Dementia and Depression! If you are currently or previously took care of someone who was prescribed any of these medications, thoughts?

I agree 100% each patient ought to be assessed and treated as an individual and the risk vs benefit calculation done thoroughly and carefully.

The key word is " assessed" meaning to evaluate.

The very beginning of an individual's assessment and evaluation are crucial !! Plus honesty !!

Then you execute a goal and plan after the assessment and evaluation.

Risk vs benefit calculation done thoroughly and carefully.

A persons Health Insurance Coverage also plays a part in this.

I might not agree on everything you have said, and I can take criticism from someone like yourself. Your an asset to any company.

Documentation, Documentation, Documentation.

What happens when the execution of the goal and plan maybe half way done, but you know that it will be impossible to meet those goals but you need to because of the insurance.

Heath Insurance plays a huge roll with the treatment of the individual also.

Honesty, Respect, Documentation, Documentation, Documentation

Documentation, Documentation, Documentation,

There are great individuals working in the Health Care System who truly care and give their 100%. Unfortunately you don't get 100% all the time.

Keep up the good work!!

I had to go and lie down after reading your post until my heart rate went back to normal.

If I discussed a client's condition with her family in the way that you describe, I think the service I work for would probably have me fed limb by limb through a food disposal unit and then buried in unconsecrated ground.

Here is what you do. If you have concerns about a marked/sudden deterioration in a client's condition, you report it. If you have concerns about side-effects of medication, you report it. If you have concerns about the client's ability to engage in activities included in her support plan, you document that she is unable to participate during that call, and why, and you report it.

You do NOT discuss subjects beyond your role's parameters with your client or your family. If you have immediate concerns, you may suggest that they seek advice from appropriately qualified services or individuals.

There are frustrations to this which I acknowledge, but you need to remember that a) you are not the only professional who cares about your client and b) that you are by no means the best qualified to assess and address her holistic needs and c) above all that you have NO business giving an opinion on clinical subjects. There you go, despising the prescribing capabilities of your average family doctor, but who the heck are you to criticize? They may not have had as much training in geriatric pharmacology as an older age psychiatrist, but you've had none at all.

There are many things which you, as a health care worker, must not say or do. It does not mean that those things will not get done. You are *always* free to report any concerns you have about your client's wellbeing, or risks to their families, to your managers or other authorized people.

If you have, in all seriousness, come across undocumented prescribing then certainly you must report that. But it is unlikely that you have free access to your client's full medical records. The fact that you haven't seen the documentation doesn't mean there isn't any.

On the subject you actually want to address, namely prescribing in older adults, it has been hotly debated for many years, it is extremely complex, and you will find a wealth of material already published. Policy continues to develop to protect elders' interests, but it is not simply a matter of withdrawing certain drugs' licences or forbidding the prescription of particular drugs to particular groups of patients. Each patient ought to be assessed and treated as an individual, and the risk vs benefit calculation done thoroughly and carefully. We all know, it is blindingly obvious, that this particular counsel of perfection is not followed 100% in practice because real-life conditions get in the way; but in my experience most people most of the time are doing their best with what they have to work with.

Keep that commitment to your clients' and their families' best interests, keep observing, keep reporting, and work with others to promote best practice. But for heaven's sake don't start imagining that you know best.

Bridger 46164,

I was in no way trying to say anything about you, as I said before I don't know you. It just happened that you worked in a Skilled Nursing Home. They always get a bad rap, and there are some greet ones and some not so greet ones.

You are the only one who addressed this forum with your own personal history working in the health care system.

I apologize and meant no harm to you by using what you had posted in this forum. I also appreciate you not Slamming me.

I have read a lot of posts on here, and it is sad the way some people answer back without really knowing the whole situation.

Once again I apologize and meant no harm to you

Hey Garden Artist,


There are thousands of individuals who have been misinformed on these drugs.

here are just a few organizations you can look up yourself.

Consumer Voice. org
Health Affair. org
National Consumer Voice.org

So before anyone wants to challenge me on the leading form of Elder Abuse in Nursing Homes being antipsychotic drugs. Type it in.

When I stated that " was it a doctor or psychiatrist " who prescribed them those drugs and their thoughts.

ANSWER: Doctor !!! When these drugs come from a psychiatrist, you have a much better chance of documentation.

ANSWER: When asking their thoughts, you can see what has been posted.

Everyone who commented on my post were upset about how I told the man his wife was going to pass away, and how he just believed me, what kind of education I had, ect. Everyone focused on that issue.

The topic was Dementia and Depression !!! I lead off with the listing of the DRUGS
and what the drug manufacture use is for them.

No one commented on antipsychotic drugs being given to people with Dementia.

No one started off at least saying " I can understand your concerns on giving a person with Dementia antipsychotic drugs, then maybe SLAMMING me. Or ask for me to clarify a little better about what took place.

Like I said in my last post, I have been taking care of this mans mother for the past 3 years. His brother is the one who hired me, and seen him over at his moms while working, but never meet his wife. This mans one son works in a hospital, one is a fireman and his wife an EMT. The man who hired me son is the head of the Sheriff's Department. There kids live 85 miles away.

I am not an expert, but I can tell if someone has been prescribed one of these drugs and having side effects from them.

The one thing I do with everyone is show them how to use the "Drug Interaction Checker" I don't assume anything. This way anytime they are taken off or added on to a new drug, they can see for themselves what areas may be of concern. I make sure documentation is recorded. When I seen what she was taking, I had a pretty good understanding her problems and decline.

When talking to the women's husband and getting more information from him on when she was put on these drugs, I gave him the results of the "Drug Interaction Checker" along with a copy the drug manufactures report on line, and I went to Walmart and asked them for a print out of what information is given to someone who is prescribed one of these drugs.

It's a lot easier for them to read and understand about the drugs their loved ones are on. This lady was on two of them at the same time. The "Drug Interaction Checker" he was able to see for himself what could be a huge problem and bring it it to he doctors attention and get some answers. Like I said to him, her doctor may have a reason why she is on two of them. He made an appointment with the Dr. and the only documentation was that she prescribed them for depression.

Yes the decline of this woman I have never seen nothing like it in my life.

It is vital that recorded documentation for anyone who has dementia, alzhiems, or the elderly get done.

I do know that these drugs have helped a lot of younger people suffering from some mental health issues. Some of them say that the drug saved their life.

Garden Artist don't worry about having to turn me in, guess what this whole forum is going to my boss and others working hard to Save Our Seniors.

Giving someone blood pressure medicine for allergies. The drug manufacture list what it is used for, and they have nothing reported or tested for people who have allergies. WE WOULD BE ALL OVER THAT!!

But giving a person who has brain and memory problems a drug that is MIND ALTERNATING and the Drug Manufacture has nothing to report or studies done with individuals who suffer these awful diseases.

I will continue to advocate for awareness !!

Hopefully you ask the next person to clarify !!!!

As I wrote I am an RN by education. I do not work as an RN and haven’t for many years. Until late December my family owned an Assisted Living and Skilled Nursing Facility for over 15 years. Those drugs show up frequently on charts of elderly persons and only PCP’s prescribing. I know of only one resident that had meds prescribed by psychiatrist. No gerontologists in our area. Many patients have rapid declines for a variety of reasons. I don’t know how facilities, other than our and locally document. Our SN documented every encounter from routine room checks to charting of all problems. All medication changes in charts, doctors ordered and updated with staff at shift change.

With the limited amount of space on here, and I understand they need to limit the space so some questions do not end up like a book. Some of you just SLAM people on here for ASSUMING that the individual has told the whole story.

I know that a lot of answers come from people in the health care system. Maybe if you asked them to elaborate a little bit more, you can learn something and try to make a difference.

To the women who has worked in the Skilled Nursing Home for 15 years, I don't know you, and you could be the best nurse in the world, part of my focus is on Skilled Nursing Homes Nationwide and to educate the importance of written documentation on all patients that are elderly, have dementia and alzhiemer's. Thank you for your truthful answer.

Because the story is so long about my mother and what to place with these drugs over 3 years, I can only sum it up like this.

My mother was already on Prozac for depression, before she was diagnosed with dementia. She had a primary doctor and a psychiatrist. The psychiatrist told us in 2000 that there were new and improved medicines, for people with depression and may help with the dementia. The psychiatrist put her on Zypreza. When that wasn't working then on Risperidone, and over a period of 4 to 5 months her medicine was being changed every two weeks. I got a print out from Walgreens on each time I was in there getting my mother a new prescription. I read about all the prescriptions. My mother was at the point where she could not walk on her own, I had to hand feed her, she was frozen like.

I had her in and out of the emergency room 4 times within those 5 months. All test clear, it was the meds she was on they said. I went to the psychiatrist and blow up, signed for her records, and took her to Stanford University. They put her in the hospital with a nurse by her side 24/7 for 7 days. Her body was so toxic I can't even explain the peeling of her skin from being so toxic. Stanford University got my mother hooked up with Dr. Munn.

Dementia = NEUROCOGNITIVE DISORDER
Zyperxa Used for Antiphychotic and Bipolar
Geodon Used for Antiphychotic and Bipolar
Resperdal Used for Antiphychotic and Bipolar
Risperidone Used for Schizophrenia " not to be used in elderly patient with dementia" May cause death.

These are MIND ALTERNATING DRUGS. The primary use is for Schizophrenia, Antiphychotic , and Bipolar.


THE MISUSE OF ANTIPSYCHOTIC DRUGS ARE THE LEADING FORM OF ABUSE IN NURSING HOMES .

15 YEARS WORKING IN A SKILLED NURSING HOME and just like you say " ALL OF THESE DRUGS ARE PRESCRIBED ROUTINELY FOR ELDERS.

If you were required to monitor and record the patient like what the drug manufacture request to be done, you would have stated the importance of it. The elderly are prescribed these drugs mostly for DEPRESSION,SLEEP, and ANXIETY. Sometimes as a MOOD STABILIZER . The same goes for people with dementia and alzheimer's.

Dr's and psychiatrist nationwide don't record or monitor the patient, it's not a law, its just what the drug manufactures suggest.

I work part time for Save Our Seniors, I have worked in a Dementia Day Care, I have no degree in this area, but have educated myself with some help from people who do have a degree and also tries to express the importance of records and documentation for anyone who has dementia or alzhiemers and all the elderly when prescribing them any of these drugs. I am retired from Shell Oil Company in the Cal-Osha SB198 Law.

Your parent has dementia, and now is on a MIND ALTERNATING DRUG that was not created for them, there is no test or statistics from the drug company after 20 years, you have voiced your concerns on the effect you see taking place.

What do you think should be done when prescribing one of these drugs to someone with dementia ?

The lady I took care of, I have been taking care of his mom for the past 3 years. Nothing documented from the doctor on these drugs, but it was for depression.

Just checked the OP's other threads:

https://www.agingcare.com/questions/am-i-falling-through-the-cracks-seeing-changes-in-my-mother-465050.htm?orderby=recent&page=1�

This is an excerpt from her post on that thread:

"Before I can go to work, I have to get my son dressed, teeth brushed, feed and off to school, then my mom dressed, hair done, teeth brushed, her morning pills, something to eat and off to daycare for individuals with dementia. "

So apparently she works at some type of day care for dementia patients.    She has no authority to be considering what meds they should be taking.

Deedee, if I knew what daycare you worked for, I'd contact them directly and alert them to your "evaluations" of medicines.

Ninersdeedee, I think you should be exploring not the issues you've raised, but the consequences of engaging in medical practice w/o the proper qualifications.  

If anyone told me what you've addressed in your post, I would (a) call the agency if the individual was employed by one, and share the information that the individual was attempting to practice medicine, well beyond her educational qualifications, or  (b) if not affiliated with any agency, I'd call the AMA and ask for recommendations on reporting someone who appears to be attempting to practice medicine w/o a license.

I found this question very odd and confusing. I’m an RN by education, but experience on the administrative side.

Like many psychotropic drugs there are warnings for using with elders and dementia patient.

I think you're setting yourself up for a lot of problems dispensing medical advice, unless you are licensed to do so. What happens if you give this "advice" to one of your clients, and they stop the medication which leads to other complications? And telling your client's husband she only had a few weeks left? I don't think that was your place to say anything.

If you really think your mom was medicated wrongfully, then contact an attorney. But I would think really long and hard before you start giving out medication advice to clients, unless you have M.D. after your name.

So, just wondering what husband is going to take the word of a new "caregiver" that his wife is going to die in 2-3 weeks due to the medication shes taking, and not immediately take action by calling her DOCTOR or getting her to the ER? He just accepted what you said, cried, called his kids and family and that was that, huh? Sorry but, what part of this story sounds fishy besides all of it?

I worked in a multi provider office and in skilled nursing center for over 15 years. all of these drugs are prescribed routinely for elders. They do NOT require a psychiatrist. I also have not seen the severe decline you described. There are many reasons for sharp declines in the elderly.

Are you a medical professional, and if so, in what profession?   Therapist?   

I'm wondering the basis for telling the husband how long you expected to live.