Regression, anxiety, agitation, fearfulness in Alzheimers

[Nurse SMS, MSN, RN]

Tonight I took care of a sweet soul who was just so pitifully tormented. The patient was genuinely fearful with many verbalizations unable to be understood, but occasionally saying things like "I didn't mean to do it!" And " I promise I'll play nice!" "Please don't leave me alone!" And "I can't!". The patient was frequently brought to tears by fear and anxiety. apparently this is the patients baseline per the family. Changing the brief usually helped for a little while-definitely an increase in agitation when wet. Xanax helped minimally. Haldol and Ativan had been given in the ER and were completely ineffective and made things worse. Holding hands, stroking the head and murmuring soothing words helped some but not completely. The patient wanted to cling to me like a little child.

My heart just aches for this poor individual. How common is it for dementia/Alzheimer's to manifest in this kind of anxiety? I have seen plenty of patients with AMS but never really one quite like this. Any tricks to put in my orificenal for next shift? I do believe this patient's suffering is going to stay with me quite a while. I would love it if there were ways to helped soothe a mind this troubled that I just don't know about yet. The patient almost seemed to be stuck on a loop of reliving bad memories.

[K+MgSO4, BSN]

Has she got a doll or Teddy bear that she could hold onto. That is something I have used in the past. On a side note I had to shackle a 90 yo man from eastern Europe the other day who had a deliurm. An hour later when I finally got through to his family I discovered his was a WW2 POW. I have never felt worse