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My father (86) has dementia, is wheelchair ridden, and prone to low sodium. Lately he has developed a habit of breathing forcefully with his lips pursed - shallow and fast breathing. Then he breaks into a sweat after doing this for hours. We've had to call the ambulance a few times when he worked himself up to asthma attacks. When his mind is distracted, if I take him for a walk for example, his breathing is fine. His long term memory is fine. He knows where his is, and what everyone's name are, but he gets the year mixed up. Has anyone dealt with this? Any ideas about what to do?

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GardenArtist...he's been in this NH since August 2016. His routine has been the same since he entered. Sad because my mom was in the same facility for 2 1/2 years and he visited her every day. She passed away 10 years ago. I thought maybe somehow he remembered being there with her, but he's in a completely different area. They have cats that they ordered for the patients. Battery operated and act just like a real cat. He will have no part of them,nor will he have anything to do with the baby dolls. He was a politician, but never had any friends. He was a loner,but boy could he play the politician. He has no interest in music,but he's also very hard of hearing. Knowing his history, they gave him a book to write in. They would tell him he needed to sign papers,etc. The last few weeks he doesn't touch the book. I wonder if there is too much going on around him now and that is what is causing the anxiety. Nothing has changed in his routine at all. Banging my head agsinst a wall trying to figure this out. AllI want is for him to be at peace.
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.... "Invictus" ... 'tis late my condolences to you and your family. In respect to you I hope others read this so they don't continue to disrespectfully speak via not having taken the time nor respect to read your further notes of your father having left.
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I have no experience with this but just wanted to share a few thoughts. How long has he been in this facility? Long enough to be adjusted, or long enough to be frustrated and frightened? Has his health deteriorated since admission? Were there other incidents that might have triggered a heightened level of anxiety? Were meds changed recently?

Since music hasn't worked, you might try getting a furry animal doll. I found this helped after my sister died of cancer. If there's no pet therapy in his facility, he might calm down just from running his hands over he soft (artificial) fur of a pet. Just a thought....
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Once again yesterday when I arrived at the NH to visit, he was having an anxiety attack. The worker in the Activity Room said that he started around 2 PM and she didn't know how to calm him down. I arrived about 3:30. Yes, he was bad. Reaching out for anyone and everyone and asking to go to the counter. He must find comfort in holding on to the counter at the nurses station, I just don't know. I took him there, and asked for something to calm him. Well, they ordered nothing! The nurse thought he may be in pain so he gave him Tylenol. I knew the Psychiatrist was there on Friday so I set out to find him. Yes, I did! He couldn't understand why there was nothing to give him for anxiety. So, he ordered a med to be given first thing in the morning, then during the day as needed. After a couple of weeks, he will see how PRN,s he has and then adjust the meds accordingly. One nurse said they took him off of the med because he was lethargic. I have to weigh.lethargic against anxious. I chose lethargic. That can be adjusted, but the anxiety can't. Does anyone know what causes the anxiety? Is it the Dementia? Well, yes, I guess it is, but is it activity around him? His mind, for whatever reason, racing? Is it because he's coming to the end of his life? I also notice he's eating less. Before I could feed him after he said he was done, but lately when he's done that's it. I just feel so helpless to watch him breathe with the pursed lips, and so upset. His speech changes when this happens too. It's 1 word and over and over again. Could it be a form of a TIA? Gosh, I only wish he could tell me why???
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Yes, it's definitely hard to watch. I don't know if the hyperventilation is caused by congestive heart failure, but that type of breathing definitely impacts the heart. It's too bad that you need to worry about costs, at the same time as worrying about your Dad. We are lucky here in Canada that most health care has been paid through our tax system already. My Dad remained at home until the end of his life, so there were costs associated with that. And since in BC the liberal gov was eager to privatize everything, they were taking way funds from public and putting it into private health care, so that did impact the frequency and quality of health care he received externally. We were lucky to have an excellent and supportive GP - and that made a world of difference, as far as the comfort my Dad received. In the end he passed away peacefully during a nap. One thing that did help my Dad a bit was listening to music, or meditation and prayer. If I got him onto a topic he enjoyed discussing that helped a bit too. But it was hard, and especially hard at night time. All the best to you and your Dad.
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Dad almost 97 has been exhibiting pursed lip breathing for a few years. He's end stage Dementia in a NH. He spends his days in the Activity Room. Only time he is in his room is for a breathing treatment. He's prob to Aspiration Pneumonia. This week he was so agitated.....I wondered how he didn't hyperventilate. Definitely agitated, but we can't figure out why. I called his nurse to take his vitals. Pulseox was 95. Called his doc. Gotta do something for him. Took blood and urine and prescribed a low dose of Xanax, as needed. Also suggested a Hospice eval. Did that yesterday. Not sure Medicare will approve it. It's ok if they don't. All I want is for him to be comfortable and not so agitated. The breathing was horrible, not easy to see.
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....she has some cognoscent control over it... for instance, we had a wedding and reception to attend, she came along and she had an amazing time, not once did that occur over a span of 6 hours (est.) But as soon as she re-entered her home, repositioned in her chair, she began. It's not a constant, she tends to go through times of it ...lasts just a couple days then it's back to normal (her normal..
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(Excuse the incredible typos, my goodness)
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My mother often dies the same thing. And it happens if I express consent of her general health. She then begins making her self breathe often and lifting chest with each breath, purses her lips and keeps lips then licks them often. She will look around and if she sees me she will start to do it, but if she thinks she's alone she will stop. I do not want her on any anxiety meds, their side effects can be worse than the ailment or phychosymatic issue.
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Maybe he is having an adverse reaction to the ativan. Check with his doc maybe try something else. Different meds will react differently in different people especially if dementia is a consideration. Just unpredictable how the brain is going to process the medication. We were lucky on the first med we tried for the sundowning behaviors, Seroquel. It is an antipsychotic but most times does the trick. Occasionally, I need to give her a xanax in addition on those nights she finds any variety of things to get anxious about that have no basis in reality.
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Anxiety. But the Ativan doesn't seem to make a difference. Also, I don't know if anxiety attack can go on for that many hours. He tends to be worse in the evenings, or when he wants something, but doesn't verbalize it. the problem is when his pulse is so high, and he gets asthma, he can't take the nebulizer meds. I try distracting him with music, or TV, or getting him to practise writing his name, but that doesn't work. It's so frustrating to watch.
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Has he had his doctor diagnose this problem? What is said about the cause?
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