dementia and re inforcement

Edinburghlass_2

Are there no nurses attached to the Dr's surgery? Can't remember what you call them but you know what I mean, the ones that come out to homes?

its Saturday and my brain not in gear yet

aurora_borealis_2

community nurses. There may be a rapid response team on at the weekend.

aurora_borealis_2

UTIs and chest infections exacerbate confusion.
The doc prob checked that though.

Kelinik

The one that came when I was there Thursday said everything was fine, oddly it was almost like someone flicked a switch as she walked in, he suddenly knew who I was and the date and everything, answered all her questions with what I can only describe as an air of defiance!! Is that like a self-preservation thing kicking in or something, as he was then OK for the rest of that afternoon?

Anyway I don't know what happened with the doc that visited in the night last night as I wasn't there but one would hope they'd think to check stuff like that! Latest update is that he is pretty calm now so they are saving the temazepam for night in the hope of a better night and preparing to sit it out until first thing Monday morning when we can get hold of everyone and throw some weight around. I've said if he flares something awful again to go to the hospital but it didn't go down well with nan so we shall see.

Thank you so much for your time, I was just stood there this morning like a deer in headlights thinking 'who can I ask?'

Primrose

Having had some experience with a parent with dimentia, I do know that sometimes the situation can deteriorate suddenly and alarmingly into violence, especially if the patient suddenly finds themself in a situation when they find themselves out of of their comfort zone for some unexpected reason. To the rest of us it may not seem an incident worth bothering about but to the patient, it is as if a light has been switched off suddenly and they find themselves in an alien world. The only temporary solution I can suggest is for those around your granddad to try talking to him quietly and gently to try and "take him back in memories to a world he can still remember which he can relate to. But if the violence continues, there is a possibility that yur granddad could be sectioned, either to prevent himself from harm, or to prevent him from harming others. I once found myself in a terrifying situation when my parent with dimentia tried to attack me with a breadknife in a sudden fit of rage because I tried to get him to remove some very dirty trousers for the laundry and put on a clean pair. An hour later, he had no memory at all of the incident and I was still a quivering wreck in a state of shock. This sudden descent into violence or aggression is one of the worst aspects of dimentia and if your grandmother is in fear of physical harm, it might be worth seeing if their GP can have your grandad moved to hospital for temporary psychiatric assessment. I don't know whether Community Psychiatric Nurses are available on emergency call but certainly your grandmother must get your grandad assessed as quickly as possible. It may be that some of the medications for dementia like Aricept would help stabilise your granddad's condition temporarily, but do be prepared for the situation to go downhill. In the meantime, try and get everybody not to argue with your granddad and get him stressed as this is often one of the things that can trigger another attack of agression. It will feel like walking on eggshells but don't let the system ignore you. You may all collectively have to shout very loud and aggressively for the help and support that is now clearly needed.

EdInvestor

Primrose wrote: »

But if the violence continues, there is a possibility that yur granddad could be sectioned, either to prevent himself from harm, or to prevent him from harming others. ... This sudden descent into violence or aggression is one of the worst aspects of dimentia and if your grandmother is in fear of physical harm, it might be worth seeing if their GP can have your grandad moved to hospital for temporary psychiatric assessment.

Absolutely.Way to go, for many reasons.It's obvious there has been a dramatic change as now it seems his carer is requiring care.

Kelinik

I see what you're both saying but as yet we have seen no actual violence, with his limited mobility I think the risk is minimal anyway but yes my Nan is afraid to be alone with him because of the constant verbal attacks and his behaviour in general so I feel he needs to be somewhere other than at home right now.

As a side note he is also insisting on a complete change of clothes several times a day (and night) because he is 'sopping wet' although all his clothes (underwear included) are bone dry. Anyone else dealt with that one?

Savvy_Sue

Can't help with that Kelinik, and hope you get some support for your nan very soon, I guess she may not yet be ready to accept how much help she needs, but maybe if you point out to her that without the help she may not be in any position to do anything for your grandad that will help, don't know.

Anyway, thanks for the links to those interesting articles: we've just seen rather more of my father in law than usual, and it is clear that there's a real problem there, which the GP is fobbing off as 'just' his diabetes. I do not know how mil copes: he could not remember what arrangements had been made, how long we were staying, or even that he'd offered to take the older two boys to the station for the journey home - he is still driving apparently competently! Hard to know how to 'remind' him of these things without appearing to contradict him when he was adamant that no-one had told him anything.

Errata

Kelink, your local Mental Health Trust will have a rapid response team which assesses older people. The GP should be able to request your FIL has an immediate emergency assessment. HTH

Savvy - if your FIL memory is getting a bit vague what does your MIL think about his driving? I had to confiscate my stepdad's car keys to stop him driving as he thought he was competent - the dents, scratches and garage doors told a very different story. He said other drivers must have bumped ito him.

Toay's Guardian has more on the Oliver James book -
http://www.guardian.co.uk/lifeandstyle/2008/aug/02/oliver.james.dementia

Savvy_Sue

Errata wrote: »

Savvy - if your FIL memory is getting a bit vague what does your MIL think about his driving? I had to confiscate my stepdad's car keys to stop him driving as he thought he was competent - the dents, scratches and garage doors told a very different story. He said other drivers must have bumped ito him.

Fortunately his driving appears to be fine, and his ability to get to places. However he gets very ratty about things: refused to wear a seat belt when DH drove him to the end of the road, and did not like it when both I and MIL asked if he was planning to put it on when he was driving us. It doesn't help that he doesn't always hear what is said.

I wouldn't like to be the one to tell him he had to give up driving. Although as he used to drive for a living that may be something he can continue to do, because he's in the past, if that makes sense. As long as he doesn't suddenly think the blue light is flashing on top ...