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Mom has begun to show aggression/anger
BarrieDreyer
Posted: Monday, February 6, 2017 1:33 PM
Joined: 2/6/2017
Posts: 17


My mom, who is 86, started showing signs of dementia probably in her late 70s.  Her short term memory is sporadic (at best), but the true turning point has been her recent display of anger and aggression towards my dad.  My father was so concerned for his safety that he took himself to a separate bedroom to sleep.  We have an appointment for mom to see a memory care physician in March, but that is a long way off.  In the meantime, her primary care physician has prescribed Risperdal.  After reading the side affects, she is refusing to take it.  She is still lucid enough to understand that she is losing her memory, but she does not see that her anger and aggression episodes are not normal for her. 

The episodes of anger, vitriol and aggression are frightening.  An example, my father was abruptly woken up at 1:37 a.m. by my mom who was yelling at him about how he is stealing her money and how she hates him and wishes he were dead.  My father has provided a beautiful life for my mom and takes care of her every need.  I don't know where this is coming from.  

I am very worried and joined this group hoping to help navigate the waters that lay ahead.

Has anyone else had anger/anxiety/aggression issues and if so, how are you handling it?  

My mom thinks my dad is trying to send her to the "looney bin," which probably makes her even more unstable, but she is off the charts almost every day.  I don't know what lays ahead and how my dad will be able to endure the constant attacks.  I need help. 

 

JustLikeMom
Posted: Monday, February 6, 2017 1:47 PM
Joined: 2/7/2012
Posts: 262


Risperdol's primary purpose is to help those dementia suffers with hallucinations.  It's a "black box" medication that a medical provider without specific training and experience with dementia should never prescribe.   

The paranoia and anger definitely need addressed, even if the meds have to come from her primary care physician, so your Dad should make an appointment for your Mom with her PCP.   

He should also call back the Memory Care physician to see about getting an emergency consult or, minimally,  to be put on the waiting list in case they have another patient cancel before your Mom's appointment date.


STY
Posted: Monday, February 6, 2017 1:55 PM
Joined: 2/6/2017
Posts: 1


I know what you are going through.  My dad displays aggression as well.  Constantly telling my mom someone bite her on the face, or seeing men in my house that aren't there and accusing my mom of doing things with these men he sees.  He doesn't always want to bath or shave.  He is a smoker and that's all I spend my weekends doing is taking him out to smoke.  I can't get anything done.  My poor mom just sits there because if she gets up to just go use the bathroom he gets in his wheelchair and follows her.  It's really crazy and has disrupted by whole household.  My 11 year old daughter cries because she just doesn't understand why he is acting this way.
LayneC
Posted: Monday, February 6, 2017 3:45 PM
Joined: 5/28/2015
Posts: 2


I'm not sure exactly how I can help.  My mom and dad live with me and I have the same issue with my mom. She has always been head strong and had a sarcastic, smart mouth. but now it has gone to an unreal degree. My dad is almost deaf and has Alzheimers as well. They are both physically handicapped on top of everything else. Dad has had numerous strokes and Mom has severe osteoarthritis. Mom realizes that she has this disease and is angry and depressed about it.

She is not only mean and angry to my dad, she is mean and aggressive towards me and my husband as we are her caregivers.  She told me the other day that if I came back to her house again, she would "beat h**l out of me."  She also picked up something to throw at me behind my back.  My husband saw it, but I didn't. I could have been hurt had she thrown it, as it was a can of dog food. This degree of anger and aggression began about a month ago.  I,too, am taking her to her doctor to seek out any meds that would help.  I know nothing about Risperdal or any other medicine that would help.

As to how I am handling it; I am reading lots of posts on boards like this one. This seems to be the best one I have found (out of 2 or 3).  I am having to learn how to respond when she says those mean and hurtful things to me when I am only trying to take care of her.  Not to respond in anger or try to defend yourself. One suggestion I received was to be kind, take the best care of her that I can, but try to distance myself from her outbursts and care for her as if she were not my mother. This is not easy, not sure I can do it. However, it will be a whole new ballgame if she hurts someone.

I understand your concern for your dad and am sorry that you and he are having this issue. I have the same issue. My dad is very frail and would be easily hurt. So far, nothing has happened, but she threatens him all the time.  

If you find good answers and ideas/suggestions, please post them here.  I will do the same. I really need help as well.


BarrieDreyer
Posted: Monday, February 6, 2017 3:58 PM
Joined: 2/6/2017
Posts: 17


JustLikeMom,

Thank you for your response. 

I feel very concerned about all the feedback I have read about Risperdal.  The good news is, I was able to get my mom's appointment with the memory care doctor moved up and she is seeing the doctor tomorrow.  I pray the doctor can help.  I will keep everyone posted and thank you again.  You are so kind!


BarrieDreyer
Posted: Monday, February 6, 2017 4:01 PM
Joined: 2/6/2017
Posts: 17


LayneC and STY, 

I am heartbroken to hear your stories. My prayers are with you and I will post any news after my mom's appointment, which is tomorrow.  

I am not completely comfortable giving her the Risperdal.  I have read the side effects are not good and I am very worried, but my mom is coming unglued and my dad fears for his safety. 

It's so nice to know others are having the same issues.


Stephanie Z
Posted: Monday, February 6, 2017 4:30 PM
Joined: 12/15/2011
Posts: 3822


Barrie, You are new to the forum, so I'd like to share some information with you. It is a compilation of links that will help a lot as you and your dad care for your mom.    https://www.alzconnected.org/discussion.aspx?g=posts&t=2147523850

This is an updated list of links about information dementia care givers will need.

    The first is a very helpful article,  "Understanding the dementia experience"  It will give you an idea of what your mom is going through, and what she needs to have a good quality of life.  "Communication skills"  demonstrates better ways for all of you to communicate with her by encouraging her cooperation  and reducing  the chance of negative behaviors.

   There are many other links included which will be more applicable, and very helpful as your mom's dementia progresses.

It is also important for you to use the 800 number at the National Alz. Assoc. if you run into problems we can't help with. The 24/7 Helpline is: 1 800 -272- 3900  Ask for a care counselor. This service is free.

 Hoping this information is helpful to you

 Stephanie Z

 

 


BarrieDreyer
Posted: Monday, February 6, 2017 4:38 PM
Joined: 2/6/2017
Posts: 17


Bless you StephanieZ.  I have some reading to do and I so appreciate the links.  

I will share the helpline number with my dad and the journey begins.

Sending you warmest regards,
me

Carolyn613
Posted: Tuesday, February 7, 2017 12:20 PM
Joined: 7/15/2016
Posts: 314


My dh is on a low dose of Risperdal. I want him off of it. I think I'd better call his neurologist right now and ask for an appointment. (He is not the dr who prescribed it.)
BarrieDreyer
Posted: Tuesday, February 7, 2017 1:14 PM
Joined: 2/6/2017
Posts: 17


Hello Carolyn 613,

My mom had her first appointment with a geriatric memory care physician this morning.  I don't have all the details, but I can tell you the doctor prescribed Lexapro, which will help with my mom's anxiety.  It is an anti-depressant and used to treat anxiety and depression.  I feel better knowing she is not going to be taking the Risperdal.  The doctor also ordered a brain CT scan.  

I am hoping this course will help calm her down and allow some peace to return to the house.  

I will keep you all posted when I learn more.  

I want to thank everyone for their input.  I did start reading the link provided by StephanieZ.  She is an RN and works with dementia / Alzheimer's patients.  Understanding the Dementia Experience is very informative.  Also, StephanieZ provided a 24/7 help line, which I will not hesitate to use should events arise.

Thank you again, and I'll be writing more as I learn more.


BarrieDreyer
Posted: Thursday, March 16, 2017 1:06 PM
Joined: 2/6/2017
Posts: 17


So my mom had her second appointment with her memory care physician on March 14th.  The doctor reviewed the results of her CT scan and it revealed she had suffered from 2 small mini strokes at some point in time.  What I have been reading is that a mini stroke can also herald an impending full-strength stroke.  

The good news is the Lexapro is doing its job and my father says that mom is doing nicely.  She is back to her normal ebullient self and no longer lashing out in anger or accusing my dad of stealing from her.  Although her memory is still failing, it does not seem as drastic as it did before the Lexapro.  She is cooking and cleaning the house and going about her daily routine.

I am relieved.  The next step is to notify her primary care physician about the news of her strokes and ask about how to proceed.  In the meantime, I am now reading up on care after mini-strokes, which are known as transient ischemic attacks.  

Mom's next appointment is in June.


rebecca2000
Posted: Thursday, March 16, 2017 1:11 PM
Joined: 9/25/2016
Posts: 173


Great update!  glad things are moving in a good direction for you all. You are a great advocate for your mom.
BarrieDreyer
Posted: Thursday, March 16, 2017 1:54 PM
Joined: 2/6/2017
Posts: 17


Thank you for that, Rebecca2000.  You are so kind.
rebecca2000
Posted: Thursday, March 16, 2017 2:00 PM
Joined: 9/25/2016
Posts: 173


I think updates like this remind us that it's a long journey.  Some days, weeks, even months,  you feel like everything is going terribly and you don't know what's going on.  When you step back and observe the long view, you can see learning and personal progress, even as your LO's disease progresses. it's encouraging!
BarrieDreyer
Posted: Thursday, March 16, 2017 2:23 PM
Joined: 2/6/2017
Posts: 17


Hello Rebecca,
You are so right.  

 

I am trying to really appreciate this time and love on my mom and dad as much as possible.  I know that change is coming and I'm trying to prepare myself for this journey.  Both of my parents are still very active and involved.  My father, who is 83, still flies his airplane and they both travel and enjoy an active social life.  I am so very grateful for the good health they have enjoyed.  

VKB
Posted: Thursday, March 16, 2017 2:59 PM
Joined: 12/4/2011
Posts: 2467


Barrie my mother had to go on a mild anti-depressant to keep her NOT sleepy but calm.  I suggest she sees a doctor who knows how to prescribe for dementia/Alzheimer's patients or a very good family doctor might work.  Peace always Veronica
BarrieDreyer
Posted: Thursday, March 16, 2017 3:06 PM
Joined: 2/6/2017
Posts: 17


Thank you for that lovely message Veronica.  

I was able to get my mom in to see one of the best geriatric memory care doctors in her area, and the doctor put her on Lexapro.  It has helped her immensely.  She is back to her normal ebullient self, and I'm feeling very grateful !


BarrieDreyer
Posted: Thursday, April 20, 2017 8:35 AM
Joined: 2/6/2017
Posts: 17


My mom was doing so much better on the Lexapro, but recently (in the last 2 weeks) she has started showing anger and aggression again.  My father has been trying to work with her in a passive way by not responding, but she insists my dad is doing things, and says she wants a divorce.  There is no way she could take care of herself.  Mom also told my dad this morning that she has lost all respect for him.  These are very hurtful words.  

Easter weekend my mom threw some coins my dad has had since he was a little boy.  She threw them in the hallway and they scattered everywhere.  My mom also withdrew money out of their account unbeknownst to my dad.  This is something she never would have done in the past. Easter Saturday eve, my dad left to go to their second home and he was going to attend church services.  He was so worried that he woke up Easter Sunday morning at 3:30 a.m. and drove back home to make sure mom was okay.  

My dad called the memory care doctor this Tuesday and the doctor re-prescribed the Risperdal. Mom has been on it 2 days, but so far, her anger is not improving.  

My poor father is so exhausted and is constantly being verbally attacked by my mom.  Last night, she woke my dad up at 10:00 p.m. ranting and raving about how he is "stealing" from her.  My dad listened for about 3 or 4 minutes and then he went upstairs to another bedroom and  blocked himself into the bedroom.

I'm so scared for what the future will hold for my mom and my dad.  


Mimi S.
Posted: Thursday, April 20, 2017 8:45 AM
Joined: 11/29/2011
Posts: 5063


Hi Barrie,

Welcome to our world. I'm so glad you found us.

From your library do get a copy of ay book by Naomi Feil with the word Validation in the title. it's not an easy read, but using her method may give both of you a happier living and you ma be able to cut down on the Lexapro.  You will have to teach dad how to also use the method.


BarrieDreyer
Posted: Thursday, April 20, 2017 9:41 AM
Joined: 2/6/2017
Posts: 17


I will look up the book now and thank you for reaching out to me Mimi S.  

I have been crying this morning.  I live too far away to drive to be with my parents.  I am at a loss when it comes to helping my father deal with my mom's mood swings and anger. 


JazzyOne
Posted: Thursday, April 20, 2017 2:15 PM
Joined: 11/28/2016
Posts: 103


Barrie, the wise folks on this forum often suggest that when a L.O. has a sudden change in behavior for the worse that one of the most important things to do is to have their Primary Care Provider do a urine culture (not just a simple stick test) to check for UTI (urinary tract infection). UTIs can trigger radical changes in mood and behavior, literally like flipping a light switch, it can be that lightning fast.

Could you or your dad call the care provider to alert them to the problem and ask whether she could be tested ASAP?  Especially with the weekend approaching.

At our clinic we can call the PCP and speak to a medical assistant, describe the situation, and they will order the test for us, without us needing an appt first. We can pick up the sample cup from the lab (and also take extras for future use!), fill it, put chiller ice bags around it and return it to the lab.

In your case it sounds like your mother may not be easily persuaded to give a urine sample, but perhaps the medical assistant could speak on the phone to your mom directly, so that the request isn't coming via your dad and he's not the bad guy.


lairdwd
Posted: Thursday, April 20, 2017 6:17 PM
Joined: 3/28/2017
Posts: 63


strokes are a known side effect of the anti-psychs. 

 I'm telling you dude, try the benadryl. You can get a big bottle at wallyworld for like $3 . Give one pill 3x a day. If it doesn't work, no big loss. A script for the benzos might be good too. This all assumes of course you have screened for interactions and/or stopped the anti-psych. 

Also more exercise! AD folks love to mimic and be led. I like to do one on one 'instructor' led personal training with my LO. Very rewarding. Get her worked up and tired out for about a half an hour. See if that helps. 

Just be advised that if you go the benzo route, the shrinks and MD's tend to over-prescribe the starting dosage, especially those not elderly savy. Start at the bare minimum, like .25mg - even if they write a script for .5. You just may avoid nasty side effects like dizziness and falling that may occur at a higher starting dosage. 


lairdwd
Posted: Thursday, April 20, 2017 6:21 PM
Joined: 3/28/2017
Posts: 63


btw, my research leads me to believe that paxil has been shown as the most effective SSRI for anxiety. I can attest that it worked well for two generations of my LO for mild agitation and anxiety. You can do some googl'ing and read for yourself. 

 


lairdwd
Posted: Thursday, April 20, 2017 7:54 PM
Joined: 3/28/2017
Posts: 63


Dude - I just re-read your post and the doctor actually prescribed risperdal with your Mom having a history of strokes? No warning to you about that? That sounds totally whacked out to me, especially given risperdal's history of causing strokes and ischemic events. I would seek a second opinion from a geriatric specialist about that before giving an anti-psych to someone with a pre-existing history of stroke. 

Just do some googling on this. J&J actually came clean about risperdal and strokes in 2003. It's right in the warning literature about side effects. There are numerous lawsuits on this. Just google risperdal strokes. 

Try CBD ,  benadryl, lorazipam, valaryian root first. Those anti-psychs scare me to death and should only be tried as a last resort. I  read an article interviewing a specialist who actually knows what they are doing say as much about the anti-psychs being a last resort. 

 


King Boo
Posted: Thursday, April 20, 2017 8:24 PM
Joined: 1/9/2012
Posts: 2303


A geriatric psychiatrist who works with dementia patients is the expert for prescribing medications addressing behavioral and psychiatric issues.  Find an M.D. Geriatric Psychiatrist.
BTW, our geriatrician warned us against using Benadryl as it makes dementia symptoms worse, even though it is an over the counter medication.  The boards are a great resource for exchanging information, but something like medication use requires medical clearance - consult your physician.  

Anti-psychs are a good thing when used and prescribed appropriately, but are indeed powerful, hence, I myself would not rx. using them as prescribed by a GP without a consultation with a Geriatric Psychiatrist.  Most MD's are horrible about deferring to the proper specialty.   Dementia behaviors which require their use are distressing to family, but it also torments the PWD, who day in and day out suffers with the rage, paranoia or anger.  Quality of life sometimes requires their use.


lairdwd
Posted: Thursday, April 20, 2017 8:49 PM
Joined: 3/28/2017
Posts: 63


our geriatrician warned us against using Benadryl as it makes dementia symptoms worse

Yep - that's true as it's anticholinergic - but compared to the alternatives it has a favorable risk/reward profile.   - benzos? check - they give you AD . anti-psychs? check - they give you all sorts of problems (strokes, etc). 

It's the lesser of all the evils and depends where you are at in the disease. For us, we're in hospice late stage 6/early 7, so it's not as much a concern. The ship has already sailed for a lot of those brain chemical levels. I've also read that the low dosages of the benadryl isn't as much of a concern as the more potent anticholergics. But you are right, it's something to consider. 

This is why the promise of CBD and medical MJ is so promising. Totally different pathways without the baggage of the synthetic meds. 

BarrieDreyer
Posted: Friday, April 21, 2017 10:58 AM
Joined: 2/6/2017
Posts: 17


Thanks to everyone who submitted replies regarding my mom.  I am very worried about her being on the Risperdal.  That's why we discontinued it.  My mom is seeing a geriatric memory care doctor, so these prescribes are not coming from the primary care physician.  

It's only because mom's behavior started scaring my dad that the doctor re-prescribed the Risperdal.  We have an appointment to take my mom to the memory care doctor next week.  I am hoping to speak with the doctor and express my concern regarding the side effects of the Risperdal and ask her if there is anything else that can be used.

My mom is definitely having delusional thoughts about my father stealing from her.  She has woken him up out of a dead sleep twice now, once before we got mom in to see the memory care doctor and then again on April 19th.  

Thank you again for all of the advice and I will study each reply carefully and research some of your recommendations.

 

This is such a horrible disease!


BarrieDreyer
Posted: Friday, April 21, 2017 11:02 AM
Joined: 2/6/2017
Posts: 17


Dear STY,  I am so very sorry for you.  This is certainly a journey that no one wants to take.  I know things are not going to get better.  I am preparing myself as much as I can for constant change and potential death or major stroke.  I can't sleep just thinking about it.  I'm always gravitating to my mom and how she is doing.

Stay strong and thank you for your kind words.


King Boo
Posted: Friday, April 21, 2017 2:42 PM
Joined: 1/9/2012
Posts: 2303


What do you mean by geriatric memory care doctor?  Chances are this is either a GP, geriatrician or a neurologist - NONE of whom specialize in the use of psych. meds.

Ask for the referral.  MD's are frequently very poor at referring to specialties, especially for this disease.

Have a geriatric psychiatrist consult - changed things for the better dramatically.


BarrieDreyer
Posted: Friday, April 21, 2017 5:02 PM
Joined: 2/6/2017
Posts: 17


This is all so overwhelming and my brain is having a hard time processing all the comments, especially as it pertains to the Risperdal.  My father doesn't want her on it, and I don't want her on it, but her fits of rage are so incredibly intense that my father is afraid and exhausted trying to anticipate her next outburst.  

I am particularly worried that mom has had 2 small strokes and I'm definitely concerned she could suffer a major stroke when she is in a rage.  It does not help her blood pressure.

 


lairdwd
Posted: Friday, April 21, 2017 6:12 PM
Joined: 3/28/2017
Posts: 63


There are actually quite a few success stories too with the anti-psychs. Use the search function of this forum and read the antidotal evidence. Please forgive me if I've startled you, but it's downright scary to read some of these things. I just read through some of the older threads and there is some encouraging data out there on the benefits. 

In any case, after your consultation if you do go there, go with a very small dosage. Also, I'm curious why the doctor didn't recommend a benzo.  Lot less risk with the benzos. Or even a combination with some of the other therapies out there (i.e. benzo + aroma therapy). 


King Boo
Posted: Saturday, April 22, 2017 9:08 AM
Joined: 1/9/2012
Posts: 2303


https://www.alzconnected.org/discussion.aspx?g=posts&t=2147519539

Sorry, the copy/paste function did not work properly and I am having trouble editing.  Here is the link you will need to copy and past to read a positive thread on Risperdal use.  Alternatively, search for JoC Risperdal.   

In the proper prescribing hands, these medications, if their use is truly indicated, can drastically change the quality of life for BOTH family member and PWD dramatically.  The whole "not wanting someone on  it" is certainly good thinking if less potent medications have not been evaluated to see if they can be used.  But, the symptoms you describe are pretty ramped up, and life is miserable for both parents.

With regard to my rx for a Geriatric Psychiatrist, it is not for talk therapy, which wouldn't work.  It is to seek information about medication options from an M.D. whose specialty training is in this area.  You will not get the same level of expertise from a memory care doctor, whatever that is, a Neurologist or a Geriatrician.  Anything more than a mild anti anxiety medication belongs in the hands of a Geriatric Psychiatrist, and our geriatrician preferred the Geriatric Psychiatrist prescribe this (even though he could have).   You will find in this journey that even with good doctors part of advocating for your LO is ASKING, REQUESTING and unfortunately, sometimes, even DEMANDING what you need.   However, most MD's will not hesitate to refer to a Geriatric Psychiatrist when asked because they know they have a savy consumer on their hands (however, the ego bound may say "you don't need that" in which case you must insist for "peace of mind").

I'll point out too, that some of us, me included, had some pre-existing bias' towards certain medications.  However, the hard truth of day to day life and the behaviors drive the decision making.  No one can continue to live or care for Mom with the behaviors described, so the question is not whether or not to use medication, but "what" medication - best in the hands of a geriatric psychiatrist.

don't let your head spin with info on the boards.  You week through what applies to your situation and you use it as a spring board for more research or guidance, not the rock solid truth.  

Good luck.  Do read the excerpt from JoC, it's encouraging with a rock solid rationale.


jfkoc
Posted: Saturday, April 22, 2017 2:39 PM
Joined: 12/4/2011
Posts: 11677


It is overwhelming and the road twists and turns. Things do not get back to normal  and we are the ones who must change if we are going to be good caregivers. It takes a lot of learning.

My concerns for you mother are that you have not discussed the diagnosis process that must take place (http://alz.org/alzheimers_disease_diagnosis.asp) and an immediate order  for a test for a UTI with following culture was not made when your mother's behavior changed.

Drugs effect everyone differently.  Lexapro made me anxious. My husband took .25 Resperidol and it was very helpful.

My husband was under the care of the dementia guru at our university. She totally screwed up on prescriptions...the pharmacist caught it.

We are here, passing through the help we have received. You have supportive and informative company on your journey.

Sending a hug for you, your father and your mother.....


 
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