I'm caring for my grandmother, she is 93, has vascular dementia (mid-late stage) and always wants to "go home" in the evening and gets aggressive and very agitated if we don't allow her to get out.
The status quo now is now she is on antipsychotics and benzos and we have to give her big doses of benzos to make her sleep when she wants to "go home".
Is someone else in the same boat as me? What do you do to cope and improve a similar situation?
When you say "evening," how late in the day is this? And how much space in the house is there?
My mother lost all recognition of the house we'd moved to five years before. Fortunately she trusted me and felt safe if I was there so she wasn't trying to escape, exactly, and she accepted my explanations (briefly, it got a bit repetitive, but you can't have everything...); but I certainly appreciate how difficult the disorientation is to manage.
Best practice is to go with the person rather than prevent her leaving, but in winter and in the dark or in the middle of the night obviously this can be impractical. I was also told I was being "maddening" when I questioned her about where she wanted to go and what she was looking for.
Coping: it helps if you try see the situation through her eyes, and think how disturbing it is if you don't recognise your place and just feel you need to be somewhere else, whether you know where that is or not. The aggression comes from her being frustrated and frightened, so as far as possible avoid contradicting her or blocking her movement. For example, rather than tell her she mustn't leave, offer to help her find her "new" bedroom; rather than tell her she lives here now, say "well let's stay here tonight at least, and then we can have a think about it in the morning."
How long has your grandmother been living with you? What does she have around her that is really familiar to her - e.g. furniture and other belongings?
It may be that this situation is going to be more than you can manage in a family home. Have you considered other care options? Do you have any help with her care?
Sadly thats the best px her doc can come out with. The situation without meds was asylum-like: if we didn't allow her to get out she would throw everything at us, assault us, scream, break windows and things.
If we decided to let her leave and "go home" with her she would walk and wander for hours even in winter/summer and ask every pedestrian the way for her "home" town.
Every non-pharmacological approach fails because she is very stubborn and doesn't trust even her sons, if you show her new bed she says she wants her old one, if you try to postpone it to tomorrow she wants to go RIGHT NOW.
She has been living with me since when I was a kid but she doesn't recognize me. We have transferred recently but the situation was the same even in her old 'real' home, probably because she is looking for her childhood home, his parents, brothers and sisters.
I have consider other care options but at the moment I feel like it would be still best to have her at home.
My father (her son) is helping me with her care.
You state that the reason non-pharmological approaches to her care fail is that she is "very stubborn." Is it equally possible that her caregivers do not have the necessary training or expertise in dementia care to apply these approaches effectively?
Would you perhaps consider a short-term trial stay in a specialist facility? This would give you much needed respite, and might also be an opportunity to rethink her care plan. If you go to alzheimers.net you will find 11 dementia care facilities within fifty miles of your location.
Her geriatrician also said that these medications are commonly used in those specialist facility for these cases.
www.nasuad.org/sites/nasuad/files/hcbs/files/140/6987/skills_for_dementia_care.pdf
Is vascular dementia your grandmother's only health issue? Were there pre-existing conditions?
She has no health issues other than the dementia and her doc said that her heart is perfect.
Have you tried day centres and similar? Just wondering if extra engagement during the day might help.
Used she to do her praying in a particular congregation? Are they still in touch?