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Mom has lived with Alzheimer's Disease for over six years. Until recently, she slept soundly through the entire night. She now lies in bed all night talking to herself. She doesn't fall asleep until early in the morning and then wants to sleep all day. Her self-conversations seem to focus on undefined or imagined worries. I assume that this behavior is a product of anxiety which is a common symptom of Alzheimer's Disease. I hesitate to discuss anti-anxiety medications such as Xanax with her doctor because of her advanced age and the attendant risks. Am I being too cautious? After all, her new behavior poses no real health or safety risk.

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Why not at least discuss the pros and cons with her doctor? A professional opinion wouldn't hurt anything!

This may not be a health risk for her. What about for you? The pattern of when we sleep and when we are awake is partly a matter of social convenience. Does she keep you up at night? Are you able to nap when she sleeps in the day?

If she mostly sleeps in the day then she is probably not getting much socialization or mental stimulation that might help her be less anxious.

My husband (LBD) took a drug to help him sleep through the night, and another one to avoid daytime sleepiness. This worked well for us. But each case is unique.

Talk to her doctor.
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all i know is my neighbor who profession was dealing with elderly and their mental and physical status said most of those new drugs to help with the disease of altimeter and demenca was all about $$$$ and over the long haul didn't work. there is no cure
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My husband went on anti-depressant/anxiety one year after stroke that came with dementia. I noticed difference that it wasn't as bad.
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Before my mom started down the slippery slope of dementia, I had had NO IDEA what anxiety even was. Who had anxiety? We were all to busy to have anxiety.

Now, in retrospect, I realize that my mother was already having delusional paranoia a few years, maybe four or five (!), before she hit this slippery slope. Anxiety can eventually generate this paranoia. Before it gets that far, however, it can be exhausting for the patient and caregiver.

Eventually and predictably, I came into the cross-hairs, and became the target of the paranoia. To make a long story short, and as I have written elsewhere, the AL where my mom is now shipped her right straight off to a Senior Behavioral Clinic after she had only been at the AL for one week. They understood that, in their words, they "were not serving her" in that condition.

I cannot say enough about the Senior Behavioral Clinic. It is a place where the patients are put under the microscope and watched all day long for their reactions to the medications until, after about ten days, the correct "recipe" for a patient is determined. Our family doctor just did not have sufficient information to do this.

So, to come back to your question, Yes, meds might be a huge help. Not to "cure" the dementia but to alleviate the anxiety. Everyone is better off with a good night's sleep. Life might be much better for all of you. There is nothing lost with a visit to a geriatric doctor. Good luck!
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I have to endorse what Salisbury says about antidepressant and anti-anxiety meds. They have changed mom from a quivering pile of dread into a relatively calm person. She still has dementia, but she no longer thinks that the IRS is coming to get her and that the facility is flooding, everyday.
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My goal was to keep my Mom as comfortable as possible. She would cry and get very upset over various things. After consultation with nursing staff and her doctor we put her on medication. Best decision ever. I suggest giving it a try.
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Babalou, I am laughing about the quivering pile of dread.

I sit with my mom now sometimes, and we a normal conversation, and I think: only a few pills are making this possible, only a few pills are standing between me and a phone call to the police to report that I stole her car. So, I am very grateful to those little pills.

I have read on this blog that some feel it is not right to give pills to change the mood of their loved one. I have only one thing to say to that: those people haven't walked in our shoes.
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My mom was much like Jeanne. Mom took seroquel at night and ritalin in morning. Very low dose of both drugs.
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Arnie, her safety and health may not be obviously compromised by increased anxiety, but high cortisol levels ( the hormone that's released when one is anxious and on high alert IS). In addition, seeing my mom in what I call psychic pain is terrible. She recently needed a pacemaker; the were not giving her anything by mouth overnight. The person we saw the next morning was not my mother; weeping, writhing, saying please please, I didn't do it, I'll be good". I can't let her be in that state. A visitor to the ice (someone else's family member commented to my sil that we should not have left her alone. To which we replied that having someone with her does NOTHING to calm her. Hospital finally gave her Ativan in her IV.
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I say give it a try. My MIL takes a low dose of valium along with a lot of other meds and it has helped her. She has Alzheimer's.
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My mom was taking xanax for years. New doctor weaned her off and everybody I've talked to, doctors and social workers say xanax is an awful drug. She also was taking risperdone,--made her hallucinate, talk in her sleep all night, uts's also did that. New New doctor took her off that. We started her on health food store supplements--notably cranberry tabs, probiotic, and Phosphatidyl serine. Can't say enough about it--my mom is close to 89 and better than she has been in years. Doctor says he sees no dementia.
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After numerous trips to every kind of physician including neurologists and putting my mother through MRI, CAT scans, EEGs etc, I found a gentle neurologist who gave Mother a Rx for Valium. She's to take 1/4 pill whenever she needs it for a condition that he was the first to identify by name after seeing many others for over 5 years. If it works, I'm eternally grateful for someone who has the knowledge to treat her. I would do almost anything to see her get some relief. Her condition is not so much anxiety, but a seizure/spasm type of thing that happens only about once per month. It is so intense that it leaves her exhausted after a bout which can last up to 24 - 48 hours. I have had some problems with her being anxious and delusional as well. She thinks people are in her room and use her bathroom. I think the Valium could be useful for this according to what I've read here. This is very encouraging to read your posts.
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A jump to the high power neuro drugs may not be necessary. A low dose Prozac made a big difference in hubbys night time walking and fretting. When hubbys happy so am I. Have the discussion with your Doc.
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OK, here I sit on a cold PA Sunday, filing papers (boring...), and have come across my mom's list of meds.

What is making her so tractable? It seems to be:

citalopram 20mg. (for depression)

donepizil 5 mg. (for memory loss)

levothyroxin 25 mg (for hypothyroidism)

risperdone 0.5 mg for delusions (yes, it says delusions, and they aren't kidding!)

melatonin 5 mg. for insomnia

Just an FYI. Bye all...
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The side effects/symptoms of dementia are sometimes very hard to handle. I too hesitated putting my mom on, what I thought were unnecessary medicines. After a few months, I gave in. My reasoning, why am I making things harder on my mom. If these meds helped Her to sleep, be able to be awake for company, help with anxiety I tried (or mom did) it. I would ask the doctor and do some research to see what was the timeline that i would see a difference, days, weeks or months. If I saw no difference, I stop the meds and would try another. As time went on, when i no longer saw that a drug was working, would discuss with doctor to see if it was worth continuing. Think all you can do is try it, you can always stop it. Anything that helps is worth a shot.
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I, too, am endorsing Salisbury's answer here. My dad was in and out of 3 facilities and two hospitals with is agitation and anxiety. Finally one ED doc sent him to a geri-psych hospital for evaluation. He was there close to a month. On the right meds, he turned into a happy man who can again 'communicate' and be OK with where he is at. The facility he's been in for 18 months now, has a geri-psych component along with regular MDs. They see him monthly and specifically look at behaviors and sleep. They keep the meds tuned to where they need to be. It has been a God-send to me, since I am a caregiver daughter who lives 200 miles away. I visit once or twice a month to see in person what is happening, and the rest is by video monitoring of my Mom at home, and then emails and phone calls to staff at Dad's place. It's not the 24/7 that so many of you do, but it is still very hard to manage from afar and also handle all the bills, money, trust and ensuing decisions that come up. I am a retired RN, and I am not at all sure I could survive the 24/7 that most of you are doing. God is going to be putting a lot of jewels in a lot of crowns when it's time.
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Alzheimer's usually calls for anti-cholinergics, if you are sure it is Alzheimer's and not some other form of dementia. Antihistamines often have anticholinergic activity, to which elderly patients are particularly sensitive. These include Benadryl (diphenhydramine) Dextromethorphan (cough syrups) and others. We have seen several positive reports with just Bendadryl.
Seizures? Sherry Anne, ask for a PRN for Ativan when you see seizures. Valium won't stop seizures, but Lamictal treats both seizures and mood swings. Allergy meds like Zyrtec and Claritin can exacerbate seizure activity.
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Good advice here. My mom, almost 89 was in hospital last March and got in an awful place. As mentioned earlier, my BEING THERE wasn't any help except to keep her from throwing things at the windows! She takes an anti-anxiety pill twice a day and they were obviously not giving to her. I was furious! They told her on Monday she would go home tuesday and then took till 3 pm to get the papers signed by the Dr. I got her to her retirement home and gave her the meds and she calmed down in about an hour, but vividly remembered the hilucinations and anxiety she had suffered. Just recently she appeared to not remember it. (10 months.) I wondered if those people had dealt with dementia patients before.
She had a new primary doctor who didn't know her well enough to give them the info they needed. (so I've got to be there for her).
It was agony for her and for me. They really believe the fears are real. I do my moms medicine machine and always make sure her anxiety meds are there. She still can't remember what happened 10 min ago, or yesterday, but she isn't afraid and worried all the time. Hope we've helped. Hugs.
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Donna, doesn't it just irk you at what happens (or doesn't happen!) in hospitals these days? I am a retired RN and I can tell you that I am tempted to take all the usual meds with me, and just GIVE them, in order to avoid having to go through this kind of stuff where either staff won't listen and call the doctor, or the doctor won't respond appropriately and then, it's the patient who is suffering and the family member who has to watch it all and feel helpless. And if only the staff could understand how much easier THEIR shift would be if they WOULD listen to the family or the patient. When I worked as an RN, I listened to patients and families and tried to get the doctor to cooperate with what they wanted or needed OR come explain to them why their request was not good during a hospitalization. Old people who are nearing end of life should have as little upset as is possible for them to endure!
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Again, I have to say--get thy loved one to a geriatric doctor.

Donna, my mom's short term memory is gone, too. Don't hate me for saying this but it has actually made my life easier. As recently as September or October 2014, if I went to NC to visit grandchildren, my mom was furious that I had left her and hardly spoke to me. Today, when I show up she has no idea when she saw me last, two hours, two days, two weeks, whatever, and is delighted.

Ahhhhhhhhhhh, much better.
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Well, Joannes, thank God someone understands. The nurses in March had to walk by and HEAR my mom saying "I'm going to throw something through the window if they don't let me out of here!" things began to move along then. As is common, that was not my mom talking. As you said, people need to hear the caretaker and patient and try to meet their needs. Thanks for your comment.
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Salisbury, thanks. My mom came up with a new one about a week ago. She said " you only come to see me twice a YEAR.". I think she meant to say twice a week and maybe once in 22 months that happened. The memory loss has its
Blessings at times when I get upset and wish I hadn't made a certain comment.
And I'm grateful when she forgets. She doesn't always tho. Hmmm.
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Hi Donna,

Before I realized that my mom was on the slippery slope (fall 2013) she was ALWAYS FURIOUS WITH ME, was sort of nice to me to my face, but then said terrible things about me to friends and neighbors. She was always majorly T-ed off because I "hadn't visited in five days." The truth: I was there every single day. I had to be. She had no license (and was furious about that, too) and I had to make sure she could get out and get what she needed. This is so much nicer.
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My mom is in a memory care facility. She is the sweetest little woman on the planet ... until she becomes overwhelmed with anxiety. The "not knowing" is very hard on her. The geriatric physician who visits her suggested an anti-depressant. I told him that she is not depressed, and I suggested Xanax. I didn't want her on a medication full time if it wasn't necessary. He complied, and she gets a low-dose Xanax prn, but no more often than twice daily. It calms her, helps her to focus on a conversation with us, and she rests well. Our goal is for her to have peace, and it helps!
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Sounds like your mother has schizophrenia---- paranoid delusional category. She was probably born with it. It can be genetic.
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My mom is starting to shake a lot lately. I have given her a Xanax twice and it stops. She gets one at bedtime also. I say if a low dose works what's wrong with making her feel better
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Pam, It's been a long ride. She isn't having seizures, but a disorder that was diagnosed by a neurologist. It is a seizure/spasm kind of thing.She has these intense muscle contractions that affect her entire body. Her electrolytes - Magnesium, Calcium and Potassium are in balance. She has had every kind of brain scan, MRI, EEG, CAT scan etc. I wish I could remember the name of the disorder, but it's some kind of violent muscle contraction that lasts 20 - 48 hours in a jerking kind of thing and varies in intensity. Acupuncture stops it while she is on the table. Getting into a warm shower can stop it. The doctor talked about Ativan, but the more he learned about her condition, the more he leaned toward a low dose of Valium. I don't think a true seizure could be stopped on the acupuncturist's table. I will be anxious to see how the Valium works. I've used chamomile tea, whiskey, progressive relaxation technique and massage to no avail.
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Sherry1anne, I have a friend in her 40's who had a stroke 10 yrs ago. She has seizures as a result. She uses liquid Valium. Takes 1/2 dropper and if it doesn't work then does another half. Don't know what type of Valium you are using for your mom but thought I would share.
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Definitely speak with her doctor, low doses of medication that can calm her at night and aid in her sleep can increase her (and your) quality of life. If she is sleeping better at night, then any side effects such as dizziness won't be apparent. It's all about quality of life, many people with dementia are awake at night and talk to themselves. Contact your local chapter of the Alzheimer's Association for behavioral interventions that may help as well. You can also contact your local Area Agency on Aging for info on in home services and caregiver support services. You might want to check on an adult medical day care in your area. It's a great place to go, mom can socialize, keep busy and eat a meal. Being a little more active may also help her to sleep better.
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You should definitely work closely with a doctor to figure out something for your situation. But FYI here's our general approach as geriatricians:
- Exercise and getting outside every day often helps. Routine, structure, and enough interesting activities during the day might help too. It's always best to try managing sleep issues with non-drug approaches, but these take more effort and coaching.
- We use benzodiazepines like Xanax and Valium only rarely and as a very last resort, after trying everything else. They do give results in the short-term for many people, but they also tend to make thinking worse, accelerate cognitive decline, and they increase fall risk.
- Same goes for antipsychotics like Rispderdal, and we usually consider these mainly if someone is having really bad delusions, paranoia, or aggression. Always best to try behavior management strategies first.
- The SSRI type medications (Lexapro, Celexa, Zoloft, Prozac) can help somewhat with anxiety, but they take weeks to kick in. We usually try them.
- We might try trazodone. It seems to have less adverse effects in older adults than other medications for sleep. Mirtazapine is another anti-depressant that often makes people a little sleepy.
- A few memory facilities have a night program because some people with dementia end up being up at night and asleep during the day. Adapting yourself to this approach may not work out but it's something to know about.
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