Need assistance with several questions.

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meds, not sure doctor is helping, I just want to cry


KH1913: We really need more information. Is this regarding your Aunt? If you could be specific we might be able to offer some suggestions. I can see you are not happy with what the doc is doing. Take a deep breath and tell us what is happening.

Hugs, Cattails
Sorry new at this my aunt is 98 and in January she fell in her home and broke her femur. After surgery and 3 months in rehab she is home walking with a walker and physical doing great but her dememtia is really bad now. She has been on excelon for two months and then the doctor also gave her Namenda twice a day. The second day she was remember things better than she has in several years. But her words were slurred and she looked drugged. He now has taken her off and he is giving risperdal and said it was to help her sleep but I see it is for schizophrenia. She does have outbursts of angry but this is when you try to tell her she has to use her walker etc. When the excelon and namaenda was working she new she had to use her walker. Now the doctor has removed the namenda and has increased the reisperdal to twice a day morning and bedtime. I can't get the doctor to even talk to me. I just talk to nurses. I think my aunt needs to be supervised to see which meds is going to work for her. I am trying to do all this by myself and work full time, paying a cna to stay with her during the day. I have only been married for two years and I have been living at my aunts since April. I just want her to be in her home and happy. And that is where she wants to be but it seems the doctor will not work with me at all. Help please
Yes, one use of risperdal is for schizophrenia, however it is a very common drug with those with dementia. It helps with the agitation that is associated with dementia.

Another possible drug combo is aricept/namenda. It really all depends on the doctor. You are better off setting up an appointment because I learned you cant really get you point across on the phone.

As for her "being in home;" there will come a point were that will most likely no longer possible. Her safety is always the number one concern. Have you ever thought of an special needs assisted living (In NY they are called SNALRS) that deal with dementia. It would give her the 24 hr supervision she needs and also the freedom for you to live in your own home.....just something to start exploring.
KH: Do you have POA for your aunt? Are you designated as someone the doctor can talk to? What kind of doc does your aunt have? Is this an MD or a geriatric doctor? Is this doc one that specializes in dementia? If you think the doc is a good one and your are authorized to speak for your Aunt, please make an appointment with him/her for a consultation.

Bless her soul, your aunt is very elderly. I'm so sorry for her mental issues, but please remember that she has had a wonderful life and your care and concern has made that possible.

Sending you love and best wishes. Cattails
Dementia is very hard to treat. As you know, it is not curable, but often symptoms can be helped with drugs. I am glad to hear that your aunt has a doctor who is willing to try. Even among the most experienced doctors it is a matter of trial-and-trial again, because individual reactions vary so widely. Also, there are very very few drugs developed specifically to treat dementia symptoms, but drugs developed for other purposes are often helpful.

All of which is to reassure you that what Aunt is experiencing with her doctor is not unusual and it is not a sign the doctor isn't competent. Accompanying her to appointments and establishing a relationship with the doctor will make future phone calls more productive.

I hope that Aunt can remain in her home. She may be eligible for more help than she is getting ... and without you paying for it. Call Social Services in her country to learn what might be available and how to apply for it.

It is very common that dementia patients cannot safely stay in their own homes in the advanced stages of the disease. Social Services can help you identify what care center options are available if that becomes necessary.

Bless you for your concern and your hard work on behalf of your dear aunt. She is lucky to have you.
Her doctor did get her into a nursing home yesterday but I feel she really needs assisted living with a dementia unit which we do have here locally. Now I do not know if I can move her without the doctors permission. I think an assisted living would be better for her spirits and health because she has always been an independant person. I just could not do it anymore and it breaks my heart. I could not walk her into the nursing home my brothers wife went with me and my husband. I walked in after the took her on to her room. This has been the hardest thing I have ever done in my life. Anyway I am hoping that I can move her without the doctors permission into an assisted living. As I stated I am her POA of both health and property. Does anyone know if I can???
Kh: I don't think you can move her to assisted living without a doctor approving the move. Is your Grandmother's doctor an MD or a Geriatrician? What precipitated the move to the nursing home? Did her doctor talk to you about it?
My Aunts doctor is an MD. I am the one who started calling about assisted living or nursing home. When contacting nursing homes even the one she is in said they thought she need assisted living that has a dementia unit. Then I called the doctor and he said no a nursing home. He called the one he is a doctor at (which is one I had already spoken to and they had said she needed assisted living) and he got her in. I have been upset with him for a while anyway. And now with the way he is doing her meds. He will not listen to me about how it is effecting her. He is a doctor at more than one nursing home and it is hard to even get into his office to see him. Usually the ask do you want to see the nurse practitioner. I really don't take a 98 year old to see a nurse practitioner, I want her to see the doctor. I am hoping when I go visit a place on Sunday, which is assisted living with a dementia unit (she goes to bathroom alone, gets her own drinks or cookies) that I can get her moved and if I have to change her doctor I will. She mainly would need help with meds reminders and bathing. And I really believe if he would have listen to me when she started the namenda with the excelon (and explained the namenda needed to be 12 hours apart) she would still be at home and I think she could have been there by herself. That is one problem when you explain something like the namenda was helping but you did not say it had to be 12 hours apart I think if we do that she will be good and not looking drugged or slurring her words he just blows you off. That day when the namenda was working with the excelon was a miracle. He instead wants to increase what he is giving her to sleep to twice a day (which is the risperidone for schizophrenia) this makes her hardly even talk. Help please can I move her and if I have to change her doctor to someone who is will to work and try to help her. I know the dementia will not go away but that one day it was like my aunt from 5 years ago...If only that doctor would listen.. HELP
KH: I would suggest that you find a geriatric doc and take you Aunt for an evaluation. You could talk to staff at the AL with the memory unit and see if they can recommend a doctor who is highly though of for his work with dementia patients.

As her POA, you have the right to change her doctor. I can't imagine the frustration of trying to advocate for someone when their doc refuses to listen or speak to you.

You may want to consider keeping your aunt in the NH while changes in her meds are underway. See how she responds before moving her to AL. You will want her to have the best chance of success in AL.

No facility will take her without written documentation from her doctor. Start looking for a new doc that you can work with.

I was thinking about asking the assisted living I am looking at if there house doctor might take her on as a patient. Right now the sooner I get her moved the better because her funds will run out faster at the nursing home and really the doctor is not doing anything with her meds now. Just therapy, which she was getting at home. The way I am looking at it right now if he does not agree I will take her out of the nursing home, take her back home, then find her another doctor if the assisted living can be of no help with getting a doctor at this point.

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