Barb, You are correct that geri-psych can be a true-blessing. But I know 2 people whose final decline involved a geri-psych unit. Who knows what their short-term outcome would have been otherwise, but they didn't have the "adjust the meds, discharge, and move on" experience. It was adjust, decline, discharge, readmit, adjust, decline, discharge, hospice. In one case, 4 visits to geri psych.
Since my DH has had periods of extreme agitation, I recently discussed with his neurologist the potential of a geri-psych visit and how to otherwise manage his aggression. She said that her preference is for her to work directly with MC or me (if DH is still at home) to adjust meds, even daily if needed, with the goal of getting DH stabilized. She's willing to put in this effort. I don't know if all neurologists would work this hard.
Sometimes it's possible to do it in the patient's current living situation, sometimes not. But she believes that geri-psych is a last choice because it is so destabilizing for patients.
Just to respond to " the beginning of the end" comment: we've had SO many posters here for whom admission to a geripsych unit was a true blessing.
Dementia is a fatal disease with a fairly unpredictable course, especially because there are so many different types, most not able to be definitively diagnosed except at autopsy.
Treating dementia is about symptom relief. It's a matter of making the least bad choice most of the time. Sometimes you have to take a chance.
Thanks for suggestions! I have read up on both seroquel and risperdal. I am going to ask internal medicine doctor for a psychiatric/neurologic consult before I start any new meds. I don’t think Mom could tolerate admission to Geriatric Psych Unit. A move like that would be too hard for her. I will definitely stay on top of situation - she cannot hurt others!
If she is a danger to herself and others med adjustment needs to be in arranged in a geri psych unit. The med adjustments and resulting behaviors require more oversight and care than a memory care unit can provide.
Her meds need to be adjusted by her neurologist or geriatric specialist. Have this done in her memory care unit IF AT ALL POSSIBLE. The last resort is the geri psych unit. They will also adjust meds here, but it will be a huge disruption to her stability. For patients that I know, geri psych units were ultimately the 'beginning of the end.'
There are meds that will help. When aggressive behaviors started with my mom, usually related with sundowning, Seroquel was a miracle drug. But, it is different for everyone, what works for one will not work for another. It is trial and error so the need for a geriatric, in-patient, psychiatric assessment.
My mom was eventually kicked out of a memory care facility because she was a danger to herself and others. She was then moved to a smaller care home with about ten residents, all of which had been kicked out of previous facilities due to behaviors. That situation worked better for mom but she was also on more meds to help control her behaviors.
Kathy Has mom seen a psychiatrist or neurologist ?
Some residents at mom's memory care get aggressive only at certain times - bath time or bed time - others are always volatile
Mom is on a fairly low dose of risperdal now and though she is immobile she will still pinch when she's being changed or showered - to her it's a violation of her body - fortunately she can turn and then be very sweet
Her behavior especially her grumpiness ramps up with a UTI so anything beyond her baseline and I'm asking for a urinalysis which is now very difficult as they have to use a catheter for collection
Good luck and I'd offer up to stay close and monitor her reaction to any new drugs - seroquel, a common go to drug, didn't work for mom
Not enough room for entire explanation of Mom’s behavior in question block. Yes she suffers from UTI’s and I am on top of those. She just finished a course of antibiotics. I have noticed increased aggression/meanness over last two months. Numerous incident reports to me from Memory Care Unit where she has hit others residents, staff and me). I have appointment Tuesday with Primary Care Physician, I will ask her about admission to geriatric psych unit. Thank you. PS I know I had asked questions in the past, I couldn’t find them, how did you? I am not computer sauvy!
Kathy, 11 months ago you posted about your mom's back to back UTI problems and her meanness when she got them. Please have her tested immediately.
Otherwise, she needs to be evaluated by a geriatric psychiatrist; there are meds that can help, but sometimes, admission to a psych unit can be the best way for the docs to figure out what meds can help.
Kathy, usually when that happens chances are your Mom has an Urinary Tract Infection. Such an infection would cause sudden aggressive behavior. The test for a UTI is quite simple, peeing in a cup for the doctor's office to have tested. Then the use of antibiotics.
Mom's primary doctor can do the test, so would any urgent care facility.
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You are correct that geri-psych can be a true-blessing. But I know 2 people whose final decline involved a geri-psych unit. Who knows what their short-term outcome would have been otherwise, but they didn't have the "adjust the meds, discharge, and move on" experience. It was adjust, decline, discharge, readmit, adjust, decline, discharge, hospice. In one case, 4 visits to geri psych.
Since my DH has had periods of extreme agitation, I recently discussed with his neurologist the potential of a geri-psych visit and how to otherwise manage his aggression. She said that her preference is for her to work directly with MC or me (if DH is still at home) to adjust meds, even daily if needed, with the goal of getting DH stabilized. She's willing to put in this effort. I don't know if all neurologists would work this hard.
Sometimes it's possible to do it in the patient's current living situation, sometimes not. But she believes that geri-psych is a last choice because it is so destabilizing for patients.
Dementia is a fatal disease with a fairly unpredictable course, especially because there are so many different types, most not able to be definitively diagnosed except at autopsy.
Treating dementia is about symptom relief. It's a matter of making the least bad choice most of the time. Sometimes you have to take a chance.
My mom was eventually kicked out of a memory care facility because she was a danger to herself and others. She was then moved to a smaller care home with about ten residents, all of which had been kicked out of previous facilities due to behaviors. That situation worked better for mom but she was also on more meds to help control her behaviors.
Has mom seen a psychiatrist or neurologist ?
Some residents at mom's memory care get aggressive only at certain times - bath time or bed time - others are always volatile
Mom is on a fairly low dose of risperdal now and though she is immobile she will still pinch when she's being changed or showered - to her it's a violation of her body - fortunately she can turn and then be very sweet
Her behavior especially her grumpiness ramps up with a UTI so anything beyond her baseline and I'm asking for a urinalysis which is now very difficult as they have to use a catheter for collection
Good luck and I'd offer up to stay close and monitor her reaction to any new drugs - seroquel, a common go to drug, didn't work for mom
PS I know I had asked questions in the past, I couldn’t find them, how did you? I am not computer sauvy!
Otherwise, she needs to be evaluated by a geriatric psychiatrist; there are meds that can help, but sometimes, admission to a psych unit can be the best way for the docs to figure out what meds can help.
Mom's primary doctor can do the test, so would any urgent care facility.