My mother-in-law is on anti-psychotic medication because of her Alzheimer's aggressiveness. Is fatigue and confusion a normal reaction to these medicines?

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When she does get up she is very unsteady, walks hunched over and shuffles. Lately, when we wake her she is completely "zoned" out and does not respond, can't stand, etc. doesn't know we're there. Is this normal for alzheimers?

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No this isn’t normal. I’m not a medical person, but I’ve ushered many elders through these medication nightmares. Your mother is being turned into what I call, a Zombie. This may only be because the doctor isn’t aware of what is going on. Occasionally, you’ll see this in a nursing home, because the old fashioned view was to keep the residents “manageable” with anti-psychotics and other drugs.
There is a place for anti-psychotics for some people with Alzheimer’s, but when they affect people in this way, the doctor needs to make dramatic adjustments. Please get the doctor’s attention and tell him or her what is going on. Journaling helps. Tell the doctor everything you’ve said here and insist on changes. If you don’t get cooperation, change doctors. In my view, this is unacceptable, unless there is a valid medical explanation. I’d at least get a second opinion.
Good luck,
As a social worker for a non medical home care agency and I specialize in dementia care, placement is the last thing I advocate for in most cases, but in your case it sounds like the best solution for all of you. From the details available it seems as if your mom needs the structure, routine and supervision of a specialty care environment. We never want to place our loved ones but often that is the most unselfish and loving decision for their sake as well as yours. From professional and personal experience with a grandparent, I have seen placement make a huge improvement in the lives of a dementia patient. It sounds as if there may be some underlying mental health issues contributing to her mood and behavior as well. Please don't see placement as a failure on your part to care for your mom. Special medical problems need special care. If she had broken her hip, you would send her to rehab right? Obviously you care deeply for your mom, please consider looking at dementia care facilities in your community, if for no other reason you may need this option in a crisis situation and will have already done your homework. Good luck and God bless.
I agree with Carol but also mention that for many demented folks, sleep is really the only respite they can get from their own living nightmare! 22 hours of sleep per day is certainly excessive but there may be many factors contributing to this pattern in addition to severe over medication. If some of these possibilities (depression, thyroid, severe hypotension . . . ) were addressed the need for anti-psychotic medications may be mitigated or even eliminated all together.
A little background here. My mother-in-law's medications didn't seem to be working and she went on and on from morning to night screaming, trying to hit, bite, etc., even hiding a hammer under her bed and trying to hit my sister-in-law with it. The Dr. tried all sorts of combinations, upping her anti-depressants, risperidol, etc. It's a dilemma, as you can imagine. If she can't get calmed down, we have to consider a nursing home, and no-one wants that at this point. But we don't want her so doped up she sleeps all the time either. Also, about every 4th day or so - she gets a burst of energy and paces, screaming, accusing and threatening - as she did just this evening. I should also mention she has always been a very difficult person and mentally abusive - so it was a process trying to come to terms with "this is Alzheimers", and not just her usual behavior. But we have gotten there and it's a better place to be for us. Thank you Carol and Cindy - we have started documenting and will discuss with her Dr. very soon.
Thank you so much Cindy. I wills share these e-mails with my husband. Hopefully, he can persuade his brother to consider this. After 2 1/2 -3 years of living full time with us she went to live with her other son and family about 2 years ago (we couldn't do it any more). She has been with us for the last month so my sister-in-law could have a much needed break. I will let you know the outcome. I so appreciate your concern.
I had a friend who's alzheimer's Mom was the same, screaming, yelling, hitting, awake ALL the time. She went on 250 depakote 4 times a day, calmed her right down and she lived with her another year or so until she passed away. Best of luck to you.

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