How can I keep my mom committed to doctor prescriptions after her first visit regarding dementia?

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I put extensive dental care and surgeries for eyes and hernias in this category too. My grandmother had a surgery- that resulted in a stroke from the stress, we probably should have skipped it. Another friend had a mom with a broken femur that cascaded through many decisions, some which did not change the outcome at all.
Once all the bedsore care begins, there is lots of pressure for extensive antibiotic use and sadly they basically become a human petri dish for antibiotic resistant organisms sitting in your home or care home.
I can talk about this now because i am currently under no pressure to make any of these decisions. Check back with me in 3 years and I will be speaking with a different tone, because it will be more personal for my mom.
The only one I am dealing with now is that she can not swallow her pills and is kind of chokey in the dental care. We can overcome those.
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Linda, you are right that there are several aspects to this topic. Once a decision is made that certain medications should be taken, then a practical way has to be devised to ensure the person with dementia gets them as directed.

Another aspect is deciding which drugs the person should have. In early stage dementia there are some drugs that can reduce certain symptoms and thereby improve the quality of life. These do not prolong life, just make life a little less unpleasant. As you say, dementia is terminal but over a long period of time. Decisions about what drugs to continue with and which ones to drop should be thought out carefully, and may change over time, as the dementia progresses.

Personally, my husband and I make decisions about his medications based on whether they are for quality of life or for prolonging life. Surprisingly this isn't always straight-forward. I asked a cardiologist about a heart medication, for example. In terms of preventing a heart-attack, it would be viewed as extending life, but the drug also acts to reduce the chance of a stroke. Having a stroke along with dementia is definitely worth trying to avoid -- at least in my mind. Hubby still takes that pill. He has a pacemaker -- that is a comfort issue. He has had his defibrolater removed -- that is a life-prolonging measure.

Abu09, if your mother doesn't want to continue taking her prescriptions because, knowing she has dementia, she doesn't want to prolong her life, I would respect that. But I would also go over all of the meds carefully to make sure she knows what they do. Our geriatrician was wonderful in doing this with all of my husband's pills at the beginning and also answering any questions along the way. (We've been on this journey 8+ years). Your mother may have many more years to live. Improving the quality of those years seems a reasonable goal.
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Perhaps I have read your question differently than the others.
There is some decision making that needs to happen about quality of life once someone has a progressive cureless disease.
Anti- biotics, heart medicines, vaccines, diabetes regimes, sobriety, they all take on different meanings once the person is terminal. The problem is dementia is SLOW to progress.
For counsel you may consider speaking with a hospice volunteer. They have a different perspective from the primary care doctor or the care home who profits from the unnecessary extension of life.
I broached this topic with my brothers and they were not willing to talk.
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Somehow it will now be up to a dementia-free person to insure she takes her medicine. Maybe it can be done with a phone call, but the only way you will really know she is following Dr.'s orders is for a responsible party to oversee this. Maybe a neighbor or close friend of your Mom's. Also, can the schedule be structured to accommodate the individual. I thought my mom was taking her medicine as directed (not even diagnosed with dementia at this point) and she became dependent on a pain drug for her back.
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This is an issue many caregivers have while caring for their loved ones. Below are two great article that will help you manage your mom's medication that the doctor prescribed for her.

Guide for Managing Medications and Prescriptions


Top 6 Medication Problems and How to Prevent Them

Hope this helps! Good Luck :)

Karie H. Team
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