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 angry in facility, how to help transition? 
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Joined: Mon Mar 18, 2013 9:07 pm
Posts: 7
Location: Los Angeles
Post angry in facility, how to help transition?
Hi All,
I am new here, have shared parts of my mom's story/case in other threads here and grateful to have found this forum.
My mom is about 7 weeks into being in AL facility. Long story short, she had some transitions (3 facilities in two weeks, trauma with 5150/police/ER, ended up declining so quickly she's on locked floor of good AL.) The staff is amazing and they take her out for walks and to visit other floors and roof garden. But she is furious about being locked in. Her condition declined more severely with the transitions and trauma and never returned to baseline of pre-facility state. (Right before entering facility for trial "respite" run, she could read, could make some sense. Now she's really out there. Never came all the way back.)
There have a been some days where seemed to be "adjusting", calmer, friendlier. But despite her intense confusion, delusions, etc, she knows she is "in jail" as she calls it.
Some days they can't take her out for walks because she's back to being a flight risk. Sometimes she doesn't want to come back in. She aggressively resists re-entry. (She's very strong still at 74). It's so hard because she loses her walks if she refuses to go back in, but then she's angrier at being locked in. As you know, reasoning doesn't work.

my heart is so broken watching all this. she never wanted to go in the first place and thinks her brain is fine and that mine is messed up for putting her in. it's hard to imagine that she's ever going to accept the situation and because her dementia is so intense, I don't think she'll be able to live in of the more independent areas. It's really really hard. she's a fighter and she doesn't give up. and i don't blame her. she's on a floor with mostly really low functioning residents, most of whom can't speak anymore. my mom is very talkative and social, still has language, but it's mostly word salad doesn't make much sense (sometimes i can decode some of it.) it's amazing because she had a tremendous vocabulary, was a big reader, so she makes great sentences with a wide variety of words, but it's like talking to a schizophrenic or lost poet.

any thoughts on how to help an angry loved one transition into facility care?

thank you

(p.s. she is on 25 mg Seroquel at bedtime... she was on Exelon patch but hated wearing it, was paranoid, thought it was a tracking device. for a moment she was on lower dose of Seroquel, 12.5 with patch, seemed ok for few days, then got really aggressive again, so upped the Seroquel. we don't know if if was lower dose of Seroquel causing aggression to return or the Exelon. or a flare up in the LBD. so hard to figure out! )


Wed Mar 27, 2013 11:50 pm
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Joined: Wed Dec 30, 2009 1:46 pm
Posts: 3213
Location: WA
Post Re: angry in facility, how to help transition?
I think I may have addressed this before but there are two possible factors, neither of which has to do with the facility. Discontinuing the Exelon patch can have adverse consequences. Most neurologists advocate continuous use. If she were to resume it, it would have to be at the lower dosage again. Also, it is probable that Seroquel was improving, not exacerbating, her anger issues. JMHO, of course.

_________________
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.


Thu Mar 28, 2013 12:48 am
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Joined: Mon Mar 18, 2013 9:07 pm
Posts: 7
Location: Los Angeles
Post Re: angry in facility, how to help transition?
thanks mockturtle. yeah, we just couldn't get her to wear the patch consistently, so will try Aricept orally.
she's been angry about being there since the beginning. she went for a week of respite, declined so intensely, never left. hasn't been back to her house, she knows it's still there, etc.. pretty intense. but no way can she go back to live. so.
we keep moving forward lovingly.
thanks


Thu Mar 28, 2013 12:55 am
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Joined: Wed Dec 30, 2009 1:46 pm
Posts: 3213
Location: WA
Post Re: angry in facility, how to help transition?
Quote:
we keep moving forward lovingly
That's the best you can do. God bless.

_________________
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.


Thu Mar 28, 2013 10:43 am
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Joined: Fri Jan 15, 2010 9:33 pm
Posts: 3436
Location: Vermont
Post Re: angry in facility, how to help transition?
Yes, that is about all you can do in this situation. Be her advocate, be her friend, be her loving daughter. There may be very little you can do to help with her anger. Some meds work for some people and they don't work for others. The drs. can continue to try to tweak meds to help her, but in the end, the sad fact is that some of our LOs are just in a lot of emotional pain because of this disease till the very end. BTDT

None of us placed our LOs in a facility because we thought that was a fantastic idea and that they were going to love it there. We did it out of love, and also because we or others were not able to care for our LOs with the level of care they require. Do not beat yourself up over this. It is an unfortunate place that many of us find ourselves. You are doing the best you can under extremely trying circumstances. You are also experiencing that unfortunate shift that happens when the parent/child roles reverse and we adult children find ourselves having to "parent" our parents. It isn't easy, it isn't fun, it isn't what most of us ever expected. And, with dementia, our LOs can often behave like 2 yr. olds having a tantrum. You just handle it the best you can, and that's all you can do.

Big cyber hug to you, Lynn

_________________
Lynn, daughter of 89 year old dad dx with possiblity of LBD, CBD, PSP, FTD, ALS, Vascular Dementia, AD, etc., died Nov. 30, 2010 after living in ALF for 18 months.


Thu Mar 28, 2013 4:36 pm
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Joined: Sat Jan 03, 2009 2:59 pm
Posts: 1978
Post Re: angry in facility, how to help transition?
Hopefully over time the angry will subside and things will get a bit easier !

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Irene Selak


Fri Mar 29, 2013 9:34 pm
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Joined: Wed Mar 02, 2011 1:04 pm
Posts: 251
Post Re: angry in facility, how to help transition?
Thanks for this thread....I am about to go through this with my dear Father.....

best wishes,

Tonya

_________________
First symptoms in 2000 at 35 yrs old. LBD early onset dx 2-17-2011 at age 46.

' "I try not to worry about the future, but rather to "wonder"....and "wonder" is one step away from "awe" '......From a wise friend........


Sun May 26, 2013 12:57 am
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Joined: Wed May 22, 2013 8:49 pm
Posts: 4
Post Re: angry in facility, how to help transition?
to caringformom - I too am dealing with my unhappy LO in a care facility. He was placed suddenly due to dangerous behavior at home. Is constantly beseaching me to take him home. He wants to be with me. It has been a very hard division after 47 yrs of marriage. I adjusting somewhat and am starting to see who I am again. It is such a long hard journey that we are on.

So far he is not combative with the staff at his facility. Is on a low dose Respirdone and seems to be doing well with it. Was told by his psych that Seroquel is too sedating. They all have side affects.

It is a good facility, well run and clean, with good food. Most of the time he is very social, chatty with staff, is under challenged and probably bored. Most of the residences are in the later stages of AD. No one else there with LBD. He is still high functioning in dressing, bathing, and eating. Short term memory is gone. Still has delusions and paranoia. Therefore doesn't believe he has a problem because he compares himself with the others who are farther advanced.

My question is how does one cope with the ongoing and repetitive "I want to go home"? So far I have told him the medical staff has to give him his medications (7) and that I can not do it as some have to be carefully monitored. Cannot reason with on this at all now. Got any ideas?
Patricia


Tue Dec 10, 2013 5:30 pm
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Joined: Fri Jan 15, 2010 9:33 pm
Posts: 3436
Location: Vermont
Post Re: angry in facility, how to help transition?
Sometimes when I was really pressed to answer this for my dad I'd say "When you are better (or can walk with your walker or whatever) we'll talk about your going home." That would satisfy him for the moment and he'd feel like he had something to hope for. When he first moved to the ALF and he was supposed to be doing walking and strengthening exercises, I thought it might motivate him with his PT and doing the PT work on his own. At the time, I didn't realize he wasn't capable of understanding the connections between PT and getting better, and he did almost nothing for the PTs so several quit having him as a patient.

Sometimes "home" meant the town where he hadn't lived since he was 16 and he forgot about his home of 60+ years. Eventually he referred to his room at the ALF as "home" for which I was so grateful (helped reduce the guilt and sadness of having to have him there) and I knew he had accepted that this was his new home.

It's hard, and I cannot imagine how difficult it must be for a spouse to have to be answering this question. Take care and I hope you find some solutions that would work for you. Lynn

_________________
Lynn, daughter of 89 year old dad dx with possiblity of LBD, CBD, PSP, FTD, ALS, Vascular Dementia, AD, etc., died Nov. 30, 2010 after living in ALF for 18 months.


Tue Dec 10, 2013 8:28 pm
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