Am I the only one who questions why doctors still treat 95 year olds for every ache and mention of something?

This sounds like my dad. 95 and in MC. Wheelchair bound, dementia, on a lot of meds, but you know what? Right now, he is the most settled in that I've seen him in 5 years. He's been in MC for 7 months. His anxiety is all but gone. Yes, he fixates but that's to be expected. His blood sugar is at a level it hasn't been in years. His blood work is better than mine. His edema and wound care in his legs is finally under control after many years. He's in a good place and has settled in well. They know how to deal with his dementia behaviors. I think everyone concerned understands we aren't going to 'fix' anything but all of this is keeping him comfortable.

Hi,
You might want to review this list of medications, or do further searching online (this is from 2008).

http://www.dementiacarestrategies.com/Medications_to_Avoid_in_People_with_Dementia.pdf

My mom had been on detrol for years for her weak bladder. That's contraindicated in patient's with dementia. Quite frankly, she was at a stage in her incontinence that it would have had little effect anyway--full blown incontenence is not going to be controlled by a med. We stopped the detrol and moved her to disposable underwear and frequent bathroom trips.
One of the things that can happen is that the specialists add meds to the list but then let the PCP manage them. Explain your goals to her provider--that is removing or reducing the amount of pills, and having anything contraindicated for dementia removed.

Maggie, I agree with everything you said! Hugs 🤗

I will always remember my mom crushing up dad's cholesterol meds and mixing them with jello to try to get them in him--while he was in active Hospice.

One day I was watching her do this and I asked "what is the actual POINT of this exercise in futility, mom?" She just looked at me with this 'huh?' look in her eyes. The chol. meds were discontinued that day. SMH, still after 17 years.

At that point, all he wanted was the morphine and Valium.

"anxiety, incontinence, dementia related, pain (arthritis), GERD, BP, cholesterol, neuropathy (not diabetes related)."

I would ask that the dementia related pills be stopped. They do no good after a certain point. Also the cholesterol. She's 95 and it has been proven statins contribute to dementia. They also eventually effect the liver and should be stopped when the enzymes are ellivated. Is she still walking? If in a wheelchair, I would have the neuropathy meds stopped too unless for pain. But then she is getting pain meds for arthritus. I would also have labs done to make sure the meds are leaving her body. Elderly don't seem to get rid of meds like younger people so they build up in the system. She may be able to take a lower dose.

Just read they build up because of kidney problems and dehydration.

At least get her off the cholesterol medication. Higher cholesterol in the elderly is protective and a good thing. Not to mention cholesterol meds can permanent damage tendons. And she's 95 does it really matter if her cholesterol is high? Sometimes I have to wonder about these doctors and their ridiculous nonsense in what they will and won't prescribe.

You can make the decision to stop medications that she may no longer need.
Medications for dementia do not work forever. At some point they can be discontinued as there is no longer a benefit to them. (If you do decide to discontinue it consult the doctor as some have to be discontinued slowly)
If mom is incontinent is a medication for incontinence actually helping? If not talk to the doctor about discontinuing that as well.
When I signed my Husband up with Hospice they gave the option of continuing medications he was on or discontinuing them I decided to discontinue Cholesterol medication and the Aricept (dementia med). He was on Hospice for 3 years after discontinuing the meds and it was a "routine" decline for what I presume to be Vascular dementia as well as the Alzheimer's. Discontinuing the meds did not seem to be detrimental to him.
But since, I presume you are POA for m om it can be your decision to discontinue meds and other treatments.

The doctor will keep providing the service as long as the service is requested. That's why we have to take charge of our own health decisions, or have a family member who will take over those decisions for us. Only a geriatrician is likely to hesitate keeping this stuff going indefinitely

If your mother isn't competent to make those decisions, who is making them for her? After consulting with my mother's hospice nurse about whether we were doing too much for my mother, I made the decision to discontinue her meds, except for those relating to comfort care. After stopping the blood pressure meds and diuretics, her edema disappeared rather than worsened, her BP remained steady, and she was finally COMFORTABLE because her body wasn't being forced medically to do things it really couldn't any longer. She lived another three weeks, and her death came naturally.

While I don't really advocate setting a random date like turning 83 as the time to stop using medications or seeing doctors, it is important for both doctor and patient to understand when the body is no longer metabolizing those medications properly and they're no longer working. My mother was on Lasix for seven years, and it didn't do anything for at least the last three years. I'm no doctor, so I didn't know that it was probably pointless to keep pouring that stuff into her, and the BP and blood thinning medications she took were more preventative to keep her from throwing a clot that anything else. She never had high blood pressure a day in her life, nor did she ever throw a clot either before or after being taken off those meds.

Make sure you're clear with your doctor and on the same page about what quality of life means to you. You're absolutely correct that once upon a time we would go along with our lives, then have a catastrophic event like a stroke or heart attack, then die. I don't care how much technology and medical advancements there are, I don't believe our bodies were meant to last 95 or 100 years, and we shouldn't keep pouring drugs into our systems to pretend they were.

My mother will be 95 in January, with pretty advanced dementia, living in Memory Care AL, wheelchair bound with non-diabetic neuropathy (20+ years now), pulmonary hypertension, GERD, depression/anxiety, incontinence, high BP, and AFIB. The reason why her doctor prescribes meds and sees her weekly is because my mother demands medication for everything! She's had a wart for 5 years that she's demanded be removed over 20x so far! She claims she 'wants to die' yet begs to be rushed to the hospital for everything under the sun. Fights off hospice tooth and nail, when hospice would give her the RELIEF she's desperately seeking. While she's 'too far gone mentally to make decisions', she's with-it enough to demand medications left and right, then complain that she's taking 'so so sooooooooooo many medications' all day long! Her blood work is always fine, and even though she has pulmonary hypertension, her EF is 50% which is quite normal for her age! So physically, she's not in THAT bad condition, but mentally, she's been in bad shape for a long time, even before the dementia set in.

So in my mother's case, it isn't the doctor who's insisting on all the drugs, it's HER! While she claims daily she wants to die and we should 'throw her out in the street' and yada yada, here she is, doing everything in her power to cling TO life, only to complain bitterly about it every single day. Makes NO sense to anyone.

I feel like the doctors are damned if they do, and damned if they don't. If they help the elders, they're the bad guy & in cahoots with Big Pharma. If they don't, then they're accused of leaving them to die. I'm glad I'm not a doctor myself, personally. And I'm glad I'm not 95, too.

One word, my friend.

Medicare.

This why a 95 year old can have a team of specialists. Access to every kind of medication. All kinds of expensive medical equipment along with physical/occupational rehab therapy just to be returned to their wheelchairs to sit out the rest of their days. It's because these old folks generate a lot of money. Throw in if they have Medicaid as their secondary insurance, and sky's the limit.
Of course none of this is for say a younger person with lesser insurance who would actually benefit from it. This of course is because a younger person may recover and the medical industry wants repeat customers. Especially ones who they can bill to Medicare and Medicaid.
I don't think it's necessarily a blessing for people to live as long as they do. You are right people did die of things like heart disease, stroke, or just plain old age.
People did not live long enough to get to the point where they became so out of it from dementia as to be totally invalid and require a professional facility staff to care for them.
It's all about the money. It's almost guaranteed today that if a person lives long enough they will be on Medicaid. This is so because every cent or asset they ever had in their life had to be spent on their "care". Finally, when they are completely beggared they go on the state for a nursing home. Quality of life is not a factor. Quality of insurance is what matters now.

Unless your working with a gerontologist, doctors are not trained on end of life care. They are trained to fix medical conditions. There is no reason a 95 year old needs to take 22 pills. Some may be necessary to control pain and offer comfort. BTW, there are no meds for dementia. Meds are be prescribed for the disease that is CAUSING the dementia symptoms. Without knowing the cause, prescribing any drug for a neurodegenerative disease is inappropriate to say the least, and may cause more harm than good. Someone with AD may be prescribed certain cholinesterase inhibitors such as Aricept or Excelon. Prescribing these drugs to someone with FTD, however, can have an adverse reaction. It's important to know what's causing the dementia. That said, no drug is effective once a person is in the later stages of the disease.

As cwillie says, it's time to discuss palliative care for your mom.

Let's begin by saying this: I love my mom more than anything. She's been my support, best buddy, and at times, frenemy. But it's just ridiculous what is being done to extend life. She's 93 and just becoming miserable with the goings on of everyday life. She aches all over, she's incontinent for urine, her memory is lapsing. I will miss her more that life itself when she goes, but really folks? Enough. I applaud her doctor who offered prednisone for her body pain (which may be a throw back to a polymyalgia rheumatica). "I don't know why you can't take it if it can help with the pain. It's not like the meds are going to impact your life expectancy. Take them to make you feel better." Excellent advice! Other than comfort drugs, let's stop with the life extending drugs once a person hits 90.

I freaked out when my mom's doctor suggested discontinuing most of her medications (what I feared most was a debilitating stroke that left her even more compromised), even then mom lived many years after that point and she did not die from heart disease or stroke. If you are your mother's healthcare proxy then there is no reason you can't discuss palliative care with her doctor with an eye to reducing medications while preserving quality of life.

Can you please provide a little more information?
- your profile says your mom is in IL, even with "stage 5-6 dementia"... how is this possible?
- Are you your mom's PoA? If not, who is? If no one, then is someone pursuing guardianship for her?
- who is taking her to the doctor for every ache and mention?
- who is administering her meds to her?

Thanks for clarifying your post!