 11:05 am
Posts: 150
Location: Raleigh, NC
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Like everyone else (or just about), we started with Seroquel, which didn't do anything but make her groggy, and she was often able to fight through that when she was agitated. We then went to Abilify, which seemed to help but she still had that final aggressive outbreak on it. The hospital (a university teaching hospital -- UNC Chapel Hill) switched her to Risperdal. She's just on a low dose once a day, with a prn should she get agitated and need more, which has happened only once or twice. It's a tablet that dissolves on contact with the tongue. Robin says Risperdal is seldom satisfactory in LBD, but it has worked far and away better than anything else we tried.

Do keep us posted on how you all get along.

Garnet


Thu Jan 08, 2009 7:12 pm
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Joined: Fri May 11, 2007 12:54 pm
Posts: 115
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Dear sdakides,

Risperdal is the only thing that worked for my mother-in-law too. It is on the no-no list for LBD, but her psychosis got so bad without it that it affected her physical health and well being. If she wasn't on this medication she would not sleep, eat, or trust any of her family. She would also try to wander so she could look for her imaginary fiancee, Aaron. The side effects from the Risperdal were minimal and worth it so she could have peace and we could keep her home with us. It in turn helped with her cognitive functioning.

Joyce K


Fri Jan 09, 2009 10:31 am
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Joined: Thu Sep 07, 2006 1:02 am
Posts: 14
Location: So Calif
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Thank you Joyce and Garnet,
I think I will mention that to my husband's doctor. At this point I am willing to try anything just to keep him safe from hurting himself or anyone else. I hate the feeling of being scared to death of him.
It's kind of strange but when I see him, I still see the love of my life, the man I married, not the ill, scary person that everyone else sees. He is my husband and I love him and want to do anything and everything that I can.
Thanks
Shawna

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Shawna
Caregiver for 59 year old Husband w/LBD


Fri Jan 09, 2009 12:04 pm
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Joined: Fri Aug 11, 2006 1:46 pm
Posts: 4811
Location: SF Bay Area (Northern CA)
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Shawna,
Surely the psych hospital is giving him an antipsychotic?? Maybe they haven't found the right one yet. Most people start with Clozaril (which requires frequent blood tests....but this sounds like it wouldn't be a problem for your husband) or Seroquel. You might check to see if he's taking any no-no drugs such as Haldol.
Robin


Fri Jan 09, 2009 1:03 pm
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Joined: Sat Oct 27, 2007 9:16 pm
Posts: 165
Location: tennessee
Post violence
I'm thinking like Robin. Maybe he was given something some time ago that even though he is no longer on it is affecting him. In trying to sort this out, has he had any surgery at all, even dental or eye? What medicines has he been on and what is he now taking? Look at everything, even the most benign seeming, like Benadryl or xanax, can cause problems with LBD. Abilify injections stopped my husband's violence until he got over the worst effects of his surgery, then he went to abilify pills, then eventually to seroquel. It helped me to know that in his case at least the problem was "disinhibion" or impulse control. Imagine how frustrated he is without the ability to understand what's happening and add to that the inability to process all the things that help us "normal" ones control ourselves like consequences and other's opinions etc. The right drugs will help. I was scared of my husband too and am not ashamed of that, nor do I feel disloyal. I still am vigilant, because I know that violence can come suddenly. You will make it through this, and your love for him will survive too. Melinda

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Would have despaired...


Fri Jan 09, 2009 10:04 pm
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Joined: Sat Jan 27, 2007 8:38 pm
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Location: CA
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Shawna, we are all with you on your journey. Be proud of how steadfast you are remaining as your husband's best advocate and nurturer. Stay safe, we'll be keeping you and your husband in our prayers.

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Renata (and Jerome-in-Heaven)


Mon Jan 12, 2009 4:14 pm
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Joined: Thu Sep 07, 2006 1:02 am
Posts: 14
Location: So Calif
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I can't thank you all enough for your love and support. I have been gone a few days. I attended a funeral yesterday for the husband of a friend from my support group. He is the same age as my husband and had Frontal Temporal Dementia. Tomorrow I have another funeral for my son's best friends dad who is my age (53) and dropped dead suddenly of a heart attack. It has been a tough week.
I have also realized that while I am in survivor mode trying desperately with the doctors to get the right meds for my husband, he is slipping into another stage of this dreaded disease. I still am trying so hard to "fix" him so we can live happily ever after. This week however I have been faced with reality of what is to come.
Here is what medication my husband is currently on. They are not done making changes and some will be dropped. He still has had some moments of hitting but has calmed down due to the meds they give him.
He is on Excelon patch, Clozapine 100mg 1xdaily, Klonopin .5 2xdaily, Serequel 50mg in a.m. & 150 mg p.m, Abilify 25mg 1x daily, blood pressure medication, and PRN's as needed: Ativan, Valium, or Klonopin.
Here is still in the hospital.
Thanks,
Shawna

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Shawna
Caregiver for 59 year old Husband w/LBD


Tue Jan 13, 2009 12:46 pm
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