Posted by zonked on April 20, 2014, at 9:18:47
My mom occasionally has episodes of delirium/dementia where she feels she is not "at home"... last night she got in her shoes, packed a bag and started walking and I bolted after her. In short, we got in a taxi and she wanted to go to her childhood home 40 miles away.
Talked her out of it. Went to see my brother instead, and had the taxi take us "home" (which she accepted as being her home)... the home hospice nurse came because I called and gave her Ativan on top of her usual night meds. It worked.
But we have Haldol in the emergency meds bag just in case she continued to stay up late worrying about the conspiracy where some unknown entity transports her between her house, and a house that looks identical but is not "home". (This is in her head, of course.)
I've read that risperdal is safer if say, she became out of control. The doses I believe they said they use (don't have the bottle handy) I believe were 0.25-1mg.
I've since read that Haldol has neurotoxic metabolites and risperdal is safer for dementia.
If she took a dose of Haldol would she feel "ok" the next morning? Should I ask hospice about Risperdal instead for emergencies, since there is research to support that it's safer? Also, this is Wikipedia I'm sourcing but apparently Haldol has neurotoxic/parkinsogenic metabolites.
I never thought I'd find myself in a position where I'd rubber-stamp giving her an old AP, but if she didn't calm down last night I would have endorsed it.
My poor Mom. No amount of showing her GPS, logic etc will take the delusion away when it's active. When it's passive, she knows she's at home but her memory of the "transports" seem real to her, in other words, she still thinks she's been transported in the past. I don't care about that, it's not dangerous.
I am going to develop a draft plan for when she wants to leave. It seems that if we get her in a taxi, and go SOMEWHERE and stop for a bit, then go "home" she feels at home again. Going all the way to her hometown wouldn't be good, she'd want to go to her childhood home, where people we do not know live, likely a family, and this was after 9pm at night. Plus the expense would be unfathomable, even though she can afford it.
Thanks all,
-zOh, her other meds: Keppra b.i.d., gabapentin t.i.d., namenda XR 21mg qam, xanax 1-2mg/day prn anxiety (we match there!), zoloft 100mg qhs, temazepam 30mg qhs.
"Emergency" meds include Ativan 0.5 and a bottle of Haldol I didn't get a look at, and meds for severe pain which thankfully, she has not had.
I am so glad home hospice is 24/7. The nurse was a lifesaver last night. If she had encountered a policeman or someone else or gone to an ER, she would CERTAINLY would have been detained and transported to a psych facility under California 5150 law.
Still trying out how to help her with this delusion - logic does NOT work, nor does GPS, nor does changing the subject. She wants an "investigation" started and I don't know what to do. Will speak with her providers Monday.
-z
poster:zonked
thread:1064516
URL: http://www.dr-bob.org/babble/20140419/msgs/1064516.html