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Is Alzheimer's causing symptom or is it medication?

My wife hallucinates frequently, cannot complete a sentence, and requires 24 hour supervision. I know all that is symptomatic of end stage AD. Her Dr. prescribed her Haldol, 3x a day, I give it once in the morning and bedtime. Ativan was prescribed as well, 1-3 times daily as needed. I wind up with one dose around 11am, and another around 3pm. Is it possible I'm causing some of the problem? Thank God the sundowners has mostly disappeared. Along with the symptoms mentioned, she shakes uncontrollably at times, as well as her lip trembles, incontinent. Another thing, and this is difficult, when do you know when it's time for a nursing home, and how do you deal with the guilt associated with it. There are times when I just can't handle it, and act in ways that I normally wouldn't. No, there is NO physical abuse, just raising my voice. I don't like it at all. This is a woman who spent almost 40 years as an RN, and it's killing me seeing her go down like this. This may be a good way for the AD patient to go since they have no idea, but the rest of us?
Status: Open    May 30, 2015 - 06:49 AM

Dementia, Caregiving

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Expert Answers

Jun 09, 2015 - 10:51 AM

I can't answer your question about the medications. However, judging by your explanation, I can answer that it is time for a memory care or nursing home.

The guilt of making a decision to place a loved one in the care of another person is extremely difficult. I meet with families every day who are in various stages of the roller coaster of emotion. Honestly, I could write you a novel on the particulars.

There have been a few considerations that have helped families over the years:
- Is it better now for your wife to be trusted to the care of trained professionals?
- Placing your wife, after FULLY vetting the communities you are considering, is another chapter in her care. In many ways it is a new beginning. It is not, however, the end.
- The decision will be no easier whether you make it today, tomorrow, two weeks ago or a year from now. Ultimately, there isn't going to be a "crisis" that is deep or strong enough to justify to yourself that you shouldn't be guilty for not being the one to provide her care. With assisted living, it is easier because it is logical: miss a medication, take a fall, break a bone, go to rehab, go to assisted living. That's not how it works with Alzheimer's, and trying to fit a square logic peg into a round emotion hole is near impossible.
- There will be a trigger when you make a decision. Use small crises as a springboard and draw yourself a line in the sand. Maybe it's the next time you shout. How far do you want it to go, though? Is your breaking point when you actually break? Don't be the husband who passes away because the care you provide is beyond your means.
- After placement, the new journey begins. You remain a caregiver, visiting as many hours per day as you are willing. You serve as the advocate for your wife. You develop relationships with staff, residents an family. You may even consider leading activities. On the other hand, you must also re-focus a percentage of your effort on yourself to remain active and healthy. Don't get lost in the caring transition. Set a routine of shopping, cooking, visiting family and being involved with your wife. Coming to a screeching halt is as dangerous as continuing to careen out of control, so you want to be sure to maintain a pace that works for you.

It's not a book yet, but it's getting there. I hope some of the information helps. Best wishes as you work through the decision making process. Lean on every resource you have for support.

APFM Staff Answers

Aug 12, 2015 - 04:21 PM

I’m personally not a doctor or dementia expert however we do have an interesting article on medication side effects and dementia on our blog:

A Startling Cause of Misdiagnosed Dementia


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