Expert: Paula Damgaard - 10/4/2008

Question
my father recently had a stroke and was dropped in the hospital and ended up needing lots of physical therapy and in the end ended up in a nursing home for dementia. he was diagnosed with dementia 6 years ago. he was supposed to be on aricept for those 6 years but my father has always that doctors are stupid and don't know what they are talking about and he abused drugs for a long time. so he never took the medicine. now his dementia is a lot worse he has made very bad decisions in the past 6 months or so and he is in complete denial about his dementia. i can not afford home health care and he is blaming me all the time for him not being able to go home because he thinks i should take care of him but i have 2 small children and a husband and i can not take care of him. he makes comments to me all the time about how he would rather be dead then be in there anymore and how if he does get out he will stop taking his medicine again. i guess what my question is is am i making the right decision by keeping him in there and how long does it take the medicine to start showing a difference. he also has crude behavior to the staff at the home. he has thrown urine in people and he cusses them everytime they come into the room. please help me understand why he is acting like this. thankyou
Sarah

Answer
Dear Sarah, at this point, your number one priority is to YOUR family.  Your young children and your husband, they must come first.  As for your dad he is where he needs to be.  I am not sure why the doctors there haven't put him on some drugs that would make him a nicer person, but you may need to ask them to.  As for his nasty behavior all I can say is that it is disease driven.  Why do some act that way and some don't, I can't tell you.  The families that have nice gentle souls have no idea how fortunate they are.  

I am not sure what medicine you are referring to when you ask me how long does it take so show a difference: do you mean Aricept? If so I don't think you will see a change in his manner with the Aricept.  It keeps the disease from progressing as fast as it would otherwise.  It does help change some behaviors, but there are some patients like you dad that need more help than that.  

He sounds like he needs some antipsychotic medicine to calm him down.  If he isn't on that I would urge you ask his doctors why not, before they kick him out of the home.  Those drugs are pretty quick acting.  

I hope this helps.  Paula

PS If you go see him and he starts yelling or being nasty, tell him you are going to leave if he doesn't change his attitude and that it is that attitude that is keeping him there.  And if he doesn't change leave.  Sometimes you have to act like the parent and treat them as a disobedient child.