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Mom moved to AL about four months ago (her third try at it). The same issues she was having at home continued on to AL. The family has suspected dementia for sometime now. One night she got confused with an asthma attack and would not let the staff help her take her emergency inhaler, etc. So, the ambulance was called. She stayed a couple of days at the hospital. She was having hallucinations, confusion and delusions. Nothing new about these symptoms but they seemed more consistent. From there she went to rehab. for about a month. While at rehab these symptoms continued and with reports of possible sun downing and a lot of confusion. At DC, we sent her back to her AL apartment. Since at rehab., she would only use a wheelchair even though previously, she had been walking and using a walker to carry her portable oxygen tank at AL. She even passed a stair assessment in efforts to find another AL she might like better. Probably, about a week or so back at AL she started making demands and going on strike. Doing things like refusing to eat or leave her room, screaming at staff and even slapping at them. Usually at night, insisting my dad was alive and they were playing a trick on her. This went on for about two days. A Dr. that comes to the facility sometimes talked her into going to the behavioral hospital. This would be her third time at one. Going in she was diagnosed with major depressive disorder. The two previous behavioral hospital she was perfect. This time has been a nightmare. She continued her behavior at the behavioral hospital. She was on Aricept and Cymbalta going into the behav. hospital. Seroquel was added when she got there. Mom continued to have behaviors and aggressive ones. She was walking around at first. Somewhere in the last 17 days she was diagnosed with dementia/Alzheimer's with behavioral disturbances and delusions along with anxiety disorder. She is now on depakote, seroquel, aricept, cymbalta, xanax, and then ativan as needed. Even on all of this she still has behaviors. She continues to pull out her oxygen tube from her nose and does not eat much but is now in a wheelchair. Yesterday, when I visited she was quiet and we had a hard time hearing want she was saying. I gave her some ice cream but she was not capable of feeding herself. Three days ago the social worker said if she continues on this path she will need 24/7 care with thoughts going toward hospice. The decline in a week is huge. Has anyone had this experience? A nurse did tell me the sleepiness was from the medicine. Even with her behaviors, she was walking and talking with some moments of lucidity but now she is totally out of it. Is this decline because of medicine and/or the Alzheimer's?

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Years and years ago, when pterodactyls flew, I worked in a nursing home. I was trained how to avoid the violent actions of patients. One woman grabbed my long blonde hair when I made the mistake of leaning over her. I gently peeled her little bird fingers off and we moved on. She had dementia and this was her fun game. There was a gentleman who would try to rape the nurses when they were alone on the elevator with him. I was pretty no nonsense but still vey kind. He never tried it with me. These things can be dealt with. I'm uncertain why these nursing homes can't deal with your loved one. Back then we didn't even have the better medicines of today. I sure would flat out ask the doctor what the deal is. Just some thoughts.
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Update. Some places have denied mom for placement. These include memory care and nursing home. Found out from the nursing home that they would not take her because she was on a restraint medicine and they could not give this type of medicine. They were afraid when she went off of it, she would go off on them. So, who can give a restraint medication? Is there something else they can give her so she is not combative with them?

Not really wanting to go the hospice route yet. My mom is 70 years old. The behavioral hospital says they suggested hospice because of my mom's COPD. Found out hospice gives the restraint medicine my mom is on. Not getting a lot of straight answers from them (social worker).
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That sounds sooooo much like my mom's story, and I've wondered the same question as you. My mom has Alz with major depressive disorder and behavorial disturbance. She takes all the same meds as your mom just to keep her from going homicidal on the nursing staff (she's in a nursing home). I'm afraid I can't answer your question for you, but I can share my story. After attacking an aide my mom got put on a bunch of these meds. At that point she was still walking and talking. Within weeks she was wheelchair bound and within months was bedridden and nonverbal and on hospice. Now, that doesn't mean I believe the meds alone caused this, since she had Alz for 12 plus years at that point and was already in a state of rapid decline, but I often ask the same question as you. I kept pressing the NH staff about it and they started weaning her off some of the meds, but she hasn't recovered any--that is, she is still bedridden, nonverbal, and on hospice. Best to you. This is so so hard to go through, and it's so hard to know what the right thing to do is!
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Oh, and Shell, I meant to offer my sincere empathy for what you are going through. I clicked Post too soon.
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In dementia, when the final decline comes it can be gradual or very sudden. It sounds like your mother has been having these behavioral issues for months, at least. That they have become more severe and/or more constant may simply be the progression of the dementia.

The drugs may have a role in her symptoms, but she is in an environment where the reactions to the drugs can be monitored, and be adjusted as safely as possible. We currently have no sure-thing treatments for the symptoms of dementia or of mental illnesses. Sometimes experimentation with drugs can provide and improvement to quality of life, and it is (in my opinion) worth trying, but there are never guarantees.

If hospice care is being suggested I think that might be a suitable path to take.
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They checked for a UTI right? UTI's can completely change their behavior.
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Alot of meds for sure! My mom took seroquel. When she was moved to memory care the seroquel was stopped during a psych evaluation. They changed her initially to ativan, whic had the completely opposite effect as intended, increased agitation. Stopped the ativan, start respiradol which seems to control her behavior. That is the only anti anxiety med she is taking.
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Facilities are very reluctant to use the word Hospice. When they do, it is usually that time, they have seen it before and they know it when they see it. The hard part is accepting it yourself. Hard to know this is the end of a very long road.
So move her to the secure unit that she needs. Find the strength you need.
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Shell43, my gosh your Mom is taking a lot of medicines. I wouldn't be surprise if her actions could be a side effect from something she had been and still is taking. I realize that dementia can cause such issues, but it is something to think about.

I know when my primary doctor wanted to put me onto something for calm my nerves from all the caregiving stress, it was a lot of trial and error. Some of the meds had the opposite effect... oops. It made my nerves worse. And yes, I have issues with waking up at 3 a.m. and not being able to get back to sleep, side effect from meds.

Another thing, as people get older they develop allergy type reactions to certain foods, similar to medicine side effects. Some foods would be dairy products and gluten. Even caffeine can have an effect. Do you notice if some days are better than others, or every day is the same? Keep a food diary and behavioral diary.

Now with dementia, any time a person is moved to a new location. A new room at the hospital to sleep in, new noises, new smells, new faces to learn, new food, even the sunlight is different. Then a move to rehab, rinse, repeat. Then a move to Assisted Living, rinse, repeat. That's a lot for one person to take in.

Whatever the case, hope your Mom can finally be comfortable.
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