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Harveylynn Asked January 2018

My wife is in a memory care home. The home wants to send her to a drug adjustment facility. Anyone have experience with this?

She has roaming and agitation issues. Anyone have any experience with these types of facilities. She is on Seroquel. Her present condition is a side effect of Alzheimer's and also the drug Seroquel. I don't like the idea of them trying all kinds of drugs on her. Bad experience with Haloperidol.

jeannegibbs Jan 2018
Here is an example of why prescribing drugs for those with damage in the brain is an experiment: Nearly all the loved ones of my caregivers group were prescribed Seroquel. For my husband and me, it was the miracle drug that made it possible for both of us to get some sleep. I would have fought tooth-and-nail if someone tried to take it away from us. For about half of the group, Seroquel didn't help at all, and for a few it made things worse. So half tried it and discontinued it.

Maybe some day we can examine blood or stands of hair or spinal fluid and say, "Oh this patient won't tolerate A, B, or W, but drug C should be OK." We are not there now!

jeannegibbs Jan 2018
Several members of my local caregiver support group talked about this experience. There are no very effective medications for dementia itself, but some existing drugs can help manage symptoms. The only way (now -- lots of research going on) to determine what medications might be effective, and in what combinations, is to try them. But there can be adverse reactions and side-effects. This is where the “drug adjustment facility” comes in. This is intended to be a safe and well-monitored place for that experimentation. It is kind of scary, but the caregivers in my group whose loved ones tried this were very satisfied with the experience.

Having a really bad reaction to Haloperidol is a diagnostic symptom for Lewy Body Dementia. Has anyone mentioned that form of dementia to you? LBD can often be helped by medications, but there are a lot of sensitivities also. Best any trial-and-error be conducted in a safe environment.

In the bad old days when my aunt and uncle worked at an insane asylum, the way disturbing behaviors were handled was by physical restraint, such as being strapped to a bed or wheelchair until the behavior passed. I guess straight jackets were an extreme case.

Law does not permit physical restraints to control behavior. But the behavior still needs to be dealt with. The modern form of "restraint" is medication. Maybe some day we'll have far more risk-free and effective methods, but right now it is what is available.

My heart goes out to you. Having a spouse with dementia is sure not how we pictured our sunset years, is it.

BTW, before allowing your wife to leave the memory care facility, get it IN WRITING, that her room is being held for her and that they will accept her back.

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Ahmijoy Jan 2018
You mean like rehab? I’ve never heard of a “drug adjustment facility”. Usually, if one medication isn’t working, the facility’s doctor will prescribe something else, and the patient doesn’t have to leave the facility. A change of scenery can exacerbate the anxiety and wandering issues. Is her facility one with doors that are locked and you need a code to get in and out? That should help the wandering. It did with my mom. I would ask why they feel she needs to go to a specific facility.

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