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 Combative/Belligerent Behavior 
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Joined: Thu May 31, 2012 6:51 pm
Posts: 60
Post Combative/Belligerent Behavior
Like many in this forum, my husband has reached the combative/belligerent phase of LBD. But because my husband also has Afib and high blood pressure, using Seroquel is not a drug his neurologist is willing to prescribe. So the doctor prescribed Tegretol, which is a drug of preference by the psychiatric community. Tegretol is an anti-seizure medication that is being used for dementia patients because of it's ability to lesson their combative impulses.

He is on a very low dose right now and will get regular blood tests to help determine the therapeutic level that is best for his body and behavior.

Now, before everyone starts running to their loved ones' neurologists for prescriptions for Tegretol, please do your research, as this medication has some side effects and drug interactions that your loved ones might not be able to deal with. As it is, I, along with our Home Health Care agency, will be continually watching for any problems with this medication, which I hope won't happen.

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Beth


Fri Nov 09, 2012 9:08 pm
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Joined: Wed Dec 30, 2009 1:46 pm
Posts: 3173
Location: WA
Post Re: Combative/Belligerent Behavior
Has it helped?

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Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.


Fri Nov 09, 2012 10:57 pm
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Joined: Thu May 31, 2012 6:51 pm
Posts: 60
Post Re: Combative/Belligerent Behavior
Hi Pat:

Not sure if it's working yet because he's just been on it a few days. He is being resistant this morning, though, and raised his hand at me. I backed out of his bedroom and closed the door. I don't want a repeat of last Saturday morning when he was hitting me and anything near him, including furniture and whatever was on it.

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Beth


Sat Nov 10, 2012 10:55 am
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Joined: Thu May 31, 2012 6:51 pm
Posts: 60
Post Re: Combative/Belligerent Behavior
Well, this morning my husband swatted a spoon out of my hand, telling me to get that d*** spoon away from him. On the spoon, however, was a small ice chip, which he is allowed every hour.
So I picked up the ice chip and put it in his mouth.

But I have been having problems with this hand lately - arthritis and tendinitis - so that swat really hurt, because it also jerked my arm, which hasn't been feeling all that great lately either. Afterwards, I firmly told him that he is never to hit me again. I also asked me if he had ever hit his first wife and he said no. Then I asked him if he had ever hit his four kids, and he said he had spanked them. To which I said, "Well I'm not your child and you will never hit me again."

This behavior worries me a lot. Right now he's refusing to get out of bed; but if he ever decides to get out of bed, I hope he doesn't come after me. Sighhhhh. I do hate this disease.

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Beth


Tue Nov 13, 2012 12:27 am
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Joined: Wed Dec 30, 2009 1:46 pm
Posts: 3173
Location: WA
Post Re: Combative/Belligerent Behavior
It's an uneasy life to always be on guard and sleep with one eye open. Believe me, I know. :cry:

_________________
Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.


Tue Nov 13, 2012 12:51 am
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Joined: Fri Apr 06, 2012 10:19 pm
Posts: 27
Post Re: Combative/Belligerent Behavior
So sorry that you are going through this. I have just bought a wireless alarm mat for my Dad. When he gets out of bed as soon as he steps on it an alarm sounds in my room. Maybe you could get one so that you aren't taken by surprise. We sleep so much better at night knowing that we don't have to sleep with one ear open. My dad gets up so quietly that often the first noise we heard would be his head cracking against something as he fell.


Tue Nov 13, 2012 8:28 am
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Joined: Sun Aug 29, 2010 5:46 pm
Posts: 609
Post Re: Combative/Belligerent Behavior
Beth,

Of course we can't rely on our LOs to remember our instructions, let alone follow them, so I hope you will take precautions to keep yourself safe, at least until the new medication proves effective against combativeness. The suggestion of an alarm mat sounds like a good one. You might want to do further planning in case violence escalates, such as having a mobile phone at your fingertips at all times in case you need to call 9-1-1, or having a neighbor who would take you in at any hour. Please think of your own safety.

Julianne


Tue Nov 13, 2012 2:13 pm
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Joined: Fri Nov 05, 2010 11:30 pm
Posts: 317
Location: southern cali
Post Re: Combative/Belligerent Behavior
beth,,,((()))

please make plans for your safety.. this is not your hubby, its lewy and he has no control.. so please be alert and ready... consider the ideas folks have suggested.. my counselor said always have a place you can go and lock it and be safe... im sure this has to be so hard on you.. please please stay safe...
cindi

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sole CG for hubby.1st symptoms, 2000, at 55. Diag with AD at 62, LB at 64.. vietnam vet..100% ptsd disability,sprayed with agent orange, which doubled chances for dementia. ER visit 1-14,released to memory care..


Tue Nov 13, 2012 3:31 pm
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Joined: Wed Dec 30, 2009 1:46 pm
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Location: WA
Post Re: Combative/Belligerent Behavior
I found this article very informative and helpful. http://www.uiowa.edu/~centrage/archive/pubs/Newest%20Versions%20-%20pdf%20format/Coping%20with%20Violence.pdf

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Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.


Tue Nov 13, 2012 3:45 pm
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Joined: Sun Aug 29, 2010 5:46 pm
Posts: 609
Post Re: Combative/Belligerent Behavior
That's a really good article, Pat. Thanks for posting it. I can't imagine anything harder than dealing with violence from one's LBD spouse, who as Cindi said is not really one's spouse anymore, it is LBD.

Julianne


Tue Nov 13, 2012 6:54 pm
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Joined: Sun Feb 17, 2013 11:41 am
Posts: 12
Post Re: Combative/Belligerent Behavior
ok, i have a bone to pick with this article.

"put the knife down?" "give me the knife?" seriously????

if your loved one picks up a knife you need to get outta there. NOW.

in fact, any violence merits escape and a call to 911.

don't fool around with this!


Fri Mar 22, 2013 9:14 am
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Joined: Wed Dec 30, 2009 1:46 pm
Posts: 3173
Location: WA
Post Re: Combative/Belligerent Behavior
That's good advice, of course. I think one reason I was always reluctant to call 911 was that I was afraid the police might hurt my husband, not realizing that he was sick. Unfortunately, that does happen. The article does advise calling 911 in some circumstances. And I locked myself in the bathroom on more than one occasion.

_________________
Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.


Fri Mar 22, 2013 10:48 am
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Joined: Sun Feb 17, 2013 11:41 am
Posts: 12
Post Re: Combative/Belligerent Behavior
there is always the possibility that the cops will hurt someone. better him than you.

i think that if i had a potentially violent spouse or parent at home, i might talk to the police before something happens, and have a "script" for when i call 911. let them know that he has dementia and that he needs to be handled carefully. but be aware that the cops will do whatever they need to, to protect themselves and you.

i wish cops got training in how to handle dementia patients and the mentally ill.

all domestic violence advocates will tell anyone living with an abuser(and your hubby is NOT an abuser-but he may act like one) that they must have a safety plan.

this means having a lockable room with a strong door, knowing the fastest and safest exits out of the house, having your keys and cell phone handy, having a neighbor you can run to.

your cell phone needs to be charged at all times and if you can afford a spare to be left hidden in your safe room, do that.

take care.


Fri Mar 22, 2013 3:11 pm
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Joined: Fri Nov 05, 2010 11:30 pm
Posts: 317
Location: southern cali
Post Re: Combative/Belligerent Behavior
really good advice bjr...

i know it is difficult to look at your loved one and think they may hurt you.... but the lewy body might...having a script for time like that is great idea...

letting them know when you call, the situation is excellent.. the training for mentally ill and dementia patients, appears to be lacking. but i know here, they have special team for mentally ill, the pert team... you might want to check and see if they have a similar team in your area, that can be called.. they usually work with the police or sheriffs dept.... but are hard to get quickly as they are really busy!!

do not take a chance with your safety...

my hubby is the most gentle person you will find, but he has ptsd.. that rears its ugly head, when he hallucinates.. and he turns into a bear... hes never hit me.. but the angry looks are very scary.. and i can tell you.. its not him when that happens..

please plan, be prepared and stay safe!!
good luck..
cindi

_________________
sole CG for hubby.1st symptoms, 2000, at 55. Diag with AD at 62, LB at 64.. vietnam vet..100% ptsd disability,sprayed with agent orange, which doubled chances for dementia. ER visit 1-14,released to memory care..


Fri Mar 22, 2013 5:39 pm
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Joined: Wed May 22, 2013 8:49 pm
Posts: 4
Post Re: Combative/Belligerent Behavior
I am new to the forum. Have been a caregiver for at least 2 years. My LO started having symptoms probably in 2009. MCI was his 1st diagnosis. I took almost 2 years and firing one neurologist and internist, to find the right medical team. It has taken me 2 years to finally have the time to respond to this forum. You all know how helpful it has been! It gave me courage to face each day. Thank you in advance.
My LO is my spouse of 47 years of a very happy and close relationship. He was a fighter pilot in the AF. Saw action in Nam, did a lot of other things that were pretty scary before I married him. He is now 83. I have no doubt that PTSD is woven into his nightmares. He has had very active delusions and paranoia this past year and half. That have involved family members, friends, neighbors, and now me. Scary stuff. Fortunately I was able to convince him to see the Psych at the VA so he could talk about his PTSD. Of course it was always "show time" with the medical teams. I had to write multiple letters to his internist and neuro to update what was going on.
The mo. of Sept. I began seeing an escalation of his abusive talk and triggers were almost anything after 3 p.m. Then one day he wanted the car keys again. When I heard that, I hid them quickly as well as my wallet. The knives were out of reach by then too. Guns and booze long gone. Not driving has been a major sore point since last yr. when his license was pulled.
That event lead to a bad sleep night. Next a.m. he came raging out of the bedrm still wanting keys. I could not redirect. He grabbed me and verbally threatened bodily harm. I later called the VA crisis line. The next day we saw the psych. It was then that my LO showed his Lewy self to the doc. He had to unwillingly be put in the hospital for observation and medication.
My family and I felt that I could no longer be put at risk and it was no longer safe to keep our LO at home. He would never allow any stranger to come in much less touch him.
This event was a heart breaker. I am numb. We then found a good DCF near us and after hospital discharge, had our LO placed. It was a scramble for sure. Of course he is not happy and wants to come home. There is no careful transition under violent, threatening circumstances. He is now on Risperdal low dose and seems to be calmer. VA doesn't have Seroquel available. This roller coaster was affecting my health as I was the only caregiver. I can only hope that he will adjust (somewhat). Patlu


Sun Oct 20, 2013 9:40 pm
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