Ladislav Volicer, M.D., Ph.D.

Caring.com Expert

About

Ladislav Volicer, M.D., Ph.D., is a courtesy full professor at the School of Aging Studies, University of South Florida, Tampa, and visiting professor at the Third Medical Faculty, Charles University, Prague, Czech Republic. Twenty-five years ago, he established one of the first dementia special care units and introduced the concept of structured palliative care for patients with advanced dementia. He is recognized as an international expert on advanced dementia care and was recently an invited speaker in Southeast Asia and Australia. He has published more than 200 articles and chapters and edited four books on the clinical management of dementia.

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Recently Published on Caring.com

  1. Monday February 20, 2012

    1. What medications are effective in minimizing angry outbursts?

      Answer - I appreciate very much that you are trying to maintain contact of your mother with your children. Unfortunately, there is not a specific medication for angry outbursts. However, people who are depressed are very often angry and have a short fuse...

  2. Friday November 18, 2011

    1. Are the symptoms of frontal temporal dementia basically the same as Alzheimers? I guess what I'd really like to know is will my husband of 40 years who has been diagnosed with FTD likely to forget me and the rest of his family?

      Answer - As his dementia progresses,your husband may become confused about your identity. For instance, he may consider you to be his mother. However, it is impossible to predict when that would happen and he will be always comforted by your presence.

    2. Is my mother's behavior caused by strokes or is she developing Alzheimer's?

      Answer - Hallucinations and delusions could be symptoms of both vascular dementia and Alzheimer's disease. Very often, both of those diseases are found together when the brain of pople who died with dementia are examined. Rapid changes are more likely caused by vascular dementia (small strokes) and there may be some improvement later...

  3. Thursday November 03, 2011

    1. If my mother is in late-severe stage of Alzheimer's, how much longer should I expect her to live?

      Answer - You do not describe in which way is your mother suffering but she should not be suffering if she receives compassionate care. Try to involve her in a hospice program because hospice staff is skillful in stopping or preventing suffering.

  4. Friday October 21, 2011

    1. Should I still take my dad with Alzheimer's to the dentist for regular checkups?

      Answer - Not cleaning his dentures may allow overgrowth of pathogenic bacteria in your father's mouth that would increase his risk of developing aspiration pneumonia. Dentist might check for possible presence of mouth cancer.

    2. What it a person's life expectancy if they have late stage Alzheimer's?

      Answer - It is impossible to provide prognosis for your mother because Alzheimer's disease does not cause death itself; death is caused by complications, most often pneumonia, and it is impossible to predict when she might develop such a complication...

  5. Wednesday October 19, 2011

    1. Should I get a second opinion about my friend's condition based on his behavior?

      Answer - I am sorry to read about your problems with your friend. His behaviors are not unusual for somebody with dementia. He is becoming more and more dependent on you as his dementia progresses. It may be useful to get him evaluated by a geriatric psychiatrist for presence of depression. Treatment for depression may improve some of his behavioral symptoms...

  6. Sunday October 16, 2011

    1. Is it typical for Alzheimer's patients to make up stories?

      Answer - People with Alzheimer's disease may develop delusions (false beliefs held with absolute conviction despite superior evidence) and hallucinations (perceptions in a conscious and awake state in the absence of external stimuli which have qualities of real perception). These symptoms may cause them to tell stories that may not be true...

  7. Monday August 08, 2011

    1. Are bouts of deep sleep associated with end stage Alzheimer's disease?

      Answer - Increased sleepiness is very common in late stage Alzheimer's disease. However, if your mother is only in the moderate stage, there could be other causes of her deep sleep. She might have an absence-type epileptic seizures that is characterized by stopping all movements and looking asleep...

  8. Friday July 15, 2011

    1. If my mom with severe Alzheimer's is sleeping a lot, does that mean the end is near?

      Answer - Sleeping a lot is a common feature of advanced Alzheimer's disease but I do not know of any evidence that sleeping a lot would decrease the length of survival. Make sure that sleeping is not related to a medication your mother is taking. Many medications used in higher doses may cause sleepiness.

  9. Thursday July 14, 2011

    1. What is the life expectancy of person in the 'severe' stage of Alzheimer's disease?

      Answer - It is almost impossible to determine life expectancy in somebody with severe Alzheimer's disease. It is because people do not die of Alzheimer's disease itself, but of complications, most often pneumonia or another infection. It is difficult to predict when they will get an infection and if they get it, if they will recover from it...

  10. Monday June 20, 2011

    1. My Mother is 93 year old with Alzheimer's. What medications can help reduce her anxiety?

      Answer - You should try first non-pharmacological means to reduce anxiety of your mother. Try relaxing music, comfortable environment, lavender scent, etc. If that is not sufficient, it is possible to make a solution from anti-anxiety pills, such as Ativan. You need a pestle and mortar to grind a pill into fine powder and suspend that in milk or water...

  11. Saturday May 14, 2011

    1. What is the difference between the Exelon patch and the Aricept pill?

      Answer - Exelon patch is causing less side effects than Exelon pill but has the same effect as Aricept pill. So you would not get much benefit except may be from easier administration.

  12. Monday March 28, 2011

    1. Is Seroquel safe for an elderly dementia patient?

      Answer - Giving Aricept in the evening may cause nightmares and sleeping problems. If your husband is not having delusions or hallucinating, Risperidone may not be appropriate and he may benefit from an antidepressant.

  13. Thursday March 10, 2011

    1. Is this behavior delirium or is it associated with end-stage Alzheimer's?

      Answer - It is difficult to answer your question without seeing your mother. A delirium may occur at the end stage of Alzheimer's disease but is usually caused by an infection or another disease and does not resolve spontaneously. Your mother might have a catastrophic reaction that occurs when the person with dementia is exposed to a stress...

  14. Sunday February 27, 2011

    1. Is it normal for an Alzheimer's patient to swing very noticeably between good and bad days?

      Answer - It is not unusual for persons with Alzheimer's disease to have good and bad days. You can check for effectiveness of medication by decreasing the dose and observing if it makes any difference. However, I am afraid that the condition of your husband will worsen significantly if you discontinue the medications...

  15. Tuesday February 22, 2011

    1. Can Alzheimer's patients express pain?

      Answer - A person with Alzheimer's disease can feel and express pain non-verbally, by facial expression, breathing, vocalization and body posture. One of the scales to measure pain in non-communicative patients is looking at following symptoms:

  16. Thursday February 03, 2011

    1. My mom was recently prescribed Haloperidol as a sleep aid....

      Answer - Haloperidol is not a medication that promotes sleep although it may cause sedation in high doses. It can cause rigidity and increases the risk of a stroke and sudden death. Haloperidol should not be prescribed unless your mother has delusions and/or hallucinations that are disturbing her...

  17. Friday January 14, 2011

    1. Is a physical decline common in late-stage Alzheimer's?

      Answer - Unfortunately, physical decline is a part of dementia progression. Your mother needs physical assistance, because her brain controlling her muscles is damaged. Eventually, she might not be able to walk without assistance. However, you still need to provide as much activity for her as possible.

  18. Friday December 31, 2010

    1. Is there anyway we can help with my husband's Alzheimer's confusion?

      Answer - Your husband is losing the ability to comprehend what you are telling him. He might not be able to distinquish left and right. You might want to use non-verbal means of communication, e.g., modeling what you want him to do. I am sure that he is not doing this just to make you mad, it is the disease...

    2. Dad forgot how to stand - is this a normal progression of dementia?

      Answer - Unfortunately, losing the ability to walk even with help is a common consequence of progression of dementia. Your father is not "giving up", he just lost the ability to coordinate function of his muscles to allow standing. You might need to try to maintain his dignity and freedom by using a wheelchair...

    3. Is it normal for someone with Alzheimer's to stop "seeing" pictures and the television?

      Answer - Vision problems as a consequence of Alzheimer's disease are rare. Most likely, your mother does not recognize what she sees because of lack of comprehension caused by the Alzheimer's disease. It is quite common for individuals with Alzheimer's disease to live in the past and consider current people to be persons from their past...

  19. Tuesday December 21, 2010

    1. How does Rapamycin help fight Alzheimer's disease?

      Answer - There is no evidence that rapamycin can fight Alzheimer's disease. It was effective in one mouse model but increased production of beta amyloid in another study. I am not aware of any research that would document beneficial effect of immunosuppresive drugs in Alzheimer's disease.

    2. Has there been any research done about Alzheimer's and the use of cord blood?

      Answer - Cord blood stem cells were investigated in cell culture and mouse model of Alzheimer's disease. Cord blood cells were effective in decreasing toxicity of beta amyloid protein and in improving cognitive function in mice. However, no human experiments in Alzheimer's disease with cord blood cells were reported so far...

  20. Friday December 17, 2010

    1. Should Mom's doctor have been so quick to put her on Aricept?

      Answer - You do not mention if your mother-in-law's doctor did any testing of her memory and cognitive function. Aricept may be indicated if the doctor found some cognitive impairment. However, you may also make your mother-in-law aware of non-pharmacological strategies for maintaining or improving memory...