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My mother is 80 years old. She has had Alzheimer's for at least 10 years and has lived in a nursing home for 14 months.


In the past 3 months, she has developed really bad aphasia and in the past 2 weeks she has started wetting herself. My mother becomes belligerent when you even suggest bathing or changing clothes. Therefore the staff at our lousy nursing home don't do it most of the time. Before you advise me to move her, I want you to know that's in the works, but it's hard to place a resident with "behaviors," which is how they've had to document her to cover their own negligence. And nursing homes aren't exactly falling all over themselves to accept someone who's already on medicaid and has a tiny social security check. Oh, and I'm darn lucky to have her in a place where she has a private room, is not beaten up, and is relatively safe. I'm in NY. The nursing home situation is not good. (And yes, I've considered other states.) I have discussed the bathing and changing issue with everyone from the aides to the nurses, charge nurse, DON, social worker, and yes, even the CEO. I hit a stone wall with every single one of them. Their response was to both threaten me then follow through by beginning to send her to the ER for the slightest infraction, which they let slide, or handle, in other residents. They said she's a "danger to self and others" and they use loaded words like "abusive to staff" in their paperwork to the hospital. (The hospital staff tells me they're not doing their job.) So that's their game, I am looking for better for my mother, but that's not the answer I'm looking for here.


Here's my question: Mom has aphasia. She gets frustrated because she's not understood. She's having accidents (#1 and sometimes #2). It doesn't seem to bother her that she has soiled herself. She has forgotten most of her life. Seeing her like this, a scared angry woman with urine stains on her clothes, a woman who opens her mouth an gibberish comes out. She pleads with her eyes to be understood, but we are not able to understand her. I understand her more than most. I see her relegated to that tray and table at the nursing home while all sorts of horror goes on around her, from the screamers to the aides complaining about their jobs. I feel so sorry for her. I know the woman she used to be and I know in my heart, for a fact, that she would NOT want to live like this.


She takes Aricept, which breaks down the proteins and tangles in the brain of a person with Alzheimer's. It allows that person to function better, longer, but ultimately the disease will outpace the affect of the Aricept and the person will die of Alzheimer's.


I am considering asking the NP to stop the Aricept so the brain damage will kill her faster. I feel like a monster putting it into those words, but that's what I mean. It's beginning to feel like forcing a terminal cancer patient into rounds and rounds of chemo that's only prolonging their suffering. Nothing will bring my mother back to the woman I have known. She's so unlike herself now that I'm beginning to get these flashes of thoughts that she's not even my mother. Please help.


I hope this question makes sense. I love my dear mom more than life and owe it to her, always, as much as I can, to do what's right by her. So would she suffer more with the Aricept or without it. If it is stopped, our previous neurologist said she will "tank." I wonder if that would be worse than prolonging her life....

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You may also find that stopping the Aricept does nothing at all. No it won't kill her to stop it. Medicate her anxiety and depression, modify her outburst, because emotional pain is just as agonizing as physical pain. Comfort first. Even if comfort shortens the days left, comfort first.
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Helping her die sooner can be viewed alternately helping her escape the prison of her mind sooner, as helping to relieve her from more suffering. I see no benefit in prolonging a life that's not worth living. While some may think that it's necessary to keep her alive as long as possible, I would see your D'Cing a med that's prolonging her life as an act of kindness, perhaps the best thing you could do for her under the circumstances.

However, I don't know if D'C'ing Aricept would actually bring death sooner or merely fail to moderate the complications of dementia.
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i sometimes think that dementia is a reprieve from the reality of decline and death
. dementia sufferers are confused and rightfully upset , but i have also seen by personal experience that they can be quite disconnected and content .
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Since no one knows your Mom like you do and you believe and more than likely kniw in your heart that she wouldnt want to live like this, then I would ask if Hospice can step in and if that would be appropriate. Towards the end for my mom, hospice decided what meds to stop and what meds to keep taking. Hospice in my area takes NH patients as well aa home bound patients. The question being, how is her PHYSICAL health? If her body is strong and she is going to stay with us for a while, months, or even years, then stopping the drug may not be good idea. Very difficult and stressful, so sorry.
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Christine, I am also thinking about this. My mom is moving from Assisted Living to Memory Care next week. She is an angry, frustrated woman who wants her life to be like it was 40 years ago. I plan to have a meeting with her provider (a physician's assistant) and discuss what medications can and should be discontinued. Over the past five years several meds have been added, and none discontinued. She is on Namenda, Aricept, a statin, a blood pressure med, an antihistamine (she complained constantly about having a cold), a couple of other prescription meds and a host of over the counter stuff. She is 89 and has no short term memory. She is starting to have trouble forming a sentence. She has expressed a wish to die over the years, but I don't think she is even capable of forming that thought anymore. Who knows, maybe discontinuing meds will actually improve her functioning. Maybe some of the meds, or a combination of the meds, are doing her more harm than good. Like Garden Artist said, it may be more kind to not prolong her decline when she has very little quality of life. I don't see this as helping her die sooner, but rather as not making her suffer longer.
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Akdaughter, well said, "I don't see this as helping her die sooner, but rather as not making her suffer longer"

I agree.
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Yes, get with her doctor about taking her off the Aricept. It will probably be done in 2-3 steps so it doesn't shock her system too badly. Aricept is not useful in late stage dementia, so there is really no point to it. It helps some people in earlier stages, but is generally not recommended for advanced stages.

I think what Pam said is the way to go -- trying to reduce the anxiety and giving as much comfort as possible. If she doesn't like wet baths, is there someone who will give dry baths? Or would she also fight against them? My father would tolerate dry baths better than wet ones, so we used dry mixed with some wet when it was needed.
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Hello, I could have written your post the situation is so similar to my own. I did remove my mother off all her medication and nothing happened. I eventually, through the doctors suggestions, had her put on anti-depressants and anti-anxiety medication which have helped her tremendously. She is no longer abusive, combative and uncooperative. When I visit now I can actually get her to smile. She is much happier and more content which makes it easier for the staff dealing with her and for myself as her sole caregiver.
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cwillie - I guess there is no predicting the outcome, is there? A lot of the stopped meds make complete sense - moms dr had her on a bunch of vitamin supplements which just seems silly for an 89 yr old woman - especially since mom isn't eating much and the pills are probably sitting like little rocks in her stomach causing an upset tummy. Then there was a cholesterol pill - mom never had a cholesterol issue but it was suspose to help prevent a stroke. We agreed to keep all the "mood" meds recently prescribed by a geriatric psychiatrist as its made a world of difference in changing mom from an angry, mean, hateful woman - whom no one wanted to be around - to a pleasant, agreeable person. Pain pills were up'd of course but mom has to ask for them - which she won't remember to do unfortunately. Sooo - who knows? If there really is some sort of "plan" for each of our lives, it certainly makes you want to be let in on it. At times like this one certainly has to wonder.
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Sorry, this must be horrifying for both of you.
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