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My Gram has been living with me for just over a month. She was in assisted living, but kept being sent to psych for med evaluation (for combativeness). After the last trip we brought her to live with me and we were successful at weaning her off some of the medication that had her so sedated.

She did well for the first couple of weeks, but then started getting combative with me. Now our biggest challenge is trying to get her to use the toilet and to take a shower. She starts punching, biting, kicking, slapping, etc. I don't know what choice I have, but to get her to the toilet. I can't let her urinate all over the house.

I've tried everything I can think of to get her to cooperate with me, but I'm afraid I've become just the caregiver to her and she resents me now. She acts very normal when others are around. But when it is her and I (and even the home health aide) she is very combative when we try to do bathroom functions.

At this point we are giving her Ativan to sedate her to make her easier to deal with. Has anyone else dealt with this problem with any success? I physically can't take care of her when she is so sedated, but I also don't know how much more I can take emotionally. It's exhausting.

Any help is greatly apreciated!

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Ativan is a good drug. They don't like to use too much of it, but in a case such as your grandmother, there really isn't much choice but to sedate her to some degree. Don't feel guilty. Just work closely with the doctor. They should be able to find something that can make her less anxious. It's anxiety and fear that make her act out, so remember that the medication isn't just to make her easier to handle but to help her feel less anxious.
Take care,
Carol
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put her back on the stronger meds . ask the dr about it .
its way to dangerouse she could hurt you realy bad , i know a caregiver eneded up with a broken knee . kicked right into the knee cap . grandma isnt the same lady any more .
i told my kids if i get mean , kick , bites , please i am already too far gone . just keep me drugged up plz ,,
i am so sorry that you have to go thru it . it ll get worst if she doesnt get treated for it . sometimes all the strong meds out there doesnt work at all !
please talk to the dr about it . xoxo
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Hi deanbean, 1st the quilt; seems all us CG have some about some aspect of care. No matter what, we won't get everything as "right" as we hope for. Do the best you can n try to "forgive" ur self, n keep trying. More important than the individual tasks or details is that she is in a home setting w her GrD who luvs her and whom she knows is family. Obviously you r trying hard to give her great care! 2nd: just a month of having GMa w u is still the early part of a HUGE period of adjustment. As u go along, u'll figure things out, n get a rhythm going-promise! It doesn't get "easier" but better, more familiar ( but be prepared, as u "catch up / figure out, things change n u have something else to "solve", n so it goes). 3rd:
Her appetite-it takes a ton of calories to kick, hit n bite, many less to "chill". I think Sr's. Need fewer calories than we often think. Think child portions. That said, I'd feel concern too re the weight loss. If after a few weeks of time to adjust to regular use of Ativan, and weight loss continues, see her doc, ask for blood work, n maybe a nutritionist consult. You might also consider things to bump up calories n nutrients. In addition to the boost type products, try soups (homemade if you can manage it), smoothies w yogurt n fresh or frozen fruits n throw in a few extras-half a carrot or handful of baby spinach leaves, a tiny bit of broccoli or cabbage. A small bit of veggie is barely detectable. If that doesn't fit, just bump up the calories other ways that she will eat, ice cream, egg custard, milk shakes, fruit cobblers, puddings. Dementia is terrifying to the patient (n family!). Changes in environment are very hard. Pat ur self on the back for caring for ur GMa, and for doing so much right. Give it all a little time. If u can stay relaxed, it will make managing her a little easier. I can't stress enough what a great resource teepa
snow has been for me in caring for my mom. Not supposed to share links here,
but look her up. She has a resource tab on her site that takes u to her u tube
clips so u can see some free stuff to see if u think it would be helpful. DVDs are
very cheap for the quality of training. Alz foundation has info on her speaking
engagements / live trainings. Also a big help to me has been to try to "enter her
Dementia world" ( how awful must it feel) as she can't be expected to reason or
remember or be in our "rational" world. Loving reassurances go far to make it
easier for both of you. There is more about thi under "alz world" in a site called alz reading room, a blog n info site from Florida, San Marco, I think. Hang in
there the best u can, learn all u can, n get some help for at least some time ea
week so u can have the truly NECESSARY break from 24 / 7 CG. If u dont get what u need for u, u cant keep helping her- u 'll just get crispy. Area Agency on
Aging can help u locate "respite resources" nearby. One other thought: my mom
(likely Lewy Body Dementia) is more difficult if she is bored. She can't tell me
this, but over time, I've learned she does better w more "chores" n activities. Hats off to you for caring for your grandmother, she is lucky to have you! Don't forget to breathe!!, n keep coming back to the AGING CARE SITE, lots of help, support n understanding here. Have a look at the alz dementia articles, n the various Care Giver threads. Local support groups are a plus too, see if you can find one that works w your schedule. kimbee
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Sedation = less movement = less appetite. The attack behavior is not necessarily permanent. What was the situation in assisted living? Did they use diapers? She needs time to adjust to your home environment, even if it's an improvement, because it's still a change.
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Look at teepa snow on bathing. She has some good ideas. My mom is a bit difficult to get in the shower. I don't announce the shower. Just get everything ready in advance: bathroom warm, clean clothes ready. Then I use loving lies to move towards the shower. Once there, I have her sit on a chair n distract w some other reason, lately looking at the beautifully colored maple out the bathroom window. I get the water going, and say, oh this nice warm water is wasting, let's hop on in there, I'll help you. And I do. Once in shower announce each thing : noe I'm going to get your hair wet, so we can wash it, etc. We have a bench she can sit on, n I give her a small towel to hold or cover herself with. If nothing else, she is trying to do something w the towel other than stop the process. I also do + reinforcements along the way n after, including back rub, lotion, etc.
Remember, behavior is a communication-what might she be trying to express? Modesty, fear, anxiety, something else? you could have an OT come in to do some teaching, too. Combativeness can be dangerous, get some help w this? Kimbee
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Thank you all for your advice. We have continued to give the Ativan each day and each day she is more out of tune with the world. However, it has made my life easier. And for that I feel guilty!

I am finally able to get a good night's rest, but I have this overwhelming feeling that I'm "drugging her up" just to make my life easier. But in the back of my mind, I know that she is much more comfortable and relaxed when she is on the Ativan.

One of my main concerns for her is that she doesn't eat much while on the Ativan. She's gone from eating three full meals a day to just eating a small cup of fruit or veggies several times a day.

I'm going to start giving her Boost or Ensure tomorrow to suppliment.

When she went into the psych ward she weighed 126 lbs. When she got out she weighed 108 lbs. I was able to "fatten" her back up to 115 lbs when she was off the Ativan. I'm just worried that she will waste away now that she has no appetite.

Any suggestions?
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