Today, after a conversation with the home nursing service, I wrote to our case manager as follows:

Lana,

My mother has now been prescribed Risperidone to calm her down. This is a daily medication and an authorisation has been sent to the home nursing people. I gave my mother a tablet yesterday, and the nurses will start administering it from tomorrow.

While I hope that this has positive effects, I think that the following factors might militate against this:

1. Nurses do not visit on Mondays and Wednesdays, therefore my mother will get only 5/7 of her weekly dosage of both Risperidone and Aricept.
2. For the same reason, my father is getting only 5/7 of his Aricept, which seems to have resulted in a return of his confusion, which is in turn providing more aggravation for my mother.
3. The nurses themselves advise that Risperidone is best administered in the evening before bedtime due to its tendency to make people 'less steady'.
4. The nurses visit at times when my mother is sometimes still in bed and will not open the door - further attenuating her dosage.

The solution to all of the above seems to be to visit in the evening instead. I suggested this to the nurses but apparently they have a rule that prevents this. The rule is that they will not visit where there is a possibility of violence and no available backup. Apparently there is no backup in the evening. Apparently they do not have much faith in the Risperidone, either.

This seems a classic catch-22 situation in which the administration of the medicines would only be possible if they were not needed.

I don't know if you can help. Do you have any suggestions?

Cheers, Mike