PALS major panic and stuffy nose issues

I'm just at my wits end trying to help my PALS and would appreciate any suggestions.

He is constantly stuffed up and we have tried the saline sprays, gels, Afrin, tissues in water used to wet his nose, Sudafed you name it and nothing has helped. We've mentioned it to our clinic and VA docs and it gets shrugged off as yeah that happens.

Then every afternoon - think sundowners with dementia pts - he starts getting panicked.

He gets Ativan and a low dose buspar at 8ish but it doesn't help much. I give him .5 Ativan earlier if it's getting too bad but it never seems enough.

Now that I need to Hoyer him into bed as soon as I begin to lower him he begins screaming that he can't breathe-his nose - and just plain freaks out. And back into the recliner he goes.

That of course is causing its own issues- tail bone is getting sore and red, shoulders and back hurts and he slides down but not out.

Has anyone run into a similar situation? I just don't know what to do any more.

Any suggestions would be so appreciated.

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