Hello Everyone: I am looking for ideas. My mom is 75 & stage 6. She lives at home with dad on their small hobby farm that includes chickens, cows and gardens. Dad had a heart attack the end of July & is recovering & is in pretty good health. I have finally come up with a plan that gives them 5-6 hours of support a day. I have told the caregivers to follow mom's lead to decide what to do. It has gone smooth for a few weeks but now mom has gotten very territorial & tells them stay out of the kitchen. I can do that. You should go home. I don't need you. I can sweep my own floors. etc. Mom has slipped considerably in the past month & yes I have had her in to check for urine infections. She has none. The caregiveers have also backed off on housework and mostly just try to spend time with mom. On Saturday, before the caregiver was leaving she was going to make a hot dish. Mom grabbed her by the arm and had a paring knife in her hand. The caregiver said she knew that mom really wasn't going to hurt her but it did shake her up a bit. Mom cannot be at home if we don't have help. I go 3-4 days a week and I know that is my limit. Mom takes lexapro, aricept, namenda & celebrex. Any ideas of how to defuse the situation? It seems I just get one thing working and then there is another crisis. I am sad, tired & not sure what to do next. Mom does sleep through the night & she does not wander.

Maybe a med adjustment? How long has she been on her current meds? My Dad started Abilify when he became overly agitated and it seemed to have helped.

Mom has been on the same meds for at least a year. She started namenda late last summer & that stopped bed wetting & accidents. I've never heard of Abilify. I plan on calling the doctor today. Thanks.

Abilify is an atypical antipsychotic. It helps with the delusions and sundowning. I was a little doubtful of it when Dad went on it, but I could tell a difference. He doesn't seem as paranoid as he was and he doesn't seem to sundown as much, only when he is very tired or has had a very full day. He is also on the Excelon patch and that seems to be working well for him. He has not been on any anti- alzheimer's drugs before this.

Lammie: Wow, you are very helpful. I just talked to the doctor last week and told him that I thought mom was more anxious but at that time I didn't think we needed to do anything about it. He mentioned raising the Lexapro & then if that didn't work trying an atypical antipsychotic drug. After talking to the doctor mom had a couple difficult days with caregivers so I guess her meds should be adjusted. Thank you for your time.

b-joyful, it may be possible to minimize this kind of reaction if you change strategies. For example, instead of taking over the kitchen, maybe the helper could tell your mom that she thinks your mom is a great cook and would like her to teach the helper how to cook.

You should be aware that there is some risk to the atypical antipsychotics. If they're necessary, then they're necessary (and can be essential!), but it's best to try other "interventions" first.

Also, you keep using the word "anxious". If your mom's behaviors are anxiety-driven, then an anxiolytic or selective serotonin reuptake inhibitor (SSRI) may be more appropriate (and safer).

Lexapro is an SSRI. These were originally used for depression but may also help lower anxiety. Another SSRI may work better, and there are many to choose from. SSRIs may actually cause anxiety as a side effect, rather than relieve it, so some of your mom's behaviors may stem from taking the Lexapro.

Anxiolytics include lorazepam (Ativan) and oxazepam (Serax).

JAB You gave me alot to think about. As I used the word anxiety I thought about it. I'm not sure it is the right word to describe mom's behavior. Maybe aggressive towards the caregivers is more appriopriate and also paranoid. We have been communicating and the caregivers have tried a variety of strategies and some have worked for awhile but not so good lately. I know mom feels like they are taking over things she should be doing & I can't imagine how difficult that must be. I appreciate your insight. I am waiting for the doctor's call now. Thank you very much. I need all the help I can get.

JAB, what class of drugs does Depakote fall into? My mom was on that for a while and it helped calm her angry outburst over situations she wasn't happy with and made her more compliant with the home health care aides. She doesn't need it anymore. But is that something B-joyful's mom could try?

Depakote is an anticonvulsant/mood stabilizer. It is sometimes prescribed for hostility or aggression. And you've made another good point -- our ADLOs may only need meds for behavioral problems for a while, and then can go off them again.

b-joyful, your mother's symptoms may fall more under the category of agitation, or hostility/aggression.

There are some articles on treatments for dementia-related agitation at:

http://alzheimers.boomja.com/T...Agitation-72531.html

There are more general overviews on the medicines that may be used to treat behavioral problems in ADLOs at:

http://alzheimers.boomja.com/T...-Symptoms-67128.html

b-joyful,
What a nice name. Glad you are here.
I moved into my mothers home in Dec. and she knows who I am most of the time but she has separated "that lady that is taking over my house" from me. She would even ask me if we should ask the lady in the room at the end of the hall to come and eat with us. I would just say no not this time and she was ok. She was very angry about my being here. Ask me justs who told me to come and take over and many more angry responses. I just move on a gentle as I can and do what I must. It is hard to "take over" as never thought this would be happening but her angry did make me nervous several times. She has gone to stage 6 and decided she can't walk so there is not a feeling of angry when I do things now but I was careful to removed some items from her area, ie knifes. She would look for one and I just said well let me use mine and do that for you and worked ok. I did have my own so that it was not familiar to her and "hers". As her daughter was in a little different place than your caregivers but they sound very resourceful so you might volunteer to remove some of those items that could be used to harm them and they might be more comfortable.
Exelon....Has been good. Mother was started on 4? mg patch and was more social and just started on 9.5mg patch Sat and there is again a noticable alertness and correct name usage. I am for it so far as a big plus with Mother. Hope she will decide to get up and join me in the living room again as she just won't. If we put her in geriatric chair she fights it and says it hurts and since she does have compression fracture I agree and let her back in bed. I do hate this disease but I love my mother. So whatever it takes is the ticket.
I think I rambled but hope you are able to glean some helpful thoughts.
Sheryl

shery1726
I picked that name because I am trying to remind myself to bejoyful & remember God is in control. I really appreciate hearing about your mom & situation. This is such a dreadful disease and it is hard to make these decisions. I do have siblings & my dad but I know that I am the one leading the decision making and it is overwhelming at times. I did get a call from the doctor and he said he would call in a prescription for Efexon or maybe what you are talking about. When he said it it sounded like long E followed by the "f" sound. I know I should have had him spell it. He said it is kind of like Lexapro. My mom has also talked about "those girls" that come and take things. She definitely has delusions about people stealing things. I try not to be sarcastic with her but it cracks me up when she thinks someone came in an stole the flyswatter. You really do have to keep your sense of humor and keep trying things to make it work. May God bless you and give you strength and thank you for your input!

Is he prescribing "Effexor", perhaps?

It's an anti-anxiety/antidepressant medication.

Grassflower:
Yes, you are right it is Effexor that the doctor prescribed & now that I went online and looked up side effects I don't know if I should give it to her. She has been taking Lexapro and hasn't had any bad side effects from that that I know of. I'm not sure what to do...