Hello, and thank you to everyone who posts, for, it is an invaluable resource for information.

My Father, 60, was diagnosed with Early-Onset Alzheimer's in April 2007, and his condition has rapidly deteriorate. I believe he is near stage 5, and will soon be unable to continue to live at home. My mother, who is the primary caregiver, is beginning to fear for her safety because of his behavior. My father showed signs of aggression for the first few months, and in this time he has become increasingly violent.

What started out as the occasional frustrated smack or pinch is escalating to near assaults and the destruction of personal property. We are currently looking for ALZ assisted living facilities in and around the Greater Austin, Texas area, but are afraid we won't be able to find a place because of his unusually severe aggression.

A little medical information. He is on Aricept, and Lexapro for his behavior problems. The lexapro seem to do little, even after a dosage increase about a month ago.

My question is, My mother was told that some Alzheimer's care units might not take him because he can be pretty violent; so, what are our options for assisted care in the coming months?

Also, are there any Assisted Living facilities in the Austin area that would take him?

Any help would be wonderful. THank You

Hello Putzarino,

I am sorry to hear about your father's early onset diagnosis and his deterioration. By what you describe, I am sure that your mother is beside herself, not to mention exhausted and frightened. I am concerned about the excolating violence that you describe. While agitation is quite common with dementia, physical violence and destruction of property pose real dangers to both of your parents' safety and need to be taken very seriously and acted upon quickly. Your father perhaps cannot help it, but your mother does not have to tolerate it.

I am glad that he has been prescibed medication for his aggression, but please let the doctor know that it seems to be doing little to help. There may be a different medication that would be more effective. Also, talk through a safety plan with your mother. Let her know that if she ever feels physically threatened, she can call 911 and tell them that her husband has dementia and is acting aggressive. Make sure that she has phone numbers for friends, family and neighbors who would be able to help if she ever needed it.

Unfortunately, physical aggression can prove to make placement quite difficult - especially in assisted living facilities which are not usually staffed to provide constant supervision or to tolerate significant risk of physical danger. Here is a link to the Capital of Texas Chapter website. During business hours they can be reached at 512-241-0420 or 1-800-367-2132 and would be able to provide specific information about local facilities.

If you need to talk to a counselor about your situation - we have people available 24-hours a day at 1-800-272-3900. I wish you and your family peace of mind and heart as you go through this difficult time.

Sincerely,

agression is a real problem, one several people have dealt with on the caregivers board. Medication like depakote or respiradol often help, but if his behavior is violent he may need geri-psych hospitalization to manage his behavior while his medications are stabilized before he can be placed. Let both you and your mom be very carefull in the meanwhile, and strongly recommend calling 911 for immediate hospitization if necessary.

Dear Putzarino:

Aricept is a medication which can slow down the rate of memory loss. It is not a behavioral drug.

Lexapro is an anti-depressant.

Anti-psychotics are used to control agitation, depression and acting out. The most common used are Risperdal, Seroquel and Depakote.

An admission to GeroPsych may be helpful so they can assess him on a 24 hour basis to see what his triggers are and how they can best intervene with more appropriate medication.

Neurology can see him on that unit also, and may have valuable input.

I agree, mother should NOT have this dreadful violence in the house. Does she sleep in a separate bedroom with a locking doorknob? Sometimes, these episodes can occur without warning at night.

If this were my loved one, I'd try to get help asap. But, if there was another bout of violence, I'd make it a 911 call and get him 5150'd, (involuntary admission - danger to self and/or others), to a GeroPsych Unit at a nearby medical center.

I am so sorry this is happening to all of you. It is so dreadfully difficult.

Let us know how you are doing.