My mom is in Assisted Living. She has been on Exelon patch for about 5 yrs and Nemenda for about 4 yrs. Once I was told that after 4 yrs people on the meds are about the same as people who never took any meds. Does anyone have any experience with this? Is there ever a time when patients can go off meds? Do they get worse ? Don't want her to keep taking if no longer effective. Also, they are very expensive as there are not generic versions of these.