Can a doctor write a script that states "may not live alone?"

Mixedup asked...

What do we do??? I am caring for my mother in law who is undergoing treatment for stage 3 breast cancer, has had 4 mini strokes and now has dementia begining as well as some other medical problems. She has been living with my husband and I since the begining of Jan. this year. As it started it was due to lack of strength from the strokes and not being able to be at home alone, now with the dementia starting when 3 o'clock gets here you may as well hang it up the off the wall comments sometimes violence and crazy actions start. Here is the big problem, she has to use a walker now and wants to go home but there are numerous safety issues at her home and now with the dementia begining we don't feel like she could safely live alone. Doctors cannot confirm dementia due to her frail state undergoing cancer treatments...what do we do?? She loaded up some of her clothes on her walker seat this morning and was going home and I had to stand in her way until she went back into the house...again what do we do?? We have home health nurse and physical therapist comming and after I got her back into the house I called the nurse and she is sending a social worker to evaluate her on Monday sometime, unless she comes first thing in the morning or late afternoon she will not see much. Has anyone ever asked a doctor to write a script that states "may not live alone"?

Expert Answer

Joanne Koenig Coste is a nationally recognized expert on Alzheimer's care and an outspoken advocate for patient and family care. She is the author of Learning to Speak Alzheimer's. Also, she currently is in private practice as an Alzheimer's family therapist. Ms. Koenig Coste also serves as President of Alzheimer Consulting Associates, implementing state-of-the-art Alzheimer care throughout the United States.

Absolutely! Many doctors write prescriptions stating a 'cognitively-impaired' person should not live alone. As soon as possible send an email or write a letter alerting your mother-in-law's physician to her current status including your fears. Schedule a visit late in the day to assure he witnesses her change in behavior. This phenomenon is called 'sundown syndrome' and manifests late in the day characterized by mood swings, agitation, paranoia, and decreased understanding of reality. It occurs in approximately 45% of folks diagnosed with Alzheimer's disease and in many other neurologic illnesses. Your m-i-l has been through a great deal of physical assault to her body and brain; it is quite logical to assume she may have some form of dementia happening as a result of her medical condition or as part of the aging process. Only a neurological workup can confirm the prescence of a dementia; her frail condition would most likely negate this type of extensive review. Having her nurse and physical therapist as a part of the evaluation is a wise decision. Again, schedule their assessment of your m-i-l as late in the afternoon as possible. They need to witness firsthand the real picture of her change in behavior and mental status. Depending on her financial situation, I would encourage you to seek alternative living conditions such as a good assisted living community where her physical, social, and cognitive needs can be more easily met. Family visits, early in the day, then become more positive interactions and pleasant occurrences. Hiring a companion to be with her in the afternoons may also be helpful. Many religious and community organizations have volunteers who offer in -home companionship to an ill elderly person. Check with your local Council on Aging for possible contacts. This is as much for you as it is for your m-i-l! With all that is going on in your home, do remember to take care of you!