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Dad has severe dementia and is in assisted living. He is delusional and re-direct absolutely does not work with him. Sever agitation; he believes his delusions and thinks of them 42/7. He is on calming meds but is now refusing them. Help!

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If he is in an assisted living facility let staff do their jobs. Severe dementia only gets worse, and for your sake, I suggest you start visiting less frequently. There will be an end to his suffering and you tormenting yourself over his condition will not help you. Love him for the time he has left, and accept he will be gone no matter what you do. My best for all concerned.
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Surely the facility medical people know how to administer meds if a patient won't cooperate. Isn't it a common occurrence with dementia that medication (and most everything else) is resisted?

I had to cope with this when my elderly mother refused to swallow pills any more. She had creative and sometimes funny ways to dispose of them, but before long I found her out. Then the doctor was a big help to provide alternatives. Now her meds either are in liquid form -- mixed with acai juice (someone said they use Gatorade which is a good idea too, for the electrolytes) -- or crushed. For the crushed pills, I use a mix of Jif crunchy peanut butter (Mom's favorite) with Nutella to thin it a bit. This goes on a Ritz cracker, Mom thinks it's a treat and the medicine goes right down.

But not all pills should be crushed. The doctor must get involved with this. For example, we had to change her blood pressure prescription.

Whatever the fix, this challenge does not belong on your shoulders. If ever there was a situation which demanded delegation to someone else, this is it. Blessings to you for quick success in empowering the staff to resolve the issue with meds and anything else that comes up.
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I think there is a point in this disease where re-directing is totally ineffective. It might work early on and in the very late stages but not in the middle stages. At least it didn't where my Dad was concerned. Many AD patients become so fixated on an idea or obsessed with an idea that they just won't give up on it, no matter what you try. Even if you can deflect them for a moment or two, they will still go back to it. That's just the way their brain is geared now. Sometimes its just best to agree with whatever delusion or fixation the person might have and let him believe what he wants to believe, as long as he isn't hurting himself. As for "calming" meds, whether they work or not just really depends on the person I think. We tried several with my Dad, but it just made him worse. He's gotten to the point where he really doesn't fixate on ideas as much as he used to...I guess it gets better as the disease progresses, which is a sad thing to say.
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Try Reiki. Find a seasoned practitioner. Twice a week, Mom has a treatment and actually reconnects after. A friend on FB read my post and decided to try it with her agitated father. He stays happier longer and speaks more clearly after just 1/2 hour of treatment. Like everything with this brain disease, you have to give it more than one try. If you are reading this and live in Massachusetts, go to Christine at Gentle Woman Reiki. She is miraculous. Wishing you and your Dad wellness.
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All very good input. I noticed you say your dad has severe dementia yet is an assisted living. Do you mean assisted living as opposed to nursing home, locked Alzheimer's care or memory care? Is he yet hospice appropriate? The staff at assisted living, if that's really the type of place he is, are often not equipped to deal more assertively with behavioral problems and medication issues. Many times they have a hands-off, the patient has rights, approach, which is frustrating for you to deal with and certainly not good for your dad, especially when he needs more, not less, medication as his condition progresses to worsening, which it inevitably guys. The facilities with experienced staff have creative ways to get the medicine down. As already indicated, liquids, crushed (only when approved) and at it too tasty foods or even something as simple as coming back at 5 or 10 minute intervals until they catch the patient in a less resistant mood. Only you can evaluate, but your dad may need to be in a different type of facility.
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My mom was severely agitated and I started her on Prevagen. The company makes all kinds of claims of improvement in function, which I haven't seen. However, what I have notice is a huge decrease in her agitation. She still get upset about but the "meltdowns" have become far less severe and much shorter in duration. Getting her to take them sometimes be a challenge, but I wait her out and remind her she needs to stay healthy and the "Doctor said so" (I hate doing that but it really does help with that generation.) Prevagan can be found at Rite-Aid and Wallgreens. It's an OTC supplement so insurance doesn't pay. You can also find it on line. If you buy in bulk the official web site is cheapest, if not Vitacost is the cheapest single purchase I've found. I know I sound like I'm working for the company (I don't) but it really has helped my mom - just spreading the word. Good Luck!
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Music can be the best solution for soothing agitation for people with dementia.

Music can do wonders for individuals in the mid stages of Alzheimer’s Disease. There have been many studies done that indicate the positive impact of music. I suggest that you get an i-pod and download music that your father knew and loved when he was younger. I know this helped my mother particularly when she was sundowning. If you are interested I am attaching a link to an article that discusses the beneficial impact of music and Alzheimer’s.
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Lots of love, music and ask Dr for Depakote. Good Luck, it last about a year.
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He is in a Type B assisted living facility - they can do a few more things than a Type A assisted living - at least in Texas.
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Thanx, goober, for that feedback. I've never heard of such divisions of care level here in California. Of course California seems to be operating at bankruptcy level for the last ten to fifteen years. Good to know Texas has that availability. Just make sure they are stepping up to the standards of care they're supposed to be offering. There should ALWAYS be a way to get the person their medication because without it everything else just deteriorates.
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