How long does it take an Alzheimer's patient to adjust to new environment?

Carolina daughter asked...

My dad was placed in VA approved adult home care 4 days ago. Before that, he was becoming increasingly more agitated/aggressive/angry each day from mid-afternoon until he went to bed. My mom couldn't take care of him anymore, so he was placed in the home, which has access to hospice nurses & doctors. Of the 4 days there, he has had the agitated/aggressive behavior earlier in the day & for longer periods 3 of the 4 days he has been there. He is currently on Lorazepam (every 2 hours) & has also started Seraquil for anxiety. I know an unfamiliar environment will increase the anxiety, but what is the "average" length of time it takes an advanced Alzheimer's patient to adjust to a new environment? The caregiver & hospice have told my mom she needs to stay away for at least 2 weeks so Dad can bond with the new caregivers. I also wonder if those medications may actually be making this behavior worse than better.

Expert Answer

Ladislav Volicer, M.D., Ph.D., is recognized as an international expert on advanced dementia care. He is a courtesy full professor at the School of Aging Studies, University of South Florida, Tampa, and visiting professor at the Third Medical Faculty, Charles University, Prague, Czech Republic. Twenty-five years ago, he established one of the first dementia special care units.

There is no specific time that adjusting to new environment would take in all people. I think that your father needs better psychiatric evaluation and management. Anxiety is most likely a symptom of depression and he might benefit from an antidepressant treatment. Lorazepam sometimes increases confusion and can cause falls. Seraquel has other side-effects and belong to antipsychotic class of drugs that should be used only as a last resort. Is your father taking a cholinesterase inhibitor (e.g., Aricept) and Namenda? They may be helpful as well. The most important is involvement of your father in meaningful activities. His agitation may be caused by boredom. As far as your mother staying away, it depends on what happens during her visits. If your father calms down, then visits are useful.