Why so often are psychotic medications used in treating Dementia? - AgingCare.com

Why so often are psychotic medications used in treating Dementia?

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My mom was in nursing home in another state and I moved her in a nursing home near me. She then had to be admitted to a hospital because she started screaming and yelling all the time. At the hospital they found she also had UTI. All of them have been give her psychotic drugs to try and control her yelling. She has been transferred to a psych inpatient facility to try and get the screaming under control. More new psychotic medication. Even one that was just on the news back in May regarding the manufacturer advising providers to use it for dementia patients, even though it was not labeled for that and kills more elderlys with dementia.
What is wrong with these facilities? What happened to treating Dementia? Why are they all jumping to psychotic medication?

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You are absolutely correct in questioning why these medical facilities are pumping your mom full of toxic psychotic drugs instead of feeding her healthier food and perhaps giving her non-toxic vitamin (like a good Vitamin B Complex) and mineral (like an absorbable form of magnesium) supplements to calm her nerves down and help her relax. If you are your mom's POA, DEMAND that the doctor wean your mom off of those drugs and put her on Vitamin B Complex by Jarrow and 400 mgs of Magnesium Glycinate. Having dementia just means that your mom's memory is not functioning 100% but it DOES NOT warrant her needing psychotic meds. ALSO make sure that the doctors have done a THOROUGH job of healing your mom's UTI. She might be screaming because when the UTI gets bad, it can be painful. DEMAND that they take a urine sample to make sure there are no bacteria and DEMAND to see her labs to make sure that her White Blood Cell Count is w/in normal range. If any of these results are abnormal, DEMAND that they do another blood test for Sepsis and if Sepsis is present, DEMAND that she be put on an antibiotic to get rid of it. Usually that will take 14 days which after that time, DEMAND for another urine culture, lab test for WBC count and blood test to make sure the sepsis is gone. I am telling you this because my mom has dementia and the doctor was acting like whatever she was reporting to us or however she was acting was not relevant anymore and that is when I had to PUT MY FOOT DOWN and do what I needed to do to protect my mom. You gotta do the same thing too. Good luck. All the best. Keep us posted.
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Is she screaming because she is in pain? If not-then you need to consider that she is not in touch with reality and an anti-psychotic drug is appropriate. A patient who is screaming constantly puts a terrible stress on those around them as well as themselves. Why would you want someone to remain in that state? Risperdall has helped my mother control her rages and participate in her own care and decision making. I wish her doctor had put her on it years ago. If you object to the medications to make her more comfortable-keep her in your own home.
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My beautiful mom had severe COPD, temporal arteritis, and a sudden heart block, all within the last year of her life. During the year prior to that she was playing competitive duplicate bridge at the age of 86. Because she lived alone and was suddenly declining, we moved her from AZ to IL to be near the family, and the move was so very hard on her. We placed her on hospice even though we knew she could survive for a month or years. But she fell while staying with my sister - broke her pelvis in two places - and we needed to admit her to a skilled nursing care facility to "heal" because she needed care 24/7. Within a very short time she was given a tremendous amount of drugs which caused her to be paranoid, manic, hallucinogenic, and she started screaming and kept trying to leave. They restrained her so that she wouldn't get out of bed and fall. My sister and I visited daily, and the staff knew we were vocal advocates. Shortly after arriving the hospice nurse told us my mom was in kidney failure. Her urine output was scant, she had a fever, and she was "out of it." My best friend told me to inquire about a UTI because her mom had just gone through the same thing. Indeed, she had developed a UTI which caused all of her symptoms. A round of antibiotics "cured" her kidney failure. Skipping ahead two months, we watched my mom decline further, and as her POA I finally decided to take her off of ALL drugs except for the ones which helped her to breathe. (Her biggest fear was that she would be gasping for air during her final minutes.) I truly felt that the drugs she was given were causing her mental/personality issues. The staff and hospice argued with me, but it was the kindest and most humane thing I have ever done in my life. Within a couple of days she was serene and comfortable. She was able to watch TV and we had some wonderful conversations. She only lived for six more weeks, but she was herself and not the terrified, paranoid, screaming, unrecognizable person that she had been. She was my best friend and I miss her every day with every breath that I take, but I know in my heart that I did the right thing by taking her off of the drugs.
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IMO, antipsychotic meds are given because they are not DEA scheduled drugs. It's less paperwork for the doctor. Also with this "police state" the country is in, doctors don't prescribe (what I feel in many cases) are more suitable and safer alternatives, whereas antipsychotics are handed out like candy even though their side effects can be devestating. Just my opinion. I am not a doctor, just a care giver who has been through this.
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The main reason is no one can handle the screaming! No matter where she stays she needs to be managed and behave in an acceptable manner. It is too much stress on the surrounding patients and staff to put up with yelling and screaming. She should be medicated to a point where she is calm and peaceful. This will help her mainstream into the home, nursing care facility or your home. A geriatric psychiatrist will be able to target the correct medicine and dosage to your mom with the least harmful side effects. See one immediately with your mom and it will open the world for both of you to move forward to other living arrangements.
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Moving someone with dementia is extremely stressful for them. Her acting out 'screaming' may be her way of expressing fear or some other need right now. The LTC facility where she is at doen't know how to deal with her in any other way except to administer medications. The drugs are not to 'treat' her dementia in any way, they are to control her behavior. There are some places that will endeavor to meet your mother's needs in other ways, but they are few and far between. You might try meeting with the social services and activity directors, along with nursing to try and speak to them about providing things to keep your mother feeling more secure and engaged. Your local Alzheimer's Association could be very helpful to you at this point. If it were me, I'd be searching for another care facility. One that advertises 'person-centered' care and uses drugs as only a last resort. By the way, did the UTI get cleared up? A UTI can make behaviors go through the roof! If they started your mom on the drugs while she still had the infection, and it is truely cleared up now, it may be that they can taper off the meds. They should try at least. Make sure they are giving her plenty of fluids - dehydration contributes greatly to UTI. And if she's constantly sedated she's not drinking much. Hope this helps! My heart goes out to you.
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Get your mother moved ASAP. Had the same situation with my step-father. I took care of his "situation" and my mother. He was beligerent and abusive verbally.He slapped nurses and was combative.They began "sedating" him. Except he was knocked out with enough stuff to put a horse down...he would sleep for the better part of 3 days. Then, he was confused and the cycle kept repeating. What happens when we can't/don't eat and get proper hydration. I tell you his weight plumited. It is slow euthinaztion.I met with the director and told her that I understood that the safety of her staff was her responsibility, however his safety was mine. My issue was not the sedation but SO MUCH. Too high of a dosage. It was not being administered with any reason. If they canot go along to get along, this is the writing on the wall. I know you want the truth. Don't find out where this goes by just hoping it'll get better; get her MOVED. She should have a "case worker"hopefully. She can help search for a vacancy in another facility if you need help. Keep your head about you. Obviously your another foot soldier in the unseen army. But you are not alone. There are thousands upon thousands of us out here and we support each other as best we can. May God's peace be with you and your strength be renewed daily. xo
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Had the same experience when my dad had his knee operated on last year. He was sent to a skilled nursing facility for physical therapy. Did great the first two weeks but after that all went down hill. the facility had him so paranoid to even get out of bed as they had an alarm on the bed. It go to the point where he was so anxious and upset that we couldn't even leave. Someone had to be there every day with him. He lost weight and became extremly agitated all the time. Found out they were giving him pain meds a month after his surgery. That were keeping him sedated with the pain meds. I got him the heck out of there and fast. When he came home he was so afraid to move and kept asking if he was allowed to use the restroom or if his it was ok what he was wearing. He had a severe panic attack and wound up in the hospital one day after being home. Thank god for that hopsital. They had a physician prescribe remeron for dad and upped his antidepressant and no more trouble. Dad does have mid stage dementia but those drugs given by someone that cared and knew what they were doing helped make all our lives much easier. Get your loved one the heck out of there or read up on what drugs they are giving and make yourself aware and informed and straighten it out. They need to do what you want not what they want. And if they don't turn them in to the Attorney General or tv stations and get them investigated. I guarantee if you threaten with that, they will stand up and take notice of what you want and do it! They just want to put these poor people in place where they start acting like they are psychotic and they are not. They become a product of the environment they are put in. Good Luck.
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Braida - My mom started off the same way. She was on a blood pressure med only when the UTI's started. The one thing I didn't manage to do was get her doctor to prescribe a low dose antibiotic early on. He insisted on treating each infection individually. I understand that to a degree (sensitivity of individual bacteria to specific antibiotics), but now feel it was a drastic mistake. Her 2nd UTI (that resulted in her psych ward experience) was from a pseudomonas bacteria (dipstick test will not id it) that had to be cultured and it was 9 days before it was identified. Her behavior was completely bizarre by that time -she couldn't toilet without assistance or even feed herself. 2 weeks before that she was still living independently and managing fine -didn't even use a cane. After that between UTI's or whatever other infection she may have had and meds, she didn't have a chance at normal again.

Absolutely everything Chimonger wrote is gospel. Take it to the bank.

Knowing what I do now (which is still too little), I would INSIST on a low dose antibiotic immediately since she has had recurrent UTI's. Any infection can cause mental changes in the elderly -UTI's are one of the most common and I think recurrent ones cause mental degradation and that people get to a point where they don't come all the way back anymore even after treatment. And you need to know even antibiotics could cause some hallucinations (Cipro is one of them). I'm not sure how effective it really is, but adding daily cranberry juice or d-mannose too-couldn't hurt to help UTI's.

I would avoid other 'demetia' meds for as long as possible. Mom couldn't sleep with Aricept -pretty common I've found, but amazingly I've heard doctors say they've never heard of it causing that problem. Every one of the other meds doctors put her on caused additional problems or exacerbated the behavior they were prescribed for. Every Single One Of Them! Seroquel & many others caused hallucinations. Another caused Parkinson-like shaking. And etc, etc.

Vision problems can also cause problems with hallucinating. See Charles Bonnet Syndrome.

I'd very gently try to explain to her that an infection or other is causing her to see these visions and that you understand how real they seem. They're probably scaring her to pieces. Mom called me once wailing that my brother was there with her and he wouldn't talk to her. Of course he wasn't there. She coped better after she understood something was causing it -she wasn't just going crazy.

I feel for everyone here. Been there, done that and completely frustrated with no adequate answers or direction. Until something is relevant is found we're just all left grasping at any available straw to try and help our loved ones (and ourselves as caregivers). Dementia is not normal aging -it's a brain disease whose cause hasn't been figured out.

Try the low dose antibiotics, cranberry juice and talking to your mom about the visions (hallucinations) to try to make them less disturbing for her. I will pray for good luck to you and everyone else on this helpful site and for hope of a medical breakthrough for this devastating condition.
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Braida...my mom had a dramatic turn just like yours. If she has hallucinations and speaks a sort of babble? It could also be Lewy Body Dementia? Mom showed all of the same with hers...plus a lot of the dementia meds gave her adverse reactions . She was up all night long . LBD also affects their posture, walk, sense of smell, and taste. I suggest you ask questions and seek answers on the Internet . LBD is one of the hardest dementias out there, and you need to be well equipped to understand it or otherwise it can be a frustrating journey. God bless
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