Korsakoff syndrome

[Silverla]

i work in ltc and i've worked with many residents diagnosed with korsakoffs. the residents have been male/female, different races/cultures, every income level, the only thing they seem to have in common is that they are universally challenging. all have had angry dispositions and most have been verbally and physical aggressive. in all of the reading i've done on korsakoffs i haven't seen any mention of challenging behavior.

i realize my experience can all just be a coincidence. their behaviour could be related to the individuals prior temperament or there motivations for drinking in the first place, like suppressing anger, dealing with depression, or away of coping with an alcoholic spouse, i've seen a lot (can't beat'em join'em). i realize coming into care, losing there home and being away from their families could make even the nicest person unpleasant.it's just that modifying my approach, proper pain management, tests for utis and modifications to the environment to reduce potential triggers never seem to be affective.

is the challenging behaviour related to korsakoffs or is it just a coincidence? i'm wondering if anyone else has experienced the same thing or has advice of approaches they have found affective.

[CoffeemateCNA]

Korsakoff's is like dementia in that it destroys portions of the brain in the same way that portions of the brain are destroyed in people with dementia associated with Alzheimer's or Parkinson's.

As you have noticed, they have a lot of memory loss and will confabulate (fill in the gaps in their memory with made-up experiences).

You really "hit the nail on the head" in terms of reasons for their anger. They may also be angry because they can't remember certain things. Think about how many times you've taken care of someone with dementia who got flustered and angry with you because they couldn't think of the right word and couldn't communicate with you effectively. The same is probably happening here.

Sometimes I wonder if their frontal lobes have deteriorated as a result of the disease. This is the part of the brain that controls personality, acts as our "filter," and gives us the ability to inhibit saying or doing certain things.

[loriangel14, RN]

I have also done reading about Korsakpffs pts and I have seen mention of aggression, rage, paranoia and psychotic behaiour.The only thing I have seen that works is reapproaching them at a later time if they are resistant to care/

The best method I have seen of dealing with them is Seroquel, lots and lots of Seroquel.