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Mom has been hallucinating lately, she has ALZ is 87 and is living in memory care. Doc has prescribed anti psychotics.
I don't want her taking them she's already on so many pills.
She isn't lashing out or hurting herself or anyone else.
She sees things but is matter of fact about it.
Does anyone have any experience with this?
Thanks,
Sissy

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Some drugs may indeed increase the risk of death in the elderly dementia population. It is the FDA's responsibility to point that out.

Having cared for my husband and my mother with dementia, the increased risk of death would not deter me from trying a way to improve the quality of the life that remains to them. I would rather that they (or I) live another 2 years in relative contentment than suffer another 3 in agitated turmoil. I'm not talking about having benign hallucinations -- that can actually add interest to their lives -- but severe disorientation, anxiety, fear, and general misery.

I agree with Veronica that close observation should follow the prescription of ANY drug, for any population, for adverse side effects and for effectiveness.

I once took a medication that solved the problem it was prescribed for, but also made my vision so blurred I could not use the computer! I was competent to discuss this with the pharmacist and with the doctor, and the med was stopped. A person with dementia may not be able to make these kinds of connections and so continues with the side effects.

It is critical that people who cannot advocate for their own health care have someone to advocate on their behalf. I congratulate sewingsh for this advocacy.
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Do the hallucinations scare her. Mom always saw a little girl. Her neurologist didn't want to give her meds unless the hallucinations bothered her. And what doctor is prescribing? I would also go over her present meds to see if anything is interacting with each other. Sometimes elderly are over medicaded.
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Sunny girl they ask those questions to judge the level of orientation of the patient.
I was frequently asked where I was.
Once I was asked the time of day. Well the clock said 3 o'clock. However the room was painted bright yellow and brightly lit so no way did I know if it was am or pm. It was always dark out side as the only view was a brick wall.

I agree that great care should be taken with antipsychotic medications as with all meds in the elderly population, as they frequently have nasty side effects and can have the opposite effect than desired.

Another hospice nurse and I decided that when we reached the end we wanted a huge bottle of liquid morphine ordered. I recently received a couple of separate doses of morphine and both times became very nauseated so I will have to research a different drug!!!!!!!!!
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I'd speak with the doctor about it. Have you ever been in the room when he examines her? I was a little surprised that they do ask the patient certain questions, even if they have dementia. Like, where they are, how they sleep, are they depressed, have they thought about hurting themselves, have they been seeing things that aren't there (how would they know this?)  and others. I'd try to find out if there is something that you may not be aware of that caused the prescription.
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thanks everyone for your input here. I did ask the med tech to stop the medication until they find out if she has a UTI or not and then go from there. Again I don't see the reason to have her take anything that isn't necessary. I will talk to her doctor about this.
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I completely agree with Jeannegibbs. Ask the doctor what the reason is for prescribing the medication, the possible side effects and what he/she hopes is the outcome after your mother takes it. Until you know the reasoning behind the prescription, it is difficult to say whether or not you agree with her taking it.
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Anti-psychotics are a touchy subject. Some people swear they are life savers. The FDA warns against using them in the elderly with dementia. Hmmm.... Not that I believe for a moment that the FDA is always right, but they specifically spell out the increased risk of death in the elderly population with dementia. So....what to do?

I used to be a lactation consultant in another life and I will tell you that there were medications that could be used to increase a mother's milk supply but that was not a reason for the medication so doctors did not want to prescribe against "label" use. Why? They were worried about the effect on the babies and on the formula industry's bottom line. The cynical me believes that the whole statute of limitations with the pediatric population plays into effect here. Lots of time to start a lawsuit, so docs are VERY careful with how they prescribe in the peds population.

In the elderly population? Not so much. Are they more disposable? Do we WANT them to die? To put them out of their misery? Of course not. Well, maybe? No, of course not. So why do we think it's ok to give a drug that is KNOWN to increase the risk of death if you take it? Benefits outweigh the risks? Maybe.

But again, in the peds population that is not an argument for giving a drug. Or at least those benefits better be overwhelmingly large and the risks better be overwhelmingly small. In the elderly population, if there is the slightest benefit to be had (and even if that benefit is only to produce docility and sleepiness) then we go for it. And if the risk if death, well then what the heck, they are going to die soon anyway, right?

I'm not saying that I don't think the elderly population with dementia should NOT get anti-psychotics for agitation and aggression.

I'm just pointing out the inconsistencies that I see with the arguments for prescribing these drugs.
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Is this the facility doctor or your mom's prior doctor before she was in the facility ?

The reason being, my experience is that the facility will try to medicate to their convenience

I unknowingly allowed the facility to start an antipsychotic when mom entered a memory care center and when I saw what it did to her I ordered it stopped - when I got her to an independent neurologist he shook his head and said they should not have been giving her that med in that manner

All that said, it took a couple of tries to find the right anti psychotic med for mom and I delayed as long as possible from starting one in respect of her wishes - she'll barely take a Tylenol

These are dangerous drugs but it's the lesser of two evils in mom's case
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Do you have any idea what your mother's attitude toward this subject would have been before dementia set in? I know that my mother really, really did not want to take pills. I think for her I would have resisted the new medication on her behalf.

My husband was willing and eager to seek improvements through medications. For him I would (and did) go along with all prescriptions and just watched closely for side effects.

Personally, I believe in better living through chemistry. I would want responsible pro-active use of medications, but with a loved one advocating on my behalf to ensure that no drugs were given just for the convenience of the facility.

Hallucinations are very hard to treat, and if they do not bother your mother I'm surprised a doctor would prescribe something for them. Are you sure that is the only symptom that concerns the doctor? Are there other, less benign symptoms, that might be involved?

My husband's hallucinations did not bother him and we did not specifically seek treatment for them. But Aricept did seem to diminish them.

Sissy, I hope you can have a conversation with the doctor who wants to prescribe the anti-psychotic to understand the full reasoning behind that recommendation and to discuss possible side effects and interactions with the other drugs she is taking.

I don't think there is a one-size-fits-all answer to should an elderly person take anti-psychotics.
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