Severe Dementia and Doctors

3 Questions to Ask the Doctor About Severe-Stage Dementia

1. Are these drugs necessary? The medications your loved one has been taking for months may no longer be warranted or be at the appropriate dose for his or her current mental state. Often you won't know unless you ask the doctor. Most memory drugs, for example, have lost effectiveness by late-stage dementia if they've been taken for a long time. Drugs for other conditions can often be safely discontinued now as well, saving money, the hassle of administering them, and possible side effects. Instead of automatically refilling prescriptions, bring a complete roster of meds to the next doctor visit and ask to have them all reevaluated.

2. How often are checkups necessary? By the time your loved one has severe-stage dementia, there's little benefit to seeing six different specialists for the management of multiple conditions. Talk to each doctor to find out how care can be simplified. Ask one doctor to be the lead person coordinating care, if this isn't already in place.

3. Is palliative care an option? Palliative care is comfort care; unlike hospice care, the patient doesn't need to have a short-term prognosis. Palliative care is ideal for those with advanced dementia because it minimizes aggressive care, supports home care (but can also take place in facilities), and emphasizes following the preferences made in advance directives. A team of specialists provides care, which is also greatly supportive to caregivers.


over 3 years ago, said...

as soon as I found out my precious lady had Pick's...I went straight to the internet, and found out one of the drugs was not good for Pick's...Dr...agreed...how about that......took her off, and I seen an immmeadiate change for the good


almost 4 years ago, said...

Very interesting as I'll be taking Mum to the doctors tomorrow and there'll be a few things that I'd like to ask him, about her meds. Mum currently takes four, dipryodomole, simvastatin, asprin and alendronic acid tabs for bone weakness. Now that last one she sometimes don't get to take as the careworkers that come to the house are sometimes at another clients house for whatever reason. They are also trying to get a hospital bed for too however the criteria has changed and those that need it must be bedbound for 16hours or more. Mums' condition has deteriorated and she is now non weightbearing, don't speak too much or at all but there is one thing she does quite regularly, and that is she take her incontinence pad off during the early hours when we're in the land of nod! I have no idea how she does that especially when she is in bed and with little to no energy. I do find it rather amazing but unamusing as do the carers that come in and help get her ready in the mornings. I would be grateful for any suggestions to keep her in them overnight. Thank you.


about 4 years ago, said...

Hello - this is timely e-mail as I am now looking for some sort of medication that will reduce my mother's fury/anger at aides trying to help her, especially at nighttime with getting her to bed. She is basically moderate stage ALZ and since her stroke in 2008 has been surrounded by aides--and been frustrated by that all along---but in last several weeks her anger is accompanied by throwing things, trying to slap, kick.....Someone suggested seroquel but I've read and heard much negative about it----someone else said trazadone......and I am hoping there is an "alternative" such as Bach's Rescue Remedy (which I'm trying myself this week to get a sense of efficacy?)? I know medications and side effects, etc are different for each person, but I am very nervous about putting her on anything. She takes 150mg daily of setraline/zoloft. I hate to give her anything that would add to her confusion and make her feel sleepy! Any advice/insights are welcome!


over 4 years ago, said...

This is very helpful information. I am taking my husband to new doc who is a neurologist for re-eval of meds. He has early onset ALZ & has been on meds 5 years. He is now 71, but has had problems for last 10 years. This is breaking my heart. God Bless all of you dealing with this unfair disease!!


almost 5 years ago, said...

My husband has just been admitted to Hospice care. They have not changed any of his medications yet as he continues to have some "behavior" problems: squeezing arms and hands when he is given a shower or changed. The pharmacist is not ready to take him off any meds yet. He takes Galantamine, Namenda, Atavan and Risperdol. I don't like the last 2 but have given up on asking that they take him off of them. He sleeps alot. Heartbreaking.


almost 5 years ago, said...

'm always amazed about how 'hands-on' you are. We went to my husband's nuerologist last month and he told me to stop the Aricept. When I asked why, he said it had probably slowed down the progression as much as it could and there was no reason to continue ingesting a strong drug. So we've stopped and suddenly your litle suggestion appears. I really appreciate all you do. Thx. so much.


about 5 years ago, said...

Arms me with information I need when I meet my husband's physician. Explained difference between Hospice and Palliative care. My husband has just been admitted to Hospice.


about 5 years ago, said...

I am amazed once again that Caring.com sends me emails with topics that are so timely for my situation! I am grateful for all of this input and for the comments of others in my shoes. Just last week we took my mom off all blood pressure meds as they were no longer doing anything (despite 3 meds she was running around 200/110!) and she dislikes taking them. She is now on comfort care only which is very appropriate as I certainly do not want to prolong her death or her life since she is so completely disabled...does not speak, smile, swallow well, and of course cannot do any self care herself.


about 5 years ago, said...

I had the hospice nurese reevaluate the meds last month. Mom had a couple of real good weeks where she was more alert and more active. I think removing two meds was helpful. My dad had worried about keeping appointments (because they were already scheduled) instead of recognizing that the presence of the hospice nurse a couple of times a week replaced the need to deal with the hasstle of getting Mom dressed, into the car, to the office, waiting , , ,etc, etc,


about 5 years ago, said...

All three points are valid. I had already taken these steps, but others might reqire the suggestions.


about 5 years ago, said...

It was helpful being informed that a re-evaluation of medications should be inquired about by the caregiver rather than waiting for the doctor to make that determination himself. He is likely not fully aware of how long the patient has been taking the prescribed demential medications and whether or not it is still effective. It is important to take a proactive approach in the care and management of our loved one afflicted with dementia and not expect that the doctor will always be on top of the patient's condition.