On Saturday I called the house to let them know that Ken was planning to come by later in the afternoon. I spoke to Al and he mentioned that Dad got up again the night before (luckily no hitting though!) I think it was just once during the night that he got up, but then Al mentioned that he moved Dad to his recliner, and then he slept there the rest of the night. I suggested that in my experience I thought it was better to get him back to bed, reminding him that it's not time to be awake. I think Al is a bit reluctant to be too firm or insistent with Dad, to ensure Dad doesn't get angry, which I can understand. Hopefully over time they'll get to know each other better and be able to work through this.
On Sunday I stopped by to see Dad. He was relaxing and watching the Laker Game. He gave me a big smile and nice greeting when I saw him, and he was speaking very alertly, though wasn't very talkative. He had slept fine the night before.
I also stopped by to see Dad this evening during dinner. He was enjoying chicken pot pie and a nice lettuce/tomato salad. Seemed too focused on dinner to want to talk to me. I chatted a little with Juana (pronounced Wonna) and Al. They reported that Dad was able to play bingo today without assistance...finding the letters/numbers without help (he didn't do that when I had played with him a couple of weeks ago.) They continue to report that Dad is eating well and having daily bowel movements. I'm not sensing over-concern on their part (at least at this point) about the two incidents with Dad's wake-ups.
However, I have contacted Dad's doctor asking whether he would recommend any kind of medication that could be given to Dad (only as needed) on these nights/instances where he doesn't seem to sleep well and/or gets anxious, agitated or overly confused. Turns out it's not a good idea to give a sleeping pill or "sedative" type of drug as that poses more of a fall risk. He is recommending "Haldol" in a very low dose. My good friend whose husband is a palliative care doctor also recommends it.
Again, the intent would be only to administer on an as-needed basis. When I take the pills over there tomorrow, I"m going to ask that I be contacted whenever they need to give it to him (after the fact of course, but that will allow me to keep track and monitor the situation.)
4 comments:
Thanks for the update, Barb! I'm glad you asked to be informed about the administration of the Haldol. It is really good to track this, particularly if it seems that the incidents actually increase over time. In general, it certainly sounds like Dad is doing well in the new environment. No significant changes - just the usual up and down of his alertness and understanding. It will no doubt take a little while for the staff to learn these cycles.
Psychiatric drugs are generally not recommended for alzheimers patients, however a low dose may be appropriate. Have you considered consulting a psychiatrist? (like he used to use in WS--they gave me some recomemmedations of doctors in LA area.) I will let you know if you are interested.
I was also put on Haldol, it does work really well at first, but it gave me "tartive dyskinia" after a couple of days. (of course everyone has different reactions).
Another thought: just hire someone to watch him during the evening for a while. I tried to hint about this, but you did not respond.
Please call me if possible and I will let you know or send me an email.
Cathy
Thanks for your research on this Cathy. I share your concern about drugs - it's very difficult sometimes to sort out. Even things like TylenolPM are considered unsafe. Most of the studies are based on people who take daily doses of the drugs - so I think if it is a low dose and used sparingly, we can watch for any of the symptoms. I seem to recall that Dad previously had signs of the tartive dyskensia (I didn't know the term at the time - but noticed how he kept moving his mouth and tongue) - I"m not sure what drugs he was taking that might have caused it then.
I don't know that I would compare Tylenol PM to Haldol. Haldol is not unsafe in that the side effects generally go away (at least they did in me when I discontinued it). How I see it is that it does take away the terror from the mind and (after a few days) puts a pain in the body! So it is a struggle to know what is more important--I stopped it gradually (at a risk according to doctor. This actually happened several times over the years, with other meds like Navane.
Hopefully Lithium-Prozac combination will keep me on an even keel! (plus yoga and exercise and calming music to keep me focused.
Dad really likes Military music, maybe that would calm him down at night if he couldn't sleep. I don't see why he wouldn't be okay sitting on the lazy boy chair, He did that a lot in the past and I do too sometimes if I can't sleep.
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