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Mom (92) had anxiety all her life, has never taken meds. "Not starting now". She's used to living alone, sleeping late, having her own schedule. But due to recent hospitalization her dementia is lots worse.

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Good Day,
my experience is that those type of places are blessings for loved ones who need their behavior issues adjusted through medication. It broke my heart to place my father in a hospital for 10 days but he had such a controlling personality and was becoming more aggressive that they were able to monitor him and put him on a treatment plan. It began by him calling the police on me for holding him hostage (we had to move him from out of state) but It ended up being a blessing.
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Reply to WestiePatriot
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Kid
It is my understanding that one can have dementia and still be competent to create legal documents as an example but they might be considered incompetent in other ways.

Here is an article that you might find interesting on the subject.

https://www.agingcare.com/articles/competent-to-sign-will-trust-poa-153521.htm
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Reply to 97yroldmom
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Kidnurse it sounds as though your mother has a careful and thoughtful advocate in you, with your sister's support. She's a lucky lady.

What struck me is that you've got a number of different issues going on which have got rather tangled up with one another. That can't be helped because of the complex causes and effects; but it does seem important to tease them apart as far as you can.

The hospital stay was for what? Any injuries or treatment that could have been a major but temporary setback for her?

The DON is suggesting (suggesting or insisting on?) a temporary transfer to the Adult Behavior Care Center. Even firmly setting aside a qualm that it's one of the most Orwellian-sounding titles I've ever heard given to such a place... okay, let's say fine, but what *exactly* is the aim of this? How does it fit into a longer-term care plan?

Besides that, the Namenda must have been prescribed by somebody else - who, what for, and were you happy with the rationale?
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kidnurse9 Nov 18, 2018
Hi Countrymouse. Thx for your kind words. Mom lived alone til 92 with only mild b/p med. Hospitalized for fecal impaction, infection in sigmoid colon, dehydration. Looking at her fact sheet on chart I also read Dementia and Acute kidney failure! All the physical is healed it appears but the dementia is worse. DON suggested it after Mom refused the med after 7 days. She will take her b/p med. She's still pretty sharp in her thinking very much also. I wonder how important is it to have a diagnosis of which dementia she has. I'd call the place and ask but for now my 2 siblings and I have decided not to
send her. She was seen by a nurse practicianer who represents a gerontologist whom Mom liked and agreed to take the med. I thought it might help. Maybe she had side effects. She's never been on anything except abx, acidophilus, and Vit D. She seems to be accepting Assisted Living. What she really needs is cataract surgery and new dentures! Thx again! Kidnurse Retired
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Hi! My husband is going on 90 and has Alzheimer’s. He was prescribed and taking Namenda and Aricept for a few years, but he complained so much about the “stuff” I was giving, that in order to decrease the number of pills the neurologist and I decided to take him off Airicept first then eventually Namenda too. In the past few months he has refused all of his medications; blood pressure and heart meds. He is healthy for the most part, but he has had a long and well lived life, so if he doesn’t want medication at this point I don’t push it on him. I offer him his morning meds and his evening meds, if he ask what they are for I explain each one. I leave it to him to decide if he takes it or not. I did talk to his PCP about this, and she incouraged him to take his BP meds, but he doesn’t even know who she is.
Hospitalzation is the worst for dementia, and two years ago I quickly learned that a UTI can make you crazy. Now if he goes to the Dr for anything at all I have him tested for a UTI, catching it early is key.
Positive thoughts with you and your mom.
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kidnurse9 Nov 18, 2018
Thx Jennifer! I agree with you. It's their right to take them or not even if they aren't understanding. Everyone deserves to live how they want to esp. if we're in our 90's! Thx for your thoughts. Mine are also with you and your husband. (also for important info on UTI's.
Kidnurse (retired)
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At some point the medications developed to slow the progression of dementia are no longer effective (if they were to begin with, I have my doubts with some)
At 92 with dementia I doubt you will see much of a "slow down" of the progression. And at what point is a slow down a benefit? Maybe early in the disease progress but certainly not in late stages. (I always said even if there was a cure for dementia/Alzheimer's I wold not subject my Husband to it because while the "cure" might work there is no way to correct the damage that has been done)

Each "set back" any illness, hospitalization, UTI, even a cold or flu will have an effect on her ability to "bounce back" and she may never return to her mental ability level prior to the illness. And a medication like Namenda will not change that.

If this were my Mom...I would forego the medication, let her have what she wants when she wants it (ice cream for breakfast! great let her have it...a beer at dinner..pour her a frosty one {if it is not contraindicated with any meds or the potential for her to fall}) And when she decides to stop eating and drinking do not do a feeding tube or IV's.
What I would do now is.. I would call Hospice to evaluate her. She will benefit from the extra care and attention and you will get the support of another group of wonderful professionals.
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Reply to Grandma1954
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kidnurse9 Nov 10, 2018
Grandma1954, thx for the great answer and quick response. My sister and I are leaning towards not pushing it on her. She is just getting used to her assisted living studio apt. I've been reading about hospice but she's able to walk and talk, make her needs known but refuses showers. Eating pureed food due to dentures being so old. Cataracts so bad she can't see. That was first on our care plan. I was a nurse for 30 yrs so I agree w no tube feeding. She was examined by a geriontologist's Nurse Practitioner but no scans or MRI's were done. DON says they would do that at this (11 bed, 7 private) Adult BehaviorTherapy. She has a diagnosis of Dementia. She made me Health Care Proxy but not sure how much I can decide for her. I've been doing a lot of it tho in the last month. Learned there's an 80 day diff getting rehab after hospital stay after retiree advantage planned automatically enrolled her which changed her Medicare Original. Trying to get her back to just Original and a part D plan. Seniors are too sick for Advantage Plans.
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Namenda has not been proven to help BUT many take it including my aunt, also 92.
She has taken it along with aricept and is now on the combo Namzeric. No side effects that we can tell. We believe her dementia to be vascular. She also had a hospitalization and after anesthesia seemed to have advanced dementia. It took quite awhile to recover. That’s when the aricept was started. She’s been on it several years.
What symptoms is your mom exhibiting that would make the DON suggest the hospitalization? Usually it’s to adjust meds and try to find meds that work for the patient. If she refuses to take them, then I’m not sure how it would help. Has she been deemed incompetent by a doctor? She has the right to refuse medication if she’s still considered competent.
Some people crush meds and offer it in food. You can’t do that with all meds.
Is your mom living with you now or you with her? How long has it been? Many people find a hospital stay to cause confusion.
Hopefully someone will see your question who has had the experience your DON is suggesting. Is the DON with HHC?
Have you read the book “Being Mortal, Medicine and What Matters in the End” by Atul Gawande? You might find it helpful.
Also look for Teepa Snow videos on the web. She offers many suggestions for dealing with dementia.
Good luck and let us know how she’s doing. More information on her symptoms might help with better answers.
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Reply to 97yroldmom
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kidnurse9 Nov 18, 2018
Thx 97yroldmom. Mom's symptoms are anxiousness, asking same questions, hanging out in the hall waiting for personnel, upset easily and a little paranoid. But she has shown symptoms of anxiety all her life. I wonder if the diagnosis of dementia is considered as incompetent. She lived by herself for 4 decades. Very independent and kept to herself. Thx for telling me abt the book and Teepa Snow. I'll check them out.
kidnurse (retired)
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