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She has no paralysis. She is getting increasingly more violent, trying to bite my Dad, me, nurses. Twists Dad's fingers until they bruise, slapping me. Very agitated - balling up sheets, ripping off her clothes. She is on hospice and they have started Ativan .5 mg twice a day, but SNF is reluctant to give it. This is so hard on my Dad (95 y.o.), he is still very alert, active, drives, etc. I would like to know if this is common with stroke patients and any suggestions? Thanks!

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Would it be possible she has a UTI? I remember reading here that a UTI in an elderly person can cause all types of different and strange behavior, even violence.
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babalou means ATIVAN, I think auto spell got her again.
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My dad was in a facility when he went on hospice and the instructions were that he was to have Ativan PRN. And like what you've experienced, the nursing home was reluctant to give it at all. I tried to handle it myself with no success. I finally told hospice and they amended the orders to Ativan every 2 hours. No "as needed" attached. They bypassed the nursing home and had their own Dr. rewrite the orders.
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Diane; The SNF is reluctant to give the Ativan? Was the order written PRN? If so, get the doc to change it to scheduled, as in, they give it to her. Call the Hospice doc right away and report what is happening.
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Sorry to have used jargon! But the doc needs to know that her behavior is deteriorating. Something stronger may be needed. Hospice is supposed to be about comfort care and she doesn't sound comfortable. so make sure the Hospice folks know what is going on.
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There is more than just Ativan I hope. She needs something for delirium. This is beyond the SNF capabilities. Move her to a Hospice Facility.
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PRN is for pro re nata, which means as needed. Just looked it up.
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Oy, thanks Pam. I should not email at red lights. Consult with a geriatric psychiatrist if you can!
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Any change in mental status like this should be reported to the doctor. Is she on Hospice because she's terminal from something other than the stroke and/or Alzheimer's?
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What is PRN? The most recent order was to give it to her routinely, twice a day. It was explained to me that California is very strict about giving drugs like Ativan and that with input from family - in essence requesting the drug - they would then give it to her? She is not terminal from anything else. She refuses to eat and will only take sips of water & Ensure. She is slowly dying.
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