Follow
Share

I have a patient that is new to my community. he has dementia and is difficult to care for. He thinks we are trying to kill him, hallucinates (he thought he saw a cat and wanted to pet it and fell off his chair) he cries asking "why me" he is on seroquel and dont know if taking him off this drug will help or make the behavior worse. any suggestions?

This discussion has been closed for comment. Start a New Discussion.
Yes, many dementia patients, even those who were delightful to be around when they were well, are difficult to care for.

Do you have a diagnosis for a particular type of dementia? Vascular? Lewy Body? Alzheimer's? etc. Knowing that can help you research what to expect and how to cope with it.

If he is asking "why me?" he is apparently self-aware. I think this can be one of the cruelest aspects of some dementias, for the patient to understand his impairments and how much he is losing. This was really awful when my husband was in this state. Reassure him. "This is not your fault. You didn't do anything to bring this on. You have a wonderful brain and you are very smart, but you have a disease that is preventing you from using it fully. You don't deserve this, any more than cancer patients deserve their disease. We will take good care of you here, and help you with the things the disease isn't letting you do."

Hallucinations are common to some forms of dementia. In Lewy Body, for instance, they tend to be one of the earliest symptoms, and often they are not distressing to the patient. You cannot reason a person out of the hallucination. If it doesn't disturb the patient, you don't have to do anything. If it is pleasant for the patient to see crime scene investigators in his room, well, wish them good luck! It can help to accept the hallucination and then redirect. "What kind of cat is it? Do you like cats better than dogs? Have you ever owned a cat? Tell me about the pets you have had."

Who put him on seroquel? What was it expected/hoped to do? How long has he been on it? Some people will tell you that it should NEVER be used for elders. Since it was a miracle drug for my husband, I can't agree. It is on Brad Boeve's list of drugs that are suitable for treating aspects of Lewy Body Dementia. (He is one of the world's leading experts on this subject.) But in treating dementia, ONE SIZE DOES NOT FIT ALL! It is a trial-and-adjust-and-trial-again approach. Maybe your patient would be better off not taking that drug. Maybe he needs the dose increased! Can you discuss this with his doctor, and see if some experimenting by taking him off a while is in order?

Is he on any other drugs? Aricept is usually given to dementia patients. It is far more effective for some kinds of dementia than for others, so again, this is something that has to be tried, but may or may not work well.

As the wife of a wonderful man who has dementia, I want to thank you for caring enough to be searching for advice. These poor people are at the mercy of their caregivers, and it is a blessing when the caregivers do all they can to make their lives calmer and less terrifying.
(0)
Report

Subscribe to
Our Newsletter