“No, no! Oh God, no! Daddy, help!” As Mrs. James continued to yell, a nurse hurried to try to calm her but stopping as Mrs. James began swinging. She was fighting off the Germans again, as she relived being imprisoned by them during World War II. The prison was bombed by the allies the same night she was imprisoned and she was able to escape. Her’s was a fascinating and terrifying story of courage when she was lucid and could tell it. Knowing her story made it all the more heartbreaking to watch each time she slipped into the past, reliving the nightmares of her youth, fighting for her life, again, in an endless loop. It was happening more often as were her attacks on the staff and she had already hurt two employees and come close to hurting another resident.
Alzheimer’s and dementia are two of the most emotionally devastating diagnosis’s that your parent’s can receive. Not only do they loose their health, they loose themselves and their life. In some instances, their entire personality may change, not always for the better. The world becomes a confusing place, hard to understand and function in.
Your feelings of helplessness and frustration can be overwhelming as you become a stranger to a person who has changed so much you no longer feel as connected to them. The ugly truth is, you may have already lost your parent except in body. Sure, they still look like mom or dad, but the essence of who they are is hidden, occasionally peaking out to say hello, but that is happening less and less. It is usually heartbreaking. (I had one instance where the daughter told me her dad had always been mean and he was now a pleasure to be around).
Some however, become angry or violent. They can longer express their needs appropriately, their behavior may seem bizarre at times. They wander around, turning on the stove and walking off, “escaping” the house, yelling for no apparent reason, hiding things, the list goes on. People with Alzheimer’s and dementia’s can become violent, attacking their caregiver’s. Is it any wonder that exhausted families turn to nursing homes?
There is another truth you must also face: if your parent’s behavior becomes too much of a risk to themselves, caregiver’s, other resident’s or the facility there is a good chance they will refuse to accept caring for your parent. Many Alzheimer’s patients end up in psychiatric hospitals for this reason. Even nursing homes with lockdown wards are limited in what they can handle. (There was a sad incident locally when a resident with Alzheimer’s picked up a piece of furniture and beat his roommate to death before anyone could stop him).
What about medications? Dr. Daniel Carlat is a psychiatrist who points out that in large placebo-controlled trials, antipsychotic medications are the most effective treatment for the agitation that often goes with dementia. He also makes another point: there is not a single medication that is FDA-approved for the treatment of dementia.
Those same antipsychotic medication’s contain a black box warning about use with the elderly. There are more studies being done but it is very controversial.
In tomorrow’s blog we will look at two viewpoints and I’ll give you a few things to think about before making a decision.