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I had to place a relative into a care facility this past summer. Dementia symptoms were well under way at the time of placement. The facility was kind enough to let him keep his chewing tobacco as long as he was clean with it. A hospice recommendation came quickly due to no appetite. Fast forward to now. For awhile he appeared to turn a corner and began eating, but the dementia symptoms worsened quickly. Hospice has tried several medications to control agitation. Now, he has been spitting on residents so we forced to take his tobacco. He is wearing a nicotine patch, but the behaviors are getting worse. Due to COVID I can’t do face to face visits to see what’s really going on, so I feel like I am making decisions in the dark which is frustrating. I understand the need to keep a patient calm for the protection of everyone in the facility. However I am very concerned about the number of med changes in a short period of time. He is still on hospice. Is it normal to increase meds four times in a two week period? How can we keep him calm without drugging him to the point where he is barely awake? I am open to suggestions.

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You can't and they won't because it's so much easier on all the Caregivers to keep the patients drugged.

Sad but True, especially with Patients with Dementia.

They need more care even when they're eating, to remind them to take a bite, chew and swallow.

Senforcement Homes don't have the staff to spend 30-45 minutes with one patient while they eat.

My 96 yr old Dad has Dementia as if a year ago and he can only eat soft and mushy type food like mash potatoes, yogurt, oatmeal, applesauce, soup, soft brownies with no nuts, still loved pancakes and waffles with maple syrup, sift doughnuts and he loves milk which is good protein.

He can still eat hard boiled eggs cut up.

He will drink chocolate Ensure too.

Thing is, Senior Homes will not cater to eaters. They'll just put food in front of them and if they don't eat, they'll just day they're not eating.

Please don't let them talk you in to putting a feeding tube!

My 96 yr old Dad likes to eat something every 3 hrs like a baby.

He has no problems eating if you feed him what he can eat and things he likes.

Even with the so called junk food like the brownies, I find the ones with the most protein.

Sone people stop eating be because they are sad, bored, feel unloved, ect. Some because, they have actually forgotten and sometimes even think if they swallow they will choke.

Meds can also interfere with being hungry or not.

My Dad us living in his own home with 24 7 Caregivers.

Besides visiting, I have cameras set up in the house so I can keep watch anytime as to what really goes on and be able to make decisions even when I'm not there.

Whatever you do, if he has to stay where he is, please have a camera mounted in his room so you really know what is going on.

I don't allow my Dad to be on meds except if he gets a urinary infection, ect.

Every one wants to give meds and they tell you all kinds if reasons but most is just to keep the patient passive, almost like a vegetable.

And the poor patient can't even let you know what's going on because even if they're not all doped up, they can't remember.

My Dad can't remember what happened after 5 minutes or so but I can always back up the camera and hear and see what really happens.

Prayers

Old people lose their taste and start craving sweets.
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MJ1929 Dec 2020
You're making sweeping generalizations about nursing homes which simply aren't true. Anecdotal evidence is not the same thing as fact.

Also, most nursing homes won't allow you to put a camera in a resident's room because of privacy concerns.
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If you have concerns that are not being adquately answered, I suggest calling the director of nursing or the social worker. You deserve to have these questions answered. The DON will talk with you.
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Please consider having him seen by a psychiatrist. Psychotrophic medications take awhile to make a difference and need to be overseen by a psychiatrist - a doctor well aware of their actions, interactions with other medications, and side effects (and there are many side effects). Staff in a facility are not as educated in this as a physician.
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I’m sorry your relative is in this terrible situation. I think you have to trust that the people you are dealing with have a difficult job and are trying to carefully manage his medication to bring him relief from his symptoms. Speak with them and ask for assurances that this is an accepted protocol. Hopefully the meds will settle him soon. I know this is hard. We make decisions that lead us along a path in life that is unique to the individual but common to all in that we all travel a path from birth to death And there will be difficult times along the way. You are doing the best you can. The best you know to do. I hope you get good news soon and can rest well knowing you tried to help him in his last days.
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Yes, they did start meds low and are increasing upward. I was just wondering what a normal of time to see if the meds will work at that level is? The facility does not have the program you speak of. The ability to enter the building changes with the COVID count. I was able to visit right before Thanksgiving but they shut down right after and the COVID count keeps climbing. He was checked for a UTI.
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FrazzledT
Ask your dads facility if they have the essential caregiver program. Some places are allowing one person to visit. That person must test negative for Covid prior to the beginning of visitation and retest every two weeks. They must go only into the patients room and wear the proper protective gear.
I am sorry he is going through so much. Sorry for him and you. I wonder if they started the meds at a low dosage so as to keep from overdosing him and are raising it in an effort to find the right strength for him? Ask them about this. I also wonder if he has been tested for a UTI? UTIs can really accelerate dementia behavior. Left untreated they can be toxic. Please ask them to test him.
I know it’s a heavy responsibility. I hope he can get relief from his distress soon.
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