How do I go about getting the right care for my father?
My father has had many problems (stroke, heart attack with two stents inserted, atrial fib, pacemaker, congestive heart failure and prostate cancer). He was doing well on his medications. In February, he had an episode where he started having hallucinations, insomnia and being agitated. My parents have been married for over 50 years and he is 82 yrs. old. The doctor prescribed Seroquel. This medicine says not to prescribe it to the elderly for risk of sudden death. But, it does seem to help him sleep and makes the hallucinations go away. My mother says that he seems fine, then starts not being able to get enough sleep and it snowballs into having hallucinations. We are wondering if he is getting dementia or what is going on. Then he seems to bounce back and it happens all over again. The doctor is old school and doesn't seem to give my mother much information. We are both frustrated at his care, but are helpless in what we can do. The doctor has to give out a referral for him to see a specialist, but that hasn't happened yet. His ejection fraction was about 20 several months ago. We don't know if his body is breaking down or if he isn't getting something that he really needs. Any advice or comment you have would be most helpful. I dislike seeing my father suffer and have looked for homeopathic medications to help him. He is taking some B1/B4 vitamins that are making him feel a bit better. Any advice, please? I think his CHF and prostate cancer are pretty much under control, but advice about his insomnia and doubts of anxiety/irritability and hallucations (possible dementia) would be most helpful. I did a little research and my other seemed to think his posture and other symptoms may indicate Lewy body syndrome. Sorry for this long email, but I thought more details may help. God Bless you kind doctors and nurses!
Expert Answer
I am not a doctor or nurse; I am a geriatric care manager with almost 20 years of experience assisting families with older relatives improve their lives. My advice is to have an appointment with a geriatrician. This is a physician that has taken advanced training on how to work with older bodies. You may need to go into a larger town for this type of appointment but I believe it will be worth your effort; you may have to go only once. The expert's report can be sent to your regular physician, who can implement it.
Stay away from homeopathic remedies. Someone makes lots of money from these but they are not usually worth the money. This industry is unregulated, you will never know what is in the bottle. They can interact with prescribed medications and do some damage.
Seroquel has been great with all the people I work with. It helps reduce agitation and promotes sleep without the side effects of sleeping medications.
Check your father's water intake. Dehydration is dangerous and can cause some of the symptoms you mention. But the most important thing is to have him evaluated by a expert in older bodies!
Your father's ejection fraction should be tested every 6 months. Go over your physician's head and make the necessary appointments. If dad is enrolled in an HMO or other Medicare Advantage programs, wait until Nov 15, and get him out by enrolling in regular Medicare. Most of the medical schools and specialists will not accept reimbursement from any except Medicare.