We finally had to move mom to a nursing home with early-late stage Alzheimer's one month ago. The first 3 days there, we could still engage with her, but by the 5th day she was completely gone & hasn't been back since. We're not even sure she's aware of her environment at all most of the time, much less the people in it. Even the sense of familiarity that was present on days she couldn't remember us as individuals has disappeared. As her only daughter I know her about as well as anyone, & I can't identify any of her ramblings or behaviors to anything from her childhood or life that I have knowledge of. She's less than 5' tall, maybe weighs 95#, eats poorly & is usually at least borderline dehydrated for refusal to drink enough liquids. If I was allowed one sentence to describe my mother, it would be this. "Until about 5 years ago, she singlehandedly ran the world without any help from you, thank you very much!" She is no longer smoking, thank God...but it had become the worst of her OC behaviors. She herself was a caretaker of a couple family members, but when it came time for her to need the help, we hit a brick wall of resistance from the very beginning. We'd hoped she would allow the staff to care for her, but she's simply non-compliant about nearly everything. She takes clothing from other residents' rooms, wears it even though it's usually far too large, rolled & hitched up here & there...she looked like a clown coming down the hall one day. Takes charge of folks in their wheelchairs & such, & away they go down the hall...or detour off to a room! By the 5th day there, the unit's head nurse began hitting on me to allow them to medicate her due to her anxiety & 'busyness', & started pushing the idea onto her husband...she actually called him at home one day to lobby for it while I was there cleaning. We were angered that they were pushing for meds so soon, especially when we learned that she'd gone into acute cold-turkey tobacco withdrawals without being patched because AARP wouldn't pay for them. Heavy smoker for 60 years...cold-turkey. Throw in a sudden move away from what little in the world of reality she still had a precarious hold on, & severe anxiety & agitation might just occur. She paced, looked through every cart, bag, nook & cranny looking for tobacco. Wouldn't stay out of other residents' rooms or leave their belongings alone. But I argued that first, it was too soon to consider medicating her under any but the most severe situation, & then that what we were seeing in her behavior was her own personality under extreme strain & operating in dementia, that it would pass & she would adapt to her new environment & calm down. Sadly that hasn't been the case, and I'm even sorrier to say that the staff has already 'flagged' me for resisting them, as well as trying to figure out the clothing/laundry problem caused by her wandering & sharing habits. But after having been an in-home respite caregiver myself for many years & caring for several ladies long term, I also realize that the nurses & caregivers there can't take care of her like this, so it's time. I only know some of the older dementia drugs, so need a crash course so I can be her voice. Can some of you suggest the best online sites or inform me here as to what they may suggest or want to give her? My concerns are her size & historic over sensitivity to drugs of any kind. Please educate me or send me to school! Thank you ever so much.
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It is good to learn about the drugs. But you must also understand that what is true about drugs in general is true in spades for drugs for dementia symptoms: What works awesomely well for one person is a disaster for someone else. My husband did very well on seroquel, for example. It was our miracle pill that allowed him to sleep through the night without agitation and therefore allowed him to stay home. But other people in my support group had no improvement at all with it, and some got worse on it.
I would limit drugs to adding ONE at a time. If two are started, you'll never really know which one is causing side effects or if one isn't working at all. Start at a small dose. Your mother is small and drug-sensitive. She may stay at a small dose or may need to increase gradually. Don't start a second pill until she is stable on the first one (or is off of it).
Also realize that it is a risk/benefit decision. Sometimes doctors prescribe something that according to the general literature should not be given to the elderly or those with dementia. They do this based on more specialized literature, recent research results, and with an eye to how bad things are without the drug.
In addition to reading about the drugs, you'll probably want to read about how our treatment of those with dementia can affect their behavior.
Best wishes to you. Please keep in touch and let us know how this is going for you and Mom.