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My Boyfriend Has Vascular Dementia Lately He Has Been Groaning And Moaning Very Loudly And Making Other Strange Sounds Is There Any Medicine I Could Get To Quiet Him Down So He Can Be At Peace And Get Some Sleep?
Question: My boyfriend has vascular dementia. I am his caregiver. Lately he has been groaning and moaning very loudly and making other strange sounds. The first time it happened it lasted about 2 hours and then he fell asleep. But a couple of days ago he had a very bad episode which lasted about 10 hours. He sounded like he was in great distress the whole time. When this is happening, is he purposely making these agonizing sounds, or is he not even aware he is making them?. Is he in great distress when this is happening? Is there any medicine I could get to quiet him down so he can be at peace and get some sleep?
I'm not sure you received the additional information I provided. He is 74 years old. He does take clonazepam for anxiety. That did help him in the first episode to calm down and go to sleep, but not in the recent 10 hour episode. There are many medications he can not take because he has a kidney transplant.
Also, although he has had some brain scans, the doctors can't tell a whole lot from them because they can not use XXXXXXX in the scans. That would kill his kidney.
Brief Answer:
Antipsychotics may be considered
Detailed Answer:
Hi,
I read your question carefully and I understand your concern.
Regarding the scans, for a diagnosis of vascular dementia a contrast (dye) exam is not necessary. A MRI without contrast administration would show all the necessary information. Contrast would be vital only if there is doubt regarding the diagnosis, if findings from non-contrast exam are inconclusive and other diagnoses are suspected.
As for the episodes you describe, of course first it should be made sure that there is no other physical issue bothering him, should check his vitals, make sure there is no fever or other indication of an infection, that there are no issues such as bowel movement difficulties or any other type of pain.
If no such other evident cause is found then the possibility of agitation is the most likely one. It is a common phenomenon as dementia advances often due to psychotic episodes like hallucinations. The episodes are indeed distressful for the patient (as well as for the caregiver) who is confused, hallucinating, unable to fully comprehend what is happening furthermore especially in the elderly they can increase confusion.
The only means for alleviating the symptoms would be the use of an antipsychotic, like quetiapine. It does come with a black box warning that it increases risk of cardiovascular issues which is true, but it is often the only means to provide some comfort and sleep, so in the real world it is widely used by doctors. So I suggest you discuss its use with your doctor.
I remain at your disposal for other questions.
Thanks.
Antipsychotics may be considered
Detailed Answer:
Hi,
I read your question carefully and I understand your concern.
Regarding the scans, for a diagnosis of vascular dementia a contrast (dye) exam is not necessary. A MRI without contrast administration would show all the necessary information. Contrast would be vital only if there is doubt regarding the diagnosis, if findings from non-contrast exam are inconclusive and other diagnoses are suspected.
As for the episodes you describe, of course first it should be made sure that there is no other physical issue bothering him, should check his vitals, make sure there is no fever or other indication of an infection, that there are no issues such as bowel movement difficulties or any other type of pain.
If no such other evident cause is found then the possibility of agitation is the most likely one. It is a common phenomenon as dementia advances often due to psychotic episodes like hallucinations. The episodes are indeed distressful for the patient (as well as for the caregiver) who is confused, hallucinating, unable to fully comprehend what is happening furthermore especially in the elderly they can increase confusion.
The only means for alleviating the symptoms would be the use of an antipsychotic, like quetiapine. It does come with a black box warning that it increases risk of cardiovascular issues which is true, but it is often the only means to provide some comfort and sleep, so in the real world it is widely used by doctors. So I suggest you discuss its use with your doctor.
I remain at your disposal for other questions.
Thanks.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
Neurologist.
Detailed Answer:
Hello again.
The proper specialist would be a neurologist, there is no doubt about. If he has had a dementia diagnosis I suppose he must have been consulted by a neurologist at some time or the other, if not he definitely should.
Grunting is not typical for dementia. It may be a tic, or since patients with vascular dementia have at times difficulty swallowing may be an attempt to clear throat from saliva. Another thing which might want to exclude would be seizures. So might be wise to see a neurologist, both in order to decide whether any additional test such as MRI or EEG is necessary as well as for the prescriptions I mentioned.
Let me know if I can further assist you.
Neurologist.
Detailed Answer:
Hello again.
The proper specialist would be a neurologist, there is no doubt about. If he has had a dementia diagnosis I suppose he must have been consulted by a neurologist at some time or the other, if not he definitely should.
Grunting is not typical for dementia. It may be a tic, or since patients with vascular dementia have at times difficulty swallowing may be an attempt to clear throat from saliva. Another thing which might want to exclude would be seizures. So might be wise to see a neurologist, both in order to decide whether any additional test such as MRI or EEG is necessary as well as for the prescriptions I mentioned.
Let me know if I can further assist you.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
What kind of specialist doctor should I take him to in order to get such a prescription, who would also act as a consultant throughout the rest of his dementia? I forgot to mention that after that bad episode was over, he had no memory of it. But that doesn't mean that he was not suffering during the ordeal. So having medicine on hand to be able to stop these episodes would really be a blessing. Also, he "grunts" a lot even when he is not having a bad episode. Is this normal for dementia patients? I asked him if he is aware of the constant grunting and he said he is not.
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