When is it no longer beneficial to be taking medication for Dementia?
My mom never wanted to take her medications. Some of this was due to her paranoia however some days she would be fully focused and would express her humiliation and embarrassments of this disease. Now four years later she resides in memory care and more often than not she is in her own world. Other than the dementia her health is pretty good for an 84 year old. Recently upon reviewing moms care plan with the staff it was mentioned that occasionally mom would strongly flat out refuse her medications. So in light of her medical directive which refuses any life sustaining efforts did I want them to continue the dementia medications Galantamine and Namenda. I am so torn by this decision part of me feels it is wrong to not give her the meds on the other hand I remember how she felt so humiliated during her earlier stages. I know if she were able to see how her life is lived now or herself she would not like it. At this point are the meds only prolonging her misery? Is she really getting any benefit from taking the medication?
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The way to find out if they are helping any is to stop them and see what happens. Stop ONE at a time, so you can judge the effects. If there is no change, then discontinuing the drug seems appropriate. Do this with her doctor's guidance.
We stopped Aricept when my husband went on Hospice care. Amazingly, he was till getting benefit from it, so we added it back in.
Your mom doesn't like taking pills. The pills are expensive. The pills are intended for moderate ALZ. You are wise to question whether it is worth continuing them.
I am - bizarrely - quoting verbatim from the advertisement on this very page for the manufacturers of Namenda.
The question is whether your mother's medications are doing her any good. Doesn't sound likely, does it? I think Jeanne's advice - to halt the drugs in turn, under medical supervision, and review the changes if any after a set period - is exactly right.
Please do not feel guilty about your mom's meds. And, please remember you have done nothing wrong.
My husband has had Alzheimer's for over 10 years. The first 6 years he was on several meds including Namenda. Nothing resulted from these meds. My husband's condition continued to decline. His doctor finally indicated the meds were not doing any good "only making the pharmaceutical companies wealthy." So he was taken off of all Alzheimer meds, but continued his b/p and heart meds. His doctor also mentioned it was his medical experience that perhaps the only Alzheimer patients meds would help is if taken immediately upon detection. If not, it was likened to 'chasing a horse after the gate was left opened.' Sort of like a placebo...take the meds to soothe the caregiver into thinking it would slow or cure the disease of their love one while emptying out their pocketbook. I saw absolutely no change whatsoever after these meds were discontinued. NOTHING. Perhaps it helps someone...there isn't any proof out there (as far as I know) where these drugs are beneficial. The health field readily admits there is no known cause for Alzheimer's---only speculation and theory, so how could they know what slows or improves it! Commonsense, says; they do not. I suggest that labels on bottles are read thoroughly. Disclaimers are printed for a reason that...'there is no evidence the meds prevents or slows the disease...' Duh! Hope my husband's doctor and other medical personnel I have talked to are wrong, however, for my family, it just did not happen. "Hope in a jar" for 6 years was all that was given. Perhaps that is enough for those struggling each day. Sometimes hope is all we have left, however, it does make me bitter at times when I feel those threads of human fragility and weakness are being taken advantage of.
Good luck, God bless you. God bless all caregivers.
To tell the truth I doubt the Aricept had done much for him when we discontinued it. I did not see a noticeable decline after he discontinued it.
I also elected to discontinue a Statin he was on to reduce cholesterol.
At some point the medications to "slow the cognitive decline" will no longer work. It is a guessing game as to when the person has reached the point when the medication is no longer doing any good. And do you want to add another or not?.
Nothing will repair the brain and function will not return.
So the BIG question is...Do you slow the decline or allow the decline to continue at possibly a more rapid pace and allow the person to pass more quickly.
And who is to say how fast the decline would have been with or without the medication? Does it really do that much good?
Tough decisions to make and if you are like me your crystal ball is out for repair so you can not see what the future holds.
The only thing that you can go by is ..
What would my loved one want? Would they really want this to be prolonged?
At some point we begin to act selfish in not wanting to let go.
This is a once vibrant, loving person that is now unable to walk, talk, watch their beloved Cubs possibly win the Wo..not gonna say it and jinx it.....
I love this man with all my heart but I know he would not want to live like this.
Ok back on subject.
Follow your heart. Talk to the Doctor or to Hospice and ask them one simple question...."If this were your Mother, Father, Spouse what would you do, if this were you what would YOU want someone to do for you"?
I have both fear and anger against the current practices of medicating people, especially elders, for as soon as medicine sees frailty, they prescribe a pill for it. I tend to think our bodies are more like vision - some say that glasses ultimately make vision worse, for they make our eyes get used to functioning without the needed struggle which maintains strength and adds versatility. We can solve more if we are careful to use bright light when reading.
I do have a glasses prescription, and had a cataract operation on one eye, which improved a lot, to remove the cloudiness. But I lost my glasses a few months ago, and I do feel that I can manage, though I will find it easier to have the other eye done. And I got a pair of self adjusting glasses lens for each eye separately and those help for fine tuning tasks. So maybe the artificial assistance is good for short stress or needs, but ongoing is overdoing.
Yet in the complex, medicine-run residences, I feel like medications become the go-to solution, which patients don't need anywhere near the amount they receive, and the meds have the unappreciated side effect of remove the need for others to problem solve around how to work together to handle people better - learn to have short times of involvement, trade off staff if a crisis starts, train staff to notice how each individual thinks and to work to be alert to how they move best, and then, set them up to do so on their own, not do everything for them.
I know seizure meds differ some from Alzheimer meds, but all mood calming ones seem way over-used to me: since being there he has gained 40 lbs, and so he has a new diagnosis added: obesity. This one makes his life and ongoing movement, more difficult.
I was not able to continue to help him across the miles, so I agreed that he needed round the clock care and oversight, but I believe I could have done it better - if I was willing to make my life revolve around his care, which I was always advised not to do, and I would never want to be the Only person helping him. It is just a challenge that takes years, to see how to work positively with others in giving care!
I just visited him on the holiday, and we did two activities - brought another resident out with my brother, and the 3 of us sat out on a deck at a restaurant overlooking the river, for over 2 hours. Quiet, simple. Enough excitement for both of them. Helped them feel more able. My brother struggles to walk on his own, despite bal
But as many have said, there is little evidence that these drugs help and no evidence that they help a lot. Stop them one at a time, to see if she is a lucky one who benefits. Do not feel guilty if you decide to stop a medication which does her NO GOOD AT ALL.
Namenda and Aricept our a take as a combination. Neither will reverse AD but from a frame of mind point of view try aricept alone. No guarantee of hope but the patient if cognizant might feel that he is getting some help i Physiological approach.