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Dad paranoid, verbally abusive, violent, delusional
I am my father’s guardian. He’s had ALZ diagnosis for about five years.
Lately, he’s rapidly entered a new phase in which is is hallucinating things, paranoid, sometimes physically violent, and verbally abusive.
He’s already been kicked out of one care facility, and I won’t be surprised if he gets kicked out of the one he’s in now. No place else wants him.
I’m worried because I don’t know what I would do with him if he gets kicked out again. He can’t live with us - we can’t keep him safe in our home, and can’t supervise or control him adequately.
The laws in Wisconsin don’t make it easy to function as caregiver or guardian. It all SOUNDS really good, but when push comes to shove, the incapacitated person can still refuse treatment and help and make life miserable for everyone. And I get it - we don’t quickly remove people’s rights in this country, and I’m glad for it. Nonetheless, I am so frustrated with not being able to do more to help my father when he is in this state.
I’m sure I’m not the only one, but it feels good just to get it out there.
I agree with the UTI test, Scott! My mom was having delusions and was extremely agitated two weeks ago. She had never wandered before, but started talking about leaving her house in the middle of the night to go find me because she was so scared. She was convinced that her house was haunted. Had her tested for a UTI; she was positive. Took Bactrim for a week and is better now.
Hello Scott, I am sorry for what is happening and can imagine how concerning this is for you. This is one of those dynamics in which we pretty much must become detectives. Not all changes in behaviors, etc. are due to advancing dementia.
The human body has many different systems and just like us, our Loved One (LO) may be experiencing a physical change that has nothing to do with the dementia or may be contributing to the dementia behaviors.
The first thing I would do would be as already suggested; have him checked for an undiagnosed "silent" urinary tract infection. These UTIs are called "silent," because there will often be no complaints of pain or burning; BUT there are often very dramatic changes to the negative side of the ledger especially in behaviors and sometimes cognition and/or function. If the urine is tested, request that the urine have a culture run as there is a very high error rate on dipstick testing both to the positive or negative side of results.
It is important to not let any of the staff nurses tell you that urine testing is not necessary; I am an RN whose mother had this issue multiple times and I had to insist on testing when staff nurses felt it not necessary, and every time,sure enough, the urine was positive for a bacterial infection. I would also ask the nurses to get an order from the physcian for a full on check of his blood chemistry with at least a Chem Panel, CBC, B12, Thyroid Panel and anything else the physician may feel is warranted. This way, multiple body systems are checked to ascertain whether there is something else going on. The best thing would be to have your father see the doctor for an exam, but this does not sound as though it will be able to be done in an office setting secondary to behavioral issues; although one can use an ER setting.
There is also the thought that your father's initial diagnosis for type of dementia could possibly be in error and if possible, it may be helpful to have your father seen by a Neurologist who sees dementia patients as a routine part of his/her practice. I would ask for a reassessment for type of dementia and specifically ask for Lewy Bodies Dementia and the behavioral variant of FrontoTemporal Dementia to be ruled in/out. Reason being is that meds for one type of dementia can be contraindicated in another and even make things far worse.
NOTE: Another option would be to have your father admitted on an involuntary basis to a Geriatric Psych Unit. NOT a general Psych Unit; but specifically GeroPsych as they are well versed in dementia where the standard psych unit would not be. In GeroPsych, he could be assessed on a 24 hour continuum and medications adjusted and monitored for effectiveness and side effects.
I would also like to suggest contacting the Alzheimer's Assn. Helpline at (800) 272-3900. If you call, please ask to be transferred to a Care Consultant. There are no fees for this service and Consultants are highly educated Social Workers who specialize in dementia and family dynamics. They provide much support, have much information and can assist us with our problem solving. They can also refer you to services within your area which also may be helpful.
This is a difficult situation that you find yourself in, but there will be some answers once all the assessment has been done. You are a very caring person and a wonderful advocate on behalf of your father. Please let us know how things are going, we will be thinking of you.
Welcome to our world. I'm so glad you found our site.
You have received excellent advice.
Are there any residences in your locality that deal exclusively with dementia patients? Such places are apt to have better dementia training than the ordinary ALF.
Ask exactly what dementia training staff receive. The Alz.Assoc. has training. have they watched and discussed Teepa Snow's videos. I do wish Naomi Feil's Validation method training was mandatory for al Assisted and Memory Care residences. Ask at your library for any book of hers. It's not an easy read, but worth the time for all involved. What one can read on-line is not sufficient to carry out her method.
And having a qualified neurologist assess the type of dementia is so important. Many times this was not done at the initial diagnosis. More and more it is recognized that more than one type of dementia is present.
Do keep us posted.