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After the 5th violent night in a week, I had my dad taken to the hospital via paramedics again this morning. He was up all night, cussing, yelling, slamming fists, threatening me and saying the most God awful things about me, my son and my deceased mother. I know it's not him, it's the illness. But I cannot take one more night of having a knot in my stomach, worrying if he's going to waken and if he does, the type mood he will be in. Last night he attempted to hit me, grabbed my nightgown and ripped it(deliberately), threw food on the kitchen floor etc. I'd thought that I could see him through these "episodes". That perhaps they were few and far between. But I can tell they are worse, more often and last longer. I am a nervous wreck(on top of caring for him in general by myself for the last 2 1/2 years). The last two times he was in the hospital, the doctors "eluded" to the possibility of him going to a home on release. I felt I could handle it. I cannot. And what's more, at this point I don't "want" to. I love my dad, but being around him all the time with the way he has become, causes me to feel hatred sometimes. Then I feel guilty for that. Anyway, already spoke to the doctor at the ER--they are admitting him and have already verified with me that it, indeed, would be best to look at residential care when he leaves. I do have to say that they are very nice and helpful about it.. It seems to me as if they know how hard it is to make that decision and they do their best to "guide" you if they feel you're having trouble coming to that conclusion. I am grateful for that, because it makes me not feel as bad, as though they understand. So, this is the new part of the journey. I feel sad, regret and yet, at the same time, a little bit of hope and empowerment. I will let you all know what happens.

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My husband was on Bupropion (Wellbutrin) for many years after a head injury. In addition when he developed dementia he was placed on Seroquel for night time agitation. It was very effective at a small dose that remained constant for 9+ years. The real point is, as you say, that there are many drugs that can be tried, always trying one at a time, starting at a low dose, and building up gradually. What worked for my husband might not work for your dad, but it is likely that SOMETHING will work, if the doctor is patient enough to keep trying.

You are making the right decision to have him placed. If in the future the right medications have him in a more manageable state, you can reconsider then.
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An update.. this is my dad's second full day in the hospital. He is catching up on much needed sleep. They have the ammonia levels down in his blood. I still believe that his dementia and outburst are only partially caused by liver failure. Last night I noticed that around 7 pm he started to become agitated again(well after his levels had started to come down). I went home to sleep and under my breath, wished the staff "good luck" in dealing with him through the night. When I returned this morning, they said that he had been up all night, although not really agitated(sometimes I think my presence makes it worse). The doctor came to to see him and says his ammonia level is now "normal". I told him that my dad is a "nervous worrier" in general even prior to getting this illness and that prozac was prescribed many years ago for depression after my mom died. His decision was to take my dad off prozac(which does not for anxiety) and start him on zoloft which does. Thar's fine with me, as I am ready to try anything that will make my dad easier to deal with, whether at home or in residential care. Well, about an hour ago(4pm or so) my dad is getting "mildly" agitated and very emotional. Crying, demanding to leave and calling me by my mom's name. Bottom line is that this still tells me that I cannot care for him. One minute he seems fairly stable and I think "maybe that can stablelize his meds and I can actually care for him at home"..then he goes into these "episodes and I realize I can't. I still hope that the Zoloft will help. I don't know why no one ever thought to try a different anti depressant before instead of the other "physcotic" meds (Haldon etc). Afterall , it's just his first 2 doses of Zoloft.. two soon to know if it can help with the agitation outbursts.Has anyone had any luck with Zoloft or other anti depressants for elderly agitation? The doctor says it has to be one that is geared to depression and anxiety. I know there are others out there to try if Zoloft fails. I , myself have been on Effexor for many years.
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Southlover~You are doing the right thing. I commend you for taking such a heart wrenching step, but necessary one. Your well being and safety is just as important as your father's. I hate this disease as it is so difficult to deal with and you have given so much to take care of your father. Your father will be well taken care just as you have done. Take some deep breaths now knowing that you will still be advocating in his behalf. Hugs to you!!
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You have to remember that this disease can do that. But I think what you are doing is best for him and you. The nursing home staff will have the proper tools and medications to help calm him. He has no control over what his mind is telling him at this time. And I believe he needs some antipsychotic medications, he is probably having some delusions. Plus you need to think about you and your safety too. I'm sorry that this is happening. I know it's hard to let go and lets someone else take over but sometimes it's for the best.
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You are making the right decision, and you've had some tests to verify that.

Remember that you are not abandoning him, just getting him into a safe setting where you can continue to love him and advicate for him and care for him..
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Southlover, am sorry to hear the outbursts continued but am happy to hear you are making other arrangements...... it could be a number of things with him, but you are making a good choice, for yourself and for him in the long run... please keep us updated about this part of your journey...sending you hugs and prayers.
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