Vascular dementia and violence...

[Peregrine Took]

Anyone familiar with this disease?
My 83 year old wonderful, intelligent brother waited too long to get his heart valve replaced (taking care of his wife with Alzheimer's) and now he is in very poor shape indeed as the blood flow to his brain was so poor before the emergency valve surgery.
The two of them live in a residential facility and, actually, she is doing better - being social, going out for car rides, etc while he has become quite violent and is striking out at the staff, punching people, yelling out the window, etc.
He is on a blood thinner and has begun an anti seizure med this week, Depakote,
I assume he is striking out at people as he is afraid and confused.
Anyone familiar with this situation?
Its horrible for his grown kids to watch as he was always the loving and smart dad they so looked up to....
Thanks for any advice

[kickysnana]

1. This is tough. So Sorry.

We went through this with my Dad in 2010. We found only one facility in the Twin Cities Metro area that treated such folks as people and had pretty good success with stabilization and quality of life. Unfortunately Dad passed before we got to the top of that waiting list and the "treatment" he got in the locked ward at his hospital was as hard to watch as it must have been to live through. Hastened his decline. Learned that hyperactive 84 year olds are as challenging as his 19 month great-grandson was when I had to stop watching him by myself following my grandson's cranial surgery. I have MS.

Dad was driving confused for the first time Memorial Day that year and passed July 4th. The nurses were striking over patient care ratios not money or benefits and they were only out a short time and settled.

He started sundowning late at night and they were trying to adjust medications so as not to blow out the heart valves and still get blood up to the brain but they lost that battle and decided to try to try to treat his A-fib He ended up in the locked ward from the heart floor because of a nurses strike.

Following the heart procedure Dad was convinced that he was being held as a prisoner of war but that subsided. They then moved him down to a general ward without notifying us the first day of the strike, we weren't there as touchstones. He had adjusted to the room he was in on the heart ward and the staff, was making progress but totally lost and first became combative immediately after the abrupt move to general.

Anecdotally some folks we know have rallied and have some good spells of time again. Dad's doctors said there was no way to predict how this might go for him or anyone else.

Wish I had better advice than trying to find that place that takes the time, has the staff to work with suddenly confused older people. You could do it at home but it would take a lot of family members to coordinate and a core group of caregivers with the patience of Job. We just did not have enough folks to do it. But I got him another 10 good days at home, bowling, mowing, serving at a Lion's pancake breakfast before the last procedure, and then I managed to get his old rescue mama cat admitted with him to hospice the last few days and that calmed him more than anything they had to offer him.

[NCarolinawoman]

2. On Sonja Gupta's 3rd installment of Weed Wars, a woman could no longer

live with her husband because he had become so nasty with his outbursts on the verge of violence. Once he started taking cannabis, he mellowed and she could bring him home from the very expensive facility she had taken him to.

I don't remember if he had Alzheimer's, vascular dementia, or anesthesia induced dementia, the latter effects many elderly when they have surgery--particularly heart surgery.

Where does your brother live?