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Dad, 95 with Dementia is in AL Memory Care. 3 months now and he's been a pleasure they tell me. Until recently. He also has 70 to 90% blockage of the right carotid artery. Anyway, he walks around the facility constantly. No problems until recently. He screams at other patients who also walk. Lately he's put his fist up to another man's face. To me that is totally unacceptable. First time I saw him raise his voice, I told him that was being rude and we are not rude people! Now the AL is testing him for a UTI. They tell me that it's very common and will lead to aggression. I'm not sure if it's that or progression of Dementia. I am not against a mild tranquilizer if needed. Of course I'm hoping it's a UTI. His unit is small, only about 20 people and only he and 3 others walk unassisted. Anyone else encountered this with their loved one? Am I wrong to suggest medication?

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I'm not familiar with that kind of blockage, but just the fact he is in memory care, would indicate to me that he has significant dementia.

I would imagine that his anxiety must be making him quite miserable. I would certainly discuss medication to help him. Not a sedative, but something to help with his mood. I'm not familiar with tranquilizers. I would be afraid they would create a fall risk and that's not good with a 95 year-old. There are meds that work differently in that they treat depression and/or anxiety without making them sleepy or dizzy.

My cousin is so much better since she went on Cymbalta. She is calm and content, without drowsiness. I would discuss the options with his doctor, if it turns out that it isn't an UTI. I'm sure others here have their experiences with this type of thing as well.
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Thank you Sunny for your input. The only meds I've heard of are tranquilizers. You're so right about the fall problem. I was going to suggest that they make him walk with his walker. When he came from rehab, it was insisted that he have a walker. Never been used. I was thinking that if they made him use his walker, his hands would be on the walker and probably wouldn't raise them to anyone. But then I guess he could throw the walker!
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Being aggressive is a common step on the journey of dementia. If your dad is in a memory care/dementia unit then it is likely that he will not remember that "we are not rude people". As people understand their world less and less, they can misinterpret what is happening more and more. The aggression may be due to having less of a filter than in the past and or it may come from not understanding what is going on around him and being frustrated/scared/etc. of it. An anti-anxiety medication may help. Nursing homes are not allowed to use medication to make it easier for them to care for residents so their use needs to be for sound medical reasons. An UTI can significantly change how a person with dementia thinks and acts and that change can happen overnight.
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I'd be concerned about the carotid blockage. That was the cause of my husband's debilitating stroke. Our doctor explained that when blood can't get through the artery, clots form in the blockage. When a piece of the clot breaks off, it enters the brain and causes a stroke. We found out too late, and the consequences were devastating. Best wishes.
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The AL is doing the right thing by first checking for a UTI. The next step is to have him evaluated for medication. My Mom's AL has a contract with an outside agency that does an eval and suggests what might be appropriate. My mom and many elderly patients are receiving Trazodone, and it has helped her. It doesn't sedate. He may have to go through a period of time to find the correct dosage for him. I don't suggest making him use his walker if he doesn't really need it. That may make for more confrontation and increase the behaviors. My mom could be quite lethal with her walker at times, threatening people with it, or threatening to throw it through a window! Wishing you luck.
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The treatment to clear his clogged artery sounds risky. I read about it, but it has its own set of risk and it seems there is a risk of stroke just to have the procedure. I assume you have considered all of that.

Regarding his use of the walker.....if he's not inclined to use it, then I'm not sure how successful the facility will be to convince him to use one. Short of constantly following him around and insisting, I'm not sure how that is done. I would be more inclined to consider some medication that would help him with anxiety. And not the kind that drugs you up, but some that makes you feel more content. Meds like Ativan, that are supposed to be for anxiety, never worked for my cousin. She was still anxious and nervous, plus she kept falling down.

I would also discuss your dad's agitation with the memory care staff. See if they can seat him in the dining room in a place that he's not as likely to become agitated. See if they can bath him at times that he is not as upset. They know him by now and should be able to help in avoiding some difficult situations in the meantime. Maybe, if the doctor can prescribe a med for him he will return to his peaceful self.
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Thank you everyone for your input. I am leaving it to his AL facility to do what is best for him. As for the clogged artery, all doctors, heart, vascular etc decided that the best coursecof action for him is Plavix. It's too risky to do anything invasive. His minor stroke in May was caused by a piece of the blockage breaking loose. Thankfully there was no lasting damage from the stroke. I think it worsened the dementia. You know, this site is my go to therapy group! Thanks again everyone and Gol bless you all as you go on your own journies.
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The AL facility is on the ball that they checked a UTI, since both UTIs and other infections (even pneumonia)can cause increased confusion. My father has Alzheimers and we've been taking him to a geriatric psychiatrist to give him meds to calm h is agitation. What's been working for him is an antiseizure medicine called depakote..Definitely worth exploring meds but you need a geriatric psychiatrist because regular psych drugs do not usually help with Alzheimer's patients.. Good luck!
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You are absolutely correct and if it is a UTI and the behavior diminishes with therelief from the pain, that's great. But as you can read in my book, my husband's aggression did not diminish. We had to send him to a senior psychiatric hospital for 10-14 days where they removed all medication and placed him on behavioral meds so he could go to the AL and be less aggressive.
As his Parkinson's and Alzheimer's progressd, he became more mellow. But since he was small in stature, no one was afraid of him. I was always concerned that another ambulatory patient whose room he entered or whose bed he crawled into, would retaliate and hurt him, but that didn't happen either.
It does not pay to reprimand a prson with dementia. They do not remember their outbursts and they think you are nuts to accuse them of bad behavior.
We always have to remember it's not about us. We are not to feel shame or embarrassment due to the Azheimer patient's behavior. They have lost their reasoning skills and their judgment. Everyone understands this and will not judge you by your Dad's behavior.Don't judge him, just love him and distract him whenever possible. Activities help the time go by faster.
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The Memory Care is doing the right thing in checking for UTI. But i would check further and see if he is having pain any place else. He may be having a discomfort and cannot communicate what is bothering him and his nasty behavior is a way of saying something is bothering him.
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Yes. My Mom went thru what seemed like personality changes in her journey. Sometimes it was a UTI and sometimes it was just the progression of her disease. Moms nursing home had a contract with an outside geriatric psychiatric facility that made visits and tweaked meds. Moms NH did not want the residents over medicated due to fall risks etc. It wasnt always a quick fix because sometimes meds they tried had an opposite effect. As stated above reasoning or arguing with a Dementia patient will probably just frustrate you more.
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It sounds like a UTI. My mother was plagued with them for over a year until I found a very good urologist who is doing an antibiotic bladder wash weekly. This has stopped the infections, but now my mother is exhibiting symptoms of delusions. She is violent during these episodes, but ordinarily she is pretty normal with no AL, but mild cognitive dementia from multiple small strokes. I hope your dad just has a UTI, it's easier to cure.
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Just a small note: If your Dad is put on trazodone at any time, it definitely can have sleepy side effects. It's often prescribed and given at bedtime for that very reason. I've been on it myself for sleep problems and can attest to how it made me very sleepy. Best wishes for you and your Dad.
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Thanks everyone. Tomorrow I will go to see him and see what they have found.
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Again, haven't read all posts but the artery could be causing a problem. Not enough oxygen to the brain. UTI is very serious in men so glad they r checking. Aggressiveness does happen with Alzheimers patients. Talk to his doctor and see if he can give him something.
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This is a great forum for us, both families & caregivers. Sometimes our advise may seem harsh, but it's not meant to be that way. Remember, nothing is to small to ask about, and BY ALL MEANS, don't think anything is stupid or your fault. We all been or will be where you are. Stay strong...God bless through your journey.
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OH MY! GET HIM TO A DOCTOR STAT! HE IS LIKELY TO HAVE AN ISCHEMIC STROKE! THIS IS EXACTLY HOW MY MOTHER WENT OUT. I'M USING ALL CAPS BC THIS IS CRITICAL!
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hi there, it was unclear to me if your dad is AL or Al memory care... in either case, lets hope its the UTI. If not, I would really sit down with the community and reevaluate the memory care he is receiving. Unfortunately, the aggressive behavior does come with territory. As mortifying as it is for us the children, it does happen. As for the community - they should be able to modify his behaviors. The walking around my very well be the culprit. You mentioned it being a small area. Again, these are the parameters that the community should be well aware of. Ask what a day entails for your dad. He needs to be engaged (appropriate with what he enjoys and possibly recalls) Again, caregivers at the community should know the residents. I'm not a fan of the meds just yet...I have a feeling they are not tailoring things to his needs. Outbursts happen but structure, continuity and interactions help a great deal. Keep in touch. Best Regards, Kat
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I am sure you have had many good suggestions, thoughts. my father also would get nasty but this was before we placed him into NH. they do have medicines that will help to calm him but they might find that he needs to use walker or eventually wheelchair. when being calmed with medications it could cause them to become a little drousy. And your father at 95 with dementia will not remember doing any of these things (unfortunately) and the NH where he is at should be handling the situation, not you. good luck.
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Had a meeting with the Memory Care director this morning. Dad does not have. UTI and they feel that redirecting his behavior will help. If it doesn't help they will talk to the doctor about a mood elevating medication. They are a facility that tries not to medicate unless absolutely necessary. They feel that he's fine. The biggest problem is that he won't keep Depends on. They make sure he's dressed in the morning, but he will go back to his room and undress to nap. He tells them he never wore underwear! Of course he did! They've raised his fee because they have to clean his room more often due to him urinating on the floor by the toilet. He doesn't realize that he's not finished and leaves a puddle on the floor, then proceeds to walk in it. They are not bothered by this and told me today to let them do the worrying and cleaning. As for the nastiness, he hasn't yet attempted to touch someone, he yells at them to get out of his way. Again, they will take care of this. The carotid artery blockage is there. He isn't a candidate to repair it due to his age. It's basically a time bomb. My mind was eased this morning. He's not as bad as I thought he was. Thanks everyone for your input. This site has been a blessing for me.
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It's nice they don't mind charging you a greater fee to clean up behind your dad. Is that legal? Sounds odd to me.

I would keep in mind that him acting out is an indication of his state of mind. Just because he's not hurting anyone doesn't mean he is okay. That agitation is stressful on the patient. What point is there to allowing him to be stressed out and agitated? He's your dad, but I would really read a lot about dementia and really watch your father.

The staff at the facility should understand the difference between medications and how some are not tranquilizers. Plus, they are not doctors. I hope he works out for you all.
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Most Memory Care facilities operate on the Assisted Living model, where there is a menu of care levels. As you need more assistance, the price of your " package" goes up.

Make sure he's seen by a geriatric psychiatrist who can advise about meds. You are not doing meds for convenience, you're doing them because your father is in psychic pain.
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When a friend for whom I have DPOA became uncooperative in her memory care floor and resisted the staff's care (due to her incontinence), I was told to take her to a geriatiric-psych ward at a nearby hospital to find an anti-psychotic medication that would help her. Those are tricky meds to deal with an must be used carefully. It took 3 1/2 weeks there to find the right meds, the right dosage and the times of day to administer them. She was not dopey from them, could function more normally with them, could walk, etc. and allowed the staff to clean her up and see to her needs. Her health insurance covered those costs. Her downward spiral from frontal temporal dementia was nearing the end, though, and she only lived another 3 months before her brain would not allow her to swallow food anymore. Hospice saw to her needs at the end and monitored everything to keep her comfortable.
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Thank you Babalu. Psychic pain. That's what I was trying to describe. I would have a doctor (preferably a geriatric psychiatrist) evaluate him so that it could be addressed.
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no one is in a good mood when they have a uti so how can a person who cannot understand why he is uncomfortable be. maybe the walking is a way of handling this sitting maybe uncomfortable. what is great is how you are there for him. your family shows concern and love which is half the solution,
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Checking for a UTI is very wise, since that often is the cause of such behavior. If a UTI isn't the cause, the right medication is justified to keep your father more peaceful and out of "psychic pain" as it has been said. He doesn't need to be suffering from this kind of distress when something can be done about it and he can also not be a potential threat to others. A geriatric psychiatrist is best, I agree.
Treating our elder patients is different than younger adults in many ways. With the right care for this problem, your Dad can be back to walking around and about as friendly as before. But we do have to recognize that dementia isn't static and will continue to go through stages of change. You sound like you're doing a good job of caring for your Dad and his changing needs.
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we often forget no matter what the diagnosis is other problems will plague the patient. people require observation when they cannot say what is wrong think of how you would act if you were ill and could not tell someone. keep doing right hugs and love.
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