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Is instituionalization the only option for a Primary Progressive Aphasia patient?

By Anonymous August 9, 2011 - 10:14am
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My husband, Tom, was diagnoses with PPA about 2 years ago. He continually loses more language and the ability to comprehend. He is still very self-sufficient. He shops for groceries, fixes his favorite meals, does his assigned chores (wash dishes, takes out the trash and recycling, gets the mail, and takes his medication without reminder). He is always aware of his location and can direct me to where he wants to go...he just can't remember the names of stores or businesses. He still has an amazing understanding of money and change. No one will short-change Tom but he might very well manipulate a short change on someone else. Tom seems to be fixated with money. In fact, on the rare occasion when he escapes my care, he will go to neighbors houses and will enter their vehicles looking for change. As you might imagine, and rightfully so, the neighbors are unhappy and call the police on Tom. The police strongly encourage me to put Tom in a facility that can ensure he doesn't escape and bother the neighbors. I strongly believe that Tom is not ready for such institutionalization. I want to care for him at home until I feel I can no longer control him. I do not want the police or the state to make the decision for me that I believe is detrimental to Tom's best interest. I also realize that I have an obligation to the neighbors to ensure their safety and peace of mind. (I am told that none of the neighbors feel Tom is a threat or harmful...they just don't want him trespassing or taking their loose change). I have installed alarms on all the doors in my house so I will know when he might be escaping. On rare occasions, I have been known to either use the restroom or fall asleep. Tom is smart enough to use these moments to leave the house. I always am able to catch up with him within a very few minutes of his escape. Unfortunately, he is very fast and can get in trouble in a matter of moments. I need some help in finding a way to keep Tom in the house. Any suggestions would be greatly appreciated.

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You have quite a challenge! It appears that your husband is displaying obsessive-compulsive behavior with his obsession with money and escaping to the neighbors' s vehicles. You might want to make an appointment with a neurologist or neuropsychologist for evaluation. Obsessive compulsive disorder is treated with medications and therapy.The first medication usually considered is a type of antidepressant called a selective serotonin reuptake inhibitor or SSRI.
If an SSRI does not work, the doctor may prescribe an older type of antidepressant called a tricyclic antidepressant. Cognitive behavioral therapy (CBT) has been shown to be the most effective type of psychotherapy for this disorder.Medication and CBT together are considered to be better than either treatment alone at reducing symptoms.
An additional suggestion is to hire a home health aide who can watch your husband and keep him occupied with activities while you use the bathroom, take a nap or run an errand. Have you considered a special lock for the doors? A type of lock that you can engage from the inside and requires a key to open. You would keep the key with you. A hardware store employee could help you find this type of lock. Please keep us posted.

August 9, 2011 - 4:26pm
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