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He has the habit of tearing his pamper injury his right hand (half stroke left hand and leg not functionable) which he will scratch against the chair or bedside until the blood comes out, end up we have to tied up his hand at all time if we don't tie up, trouble will surfaced, he also like to call peoples name repeatedly for no reason and irritated you, he can't move much, he is on the wheelchair and sofa chair laying down most of the time, most of the time at night he will not sleep and start making shouting banging on the bedside to get respond, all this is to attract attention which we ignored most of the time. How to handle him please advise us.

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sometimes the child becomes the parent. My mom sometimes acts like a 5 year old to get her way. I tell her we arent playing this game.
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Get a clock that says AM and PM. My dad was getting up at 1am thinking it was afternoon. Getting him a clock that states am pm made a big difference.

Your dad may have tingling in the stroke leg. Keep his nails trimmed, maybe even clear polish to thicken them into less lethal tools.

The SSRI antidepressants due increase sleep. That might help your father. I worry that the TV in his room might make getting him to sleep impossible. If you do that, get wireless speakers. You don't say how old he is, if his time is short, TV might help. There are settings on the TV that can turn off the speakers, but the headphones will stay on. Or a radio with earphones, that way he might fall asleep while listening.

My dad thinks his poop is not a bad thing, leading to all kinds of trouble. Maybe you can schedule a same time every night to change his diaper. I have offered this before, because it helps, I continue what my mom did by using a removable pad inside a diaper. It is so much easier to just change the pad if the diaper is ok.

Good luck, it sounds horrible. Also, there is no failure on your part if you need to get him into a skilled care facility to get him adequate care. Talk with his doctor about all of this.
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Ours takes Sertraline 25 mgs, except for the night she came out the hospital, from the breathing treatments, we do not have sun-downing yet, she loves to sleep. That night she was looking for a handbag and glasses that do not exist anymore...if everyday that would be intolerable, does he have a light on? I found with my stroke also on the left side, that I need a TV on, at night to comfort me...
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I take care of a 91 yr old and her behavior really would go bad at night but the Dr put her on a antidepressants. So she could sleepand it works great.
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If you cannot place him, then you have to remember that this is not the adult you have known. You must use the tactics you would use with a youngster. One of the hardest parts of caregiving is trying to reconcile the fact that your "grown-up" doesn't act like one. My heart goes out to you AND bookluvr, above as you are in the midst of the battle between dignity and truly good health for you and the one you are caregiving for. Do not be afraid to do as you would with a toddler, make rules, make punishments, refuse to engage with bad behavior. But know that things like sundowning and UTI's can create hard situations that may require hospitalization, medication or placement. My best wishes to you.
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If you don't want to try placing him but insist on keeping him home, it sounds like he's sundowning. That's the "not sleeping and too active" at nights. My mom would sundown in the late afternoon, and walk for hours - back and forth. Nights, she would sneak out and then we spent hours looking for her.

My father had a minor stroke 2 years ago. He's getting confuse. He sometimes forget that mom passed away last year. Now, he cannot tell if it's day or night. Lately, he's been waking up at 5am, counting 9-20, over and over and over. Then yelling for me to get up and feed him dinner because it's 5:00. (AM not PM!!!) I tell him it's morning and go to sleep, and he's not listening. He wants his dinner now. I Think he's beginning to sundown. Or maybe he has UTI. I'm keeping track of his new behaviors.

As for your FIL's hands, not much you can do. My father touches inside his pampers at nights. He absolutely denies that that was him touching his pampers and smearing his poop all over. Someone did it. I cannot tie his hands. If I did, he would hit me when I untie it. So, I just clean the messes while he insists it's dirt.

I have read here that there are medication that can help with sundowning. If you do a search on the top right, maybe try using words "sundowning" , you can find the articles where people discussed the pros and cons of the different meds for sundowning or violent behaviors.
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Have you thought about placing him? I hope that doesn't sound harsh but if he is not sleeping and keeping everyone up it may be the best thing for your family. I know for myself I can handle alot but I need my sleep to function. Best wishes.
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