Watch Medications for all Elders, Particularly Those with Dementia

Carol, your post is right, one needs to watch out for the medications for the elderly who has  dementia. My father-in-law has a long history of the changes of medications since late 2006. First of all, aricept made him lose appetite so we stopped it. Then the blood thinner made him literally  worse in AD and got sicker in 2007. We stopped the AD drugs in 9/2008. This year is again new - he got congestive heart failure and has 7 medications all for his heart. The other danger is in the fall/winter in 2008, he didn't have any medications as the doctor thought it was best for him to have none. Wrong - he got so sick twice that he was diagnosed with congestive heart failure and started new regime of these 7 medications for his heart. He even has cardiologist now as we don't quite like his family doctor who stopped all the drugs.

Indeed it is important to watch out. We are fortunate that the caregivers are alert and my FIL also can complain about his confusion  before we stopped the drugs. Now we just observe his vital signs. Have to measure his BP every day.

It is not easy. Sometimes I am afraid the family doctor got tired of such changes...

Regards,
Nina

Monitering ones medication can be a great challenge for any individual or care giver. I found that a medicatin dispenser can make the world of difference. The one I found here

http://www.activeforever.com/p-5068-med-e-lert-automatic-pill-dispenser-with-alarm.aspx works so well!

As a director of nursing in long term care for 25 years working with frail elderly in general, and those with dementia's in particular, I also cannot stress the need for family advocacy. But I also encourage positive communication with healthcare providers until you get the answers you need.  Hospitals get stuck using medications like Haldol and Ativan to calm residents so that IV lines and other care can be provided with safety.  The consequence is almost always sedation and increased confusion and worsening of dementia symptoms. Every medication that is used today may result in severe or strange side effects in any individual, but especially the elderly.  The drug that works well for many may have terrible side effects in others.  Don't kill the messangers, but keep up communication and advocacy!

Dear Carol,

   A couple of issues to be addressed here.  First is that if you have the Medical Power of Attorney for your loved one that you are taking care of (at least here in Ohio) you

have the right to access his/her medical files at any time to determine exactly what

type of treatment(s) i.e. meds they are receiving and should not hesitate for a moment to exercise that right.  You might run into a great deal of grief from medical

staff but they must obey the law.

   Secondly, and let's face it, doctors as a whole, hate to have their judgement questioned or to admit that they might possibly be wrong.  As you have stated, you

are the one who knows the patient best because you have been their caretaker.  You

know their pain levels, their behavior patterns even though they maybe erratic due

to the nature of their dementia.  Therefore you must stand in for them and when a

medicine does not seem to be working or causes a very inappropriate response, it be-

comes your responsibility to take the steps necessary to get your loved one off that

med as quickly and as safely as possible even if it means a face to face show down

and possible change of doctors.  As you said, "Know your meds or learn about them."

As a former practioner, I was absolutely appalled that a psychiatrist would place a

person suffering from from Dementia and just recovering from brain surgery on a

heavy duty anti-psychotic like Haldol.

   Thirdly you mentioned Neurontin as being used as a seizure medication.  As an epi-

leptic who is now on her twelvth (12) medication in an attempt to control the seizures

which were under control for almost thirty years by Dilantin, I can tell you that

Neurontin has never even been suggested or recommended.  It has been used for some time by a friend of mine to control the pain he is suffering from two (2) herniated

disks in his neck.

   Lastly, if you run into some unexlained complictions with some medication and can

find no explanation from your doctor, pharmicist, or any Web site, the FDA encour-

ages you to report same to them.  That request along with a telephone number or

a Web site usually accompanies any new delivery of medication.

Sincerely,

MelIce97

P.S.  I'm sorry for any erors but my spell check is not working and my computer is on

its last legs.

I'm glad to see whitneyb and gypsywild's comments about medication dispensers. SafeCall has been providing medication dispenser service 1999 (www.safecall.biz) and have learned a few things about insuring a successful placement of these devices.

First, earlier is better. Current medications can help slow the advance of dementia symptoms associated with AD. Their effectiveness will be determined by how early in the disease they become administered. If there is a suspicion that you are dealing with AD, you should encourage a med dispenser sooner rather than later. Once the elder has moved into later stages, the medication's effectiveness is limited as will be the dispenser's.

Second, the goal is to swallow the medication, not administer it. I've seen families so focused on having the medication removed from the dispenser that they forget to complete the process by "put the meds into your mouth and swallowing". Seems obvious but needs to be covered.

Third, decorate the dispenser with 'friendlies'. Pictures, drawings, words of faith, anything that associates positively with the elder. Make the dispenser a friend.

Sanford Freed

President

www.safecall.biz