please Asked July 2014
My Mom was diagnosed with dementia and has had several small strokes. She repeats the same words over and over or phrases. Why?
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She hollers it out for example, When I leave I tell her I love her. As I walk out of her room she repeats it over and over. She is loud. She is in a nursing home and they dont seem to mind her loudness. She does at times will work herself up. I can see her breathing hard . I keep telling her to use your quiet voice. She does for a minute and then she starts again. It is like an outcry.They do give r
her meds to relax but only if needed. It seems exhausting to me. It is a dementia with a behavior disorder Why?? Help.
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It may not really need to be treated at all.
I have a problem with giving any meds to someone with dementia on a "as needed" basis. By the time it is apparent to staff that something is needed it is too late. By the time the drug kicks in the episode would likely be over on its own.
If she is taking a pill to "relax" her, see if you can get it administered on a regular schedule, as a preventative, rather than when someone thinks she needs it. See if that helps with her loud outbursts.
One reason is the brain is the organ that controls each and every movement, statement, in fact, every element of human existence. I believe, and you can look this up, that each time she has a stroke, a piece of her brain dies off.
Please Google vascular dementia (which, I believe is dementia caused by little strokes to the brain) and see what it tells you.
My mother is on three drugs to help her with paranoia, delusions, and depression. She's doing extremely well on these drugs. But they have to be given regularly. I'm sure the nursing home does their best, but from what I see, nursing homes and hospitals tend to give drugs to patients at certain times to make it easier for them. This is my personal experience.
You didn't say how old your mother is. She's in a strange place experiencing strange feelings. It must be very hard for people with dementia and I hope that they don't 'know' what's happening to them. From what I've seen of my own mother, 'feelings' is what she acts upon, not independent thought. i.e., she's hungry, she 'needs' to eat. That type of stuff. Your mom may not be able to control which voice she uses.
Not all strokes result in permanent damage. Many do, and that's the tragedy.
All dementias result in altered behaviour. That is the nature of dementia. No change in behaviour means no dementia. Keep on loving your Mum.
Diazepam reduces anxiety, and many dementia patients experience terrible anxiety without being able to express themselves and tell others about it. That is also a cause of frustration and may result in what are seen as behaviour disorders, but are really inexpressible cries for help out of the midst of an overwhelming confusion that grips dementia patients.
Out of the depths [deo profundis] have I cried unto thee - sang David when gripped by a fear he could not understand.
She needs all the help she can get. PRN 'as needed' is not a prescription for once a day or twice a day, but an instruction to administer them as often as they are required. If you have a question about frequency, do not settle it by advice given on this page by well-meaning people. Discuss it with your Mom's doctor.
Also, ask him/her about the maximim dosage in any 24 hours.
God bless you. :)
Of course only a doctor can give the orders. No one should take our lay experience as a final guideline. But if sharing our experience helps someone think through the issues they need to discuss with the doctor and nurses, it will have served a very good purpose.
If a caregiver sees the need, then meds should be given.
I nursed my late wife at home. I told the doctor that I wanted the next level of pain mjedsd available in the house so that I didn't have to chase him for them when mshe needed thenm. She had bronchial carcinoma. The doctiore agreed and I had all the meds I needed.
At the end, she lapsed into unconsciousness, and I maintained her peaceful and pain free passing away, using the syringe driver button to increase her med. when she neded them. That decision was mine. Once, she awoke and the fluid in her lungs was choking her. I called the doctor and asked him to prescribe a drug used at Hospices to alleviate embarrassed breathing due to pneumonia. He did so, dispatching a visiting district nurse with an order, and within the hour she was settled again. She never regained consciousness, and passed away peacefully.
The nurses credo:
1. To heal - sometimes.
2. To improve - often.
3. To comfort - always.
No patient should suffer pain or distress when meds are available to alleviate these conditions. It is hard enough at the end of, life to have so many things go wrong, so freeing patients from, pain and distress MUST take precedence over every other consideration.
She had a MacMillan nurse visit almost every day. Her advice was, "Don't be afraid of the morphine!"