I am the guardian for my step-dad. My mom died very suddenly last year from encephalitis caused by the shingles virus. She was 77 and healthy.

She leaves behind her 92 yo, legally blind husband of 30 years who was diagnosed with dementia approx 5 years ago. We were blown away when step-dad became the surviving spouse!

My mom was a nurse and legal advocate. She had planned everything out expecting the demise of her husband and handled every tiny detail of his life to care for him when his dementia became more debilitating.

The last year has been insane dealing with step-dad. He has always been stubborn and opinionated. Dementia has magnified that to the extreme. His daily life changed so dramatically in an instant. He was placed in memory care facility in January 2020.

Since then he wants nothing more than to go home. It’s relentless and obsessive. He’s a scrappy, agile, surprisingly strong 92 yo! We are concerned he will hurt himself or an innocent bystander when he goes into his rages.

He is currently on his 3rd hospitalization at the Psych Hospital. He landed there after tossing his room, dragging his mattress and recliner out into the hall. He then pushed through an exterior door (which emits a siren) got on his walker to try and hoist himself over the 8-9 foot high gate. All drug therapies have been tried and failed.

So, onto my initial question...his psychiatrist has suggested trying ECT “Shock Therapy”. It involves being anesthetized for a few minutes and then a seizure is induced.

I’ve had two days to process this and have to say I am on the fence. I will be talking more to the doctor tomorrow to learn more. Considering anesthesia and shock to a 92 year old seems insane to me but so does the way we are living now. He emits so much rage and hatred, I can’t imagine what it’s like in his head for him. If we are at the end of being able to have any sort of control through behavioral and medical means, is trying ECT too much?

Does anyone have firsthand knowledge of this?

I am feeling great pressure to decide something. The facility he has been living at has determined he can’t live there unless his rage is controlled. They are recommending a locked skilled nursing facility.

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What is being treated here is not the dementia itself, but the symptoms of acting out with violence. If this is a recommended treatment then I would go with the recommendation in the hope it alleviates the syptoms. It seems to me preferable to being drugged into oblivion for the duration. Wishing you good luck going forward. Hope that you will update us; your experience could be invaluable to others.
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I just did a brief search on Google for "ECT treatment in elderly" and saw at least 10 papers from peer-reviwed journals stating strongly that this is an EXCELLENT treatment option, often much more effective than meds! I was quite surprised.

My only experience with ECT is with a good friend whose mild and well controlled depression suddenly spiraled out of control when she was in her early 60s. She was hospitalized and after several meds were trialed and failed, they started her on ECT. Great results! She is still gainfully employed and doing well.

I'd go for it!
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I have a friend that also happens to be a social worker and she agreed to ECT for her mom.

They tried everything and like your dad, nothing worked. Her mom was much younger than your stepdad. She was in her 70’s when she was admitted to a mental hospital for depression. Her mom was once a very happy and involved person in the community. She became lethargic and was like a zombie.

The doctors wanted to do ECT. It was successful for her. Do you want to get a second opinion from another medical professional? That may be helpful.

My friend said the newer methods of ETC are different than they were years ago.

Best wishes to you and your family.
Helpful Answer (10)

I can’t imagine how difficult this must be for all involved. No experience here, only will say my daughter has observed ECT frequently used at the hospital where she works and has seen very good results. I wish you the best
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Is his psychiatrist someone you mom picked out, someone he has been working with for several years? I ask because your mom was so attentive to details as well as experienced in the health field so if she chose this person or even the facility and worked with the doctors there it would give me another layer of comfort about following their suggestion. That’s not to say it isn’t the best or only option at this point anyway but with or without a second opinion her comfort with the provider would likely be a tipping point for me in your shoes. What a wonderful, loving daughter (?) and step child you are for taking this on and caring so much.
Helpful Answer (7)
Purkiss Sep 2020
When I look back on my moms notes and calendar postings, I see so many crossed out appointments, things she wanted to look into. I can only speculate on this now but suspect step-dad would refuse to go to the appointments made, refuse treatments offered, refused her getting respite care. He had no regular physician or psychiatrist. When one said something step-dad didn’t like, he would insist on moving on to another MD.

One of our last conversations, she told me she had been praying to St Jude because she felt hopeless and she was
beginning to feel better, like her prayers were being answered somehow. His behavior wasn’t changing but a weight had been lifted off her shoulders somehow. She died two weeks later from encephalitis caused by the shingles virus. An answer to her prayers???

Mom began her career as a pediatric nurse and ended it working for the County as a victim/witness advocate. If anyone could compel a person to do the right thing, either by sweet-talking or arm-bending, it was her. It breaks my heart knowing some of her last lucid moments where of knowing that dementia was defeating her and it would then become my cross to bear.
I have first hand knowledge of having 79 ECT’s..... There is UNILATERAL ( Electrode on one side of head), and there in BILATERAL ( electrode on both sides of head). BILATERAL will give you brain damage severely and memory loss of short-term. The first time I had Unilateral-Monday, Wednesday and Friday and then Monday again. It was a four series ECT . Those four didn’t and a few weeks later we went to BILATERAL. In 6 years I had 4 UNILATERAL, and 75 BILATERAL ........ I can’t remember the names of things when I try to verbalize them. You know that thing in that room over there and you turn it on and it heats up food and has four circles on top??? It was so bad in beginning. I didn’t know my name or that I had quit smoking 4 months ago and had someone bring me a carton of cigarettes to the hospital, etc. I became a poor judge of character and began to do things that are against my own morals! I forgot that I went to college..... There was a very nice car out front and I asked who that sports car belonged to. It was mine..... My experience is of probably having an illegal, in-humane amount of ECT’s. I should have sued the doctors and the one anesthesiologist that put my anesthesia in the wrong order. There are two syringes that are huge. The first one to go in the IV is the one that puts you to sleep. When they are sure that you are asleep, they administer the one to paralyze the body. This jerk paralyzed me first!!!!! I have PTSD and SEVERE nightmares to this day of them forcing me to have ECT’s being paralyzed first! They won’t go away...... I had the first shock treatment (ECT) in 1994 and my last forever in 1999. In September ( today) I am still having PTSD/NIGHTMARES) . My words come and go but at least now I can verbalize through writing very well.. I still have trouble remembering the words when I try to vocalize. We can sit together and watch a movie. By the time it ends, I don’t know what the beginning of it was. I love to read. I have concentration problems and won’t remember tomorrow what I read today and I find this very depressing and distressing. If I write in a journal, I will always date it and I get amazed that I did this or thought that, etc. I am probably not a good person to answer the question since I don’t know how many treatments they want to do for your Step-Father.
ECT DOES cause BRAIN DAMAGE regardless of the video they make you watch that makes it seem harmless. Also the doctor will probably tell you that there is no danger and that it is now humane. You wake up feeling like you have a headache and a stroke. The longer the seizure the more brain damage.........
Won’t his doctor try some medications that sedate a bit? Seroquel is a good one once your body gets used to it. In the beginning all you want to do is sleep. The doctor has to dose is a little at a time until the patient is feeling fine with that dose. Good luck with your decision . I don’t know if you pray or not but if it was me, in my humble opinion, I would ask about some medications that will calm you down first before I let the doctors pass electricity through a loved ones brain that induces a grand mal seizure and brain damage.

Ms. April Day
Helpful Answer (6)
cetude Sep 2020
1979 and 2020 cannot be compared, and you may be giving advice that can actually harm the person by spreading fear.

Further, if you think medications are safe, think again. Medications--especially in combinations--can be VERY dangerous for the elderly, including severe side effects, heart damage, and falls.
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Sadly electroconvulsive therapy (ECT) has bad stigma due to the movie "One Flew Over The Cookoo's Nest" and how it was done in the old days. These days ECT is very humanely done, and a person does not even feel anything. They do not jerk around with seizures. Further, ECT is a LOT safer than medications, and often VERY effective. Medications can have terrible side effects and can also prolong what is known as the QT interval which can cause death--medications are a lot more dangerous than electroconvulsive therapy, especially for the elderly. ECT should not be the last resort. Another bad side effect of medications is falling due to impairing coordination. Psychotropic drugs are much more dangerous. With ECT these drugs are sometimes entirely eliminated or much reduced...but most benefit enormously.
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I also vote to try ECT. You have very little to lose by trying it: neither you, your poor wildly acting-out step-dad, the MC facility nor its residents and staff can continue on like this. Something’s got to give. I have heard my family members (a physician and an R.N. registered nurse) speak highly of some surprisingly good results from ECT. It has come a long way over the years, as has your step-dad. Try it, we’ll be pulling for you all.
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I sort of have mixed feelings about the process that said I can not imagine how it must be for him, the caregivers, the family to witness these outbursts. Not to mention the possibility of injury to him and or bystanders.
I think at this point you have nothing to loose by trying the treatment.
If all other therapies have been tried and have failed this might be your last best option.
I hope it goes well. Please keep us posted
And I am sorry about your mom...
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I volunteer for a lady that gets this treatment and it is the saddest situation I have ever experienced.

She is a nervous, scared wreck for about 4 to 6 weeks leading up to the "treatment" and then she is a shell for 4 to 6 weeks from the trauma of it all.

She does it because her son won't have anything to do with her otherwise. She get about 2 weeks of halfway decent quality of life between treatments.

I don't think I would put anyone through this. Especially someone that is already suffering from a brain deteriorating disease, but that is just me. I think that the end result could be tragic.
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