She has Dementia but these are not Dementia drugs per-se. I am my Mother's Primary and only caregiver. Mom has Dementia... to the point of not talking much, not eating much, drinks a little tea and chocolate milk. She is starting to have a hard time swallowing her pills. Chocolate Milk works better than water, and breaking up 4 pills into having her take two pills at a time seems to help. None of the pills are very large. She is 80 and started to have a large decline this past November (2015). She is physically weak and needs help getting up the 8 steps to the level of the house the bedrooms are on (The house is a Tri-level). She is shaky and she is frail. She was NOT this way until she had her first fall, in the bathroom on Saturday December 12th. I did have a Hospice RN come to help me get her up. This is the first fall and I don't have a medical background. The Hospice RN and I got her to bed. The RN checked her over and said nothing was broken- she would be sore but should be OK. The RN took her BP- was 112/42, the RN did not like the 42 said it was low. She also took a pulse ox reading the O2 was in the mid 80's. She said it should be 90 or better. She ordered a walker and a wheel chair. Mom used the walker on Thursday but seems to be a bit stronger these last couple days and doesn't use the walker. Mom really needed it on Thursday.
Mom has Vertigo and can no longer express when she is dizzy. She has taken a med called Meclizine for years and it always works great. Mom also has had high blood pressure that is in the normal range with medications and has been stable since January 2014. She takes Atenonol, Lispironil and Hydrochlorothaizide. She has been taking Diazepam at bedtime for a few years... it DID help with sleep. Early last month she started to go to bed earlier and then get up a few hours later and think it was the next day (even though it was dark outside). After awhile this happened every night. Her PCP (a very good Hospice MD that deals mostly with the elderly) started her on Trazodone (a SNRI Antidepressant) 50 mg to be given at 8 pm.. this was to help with the waking up and thinking it was daylight when it was dark. This has worked very well.
Mom has been on Aricept since June of 2013 - she had a different PCP then- There was trouble increasing her Aricept from 5 to 10 mgs. She had physical side effects. Eventually she was getting very aggressive with me and finally went to 10 mgs. That helped with the aggression. Next she was to start Namenda XR (for the PCP she had - that PCP left the clinic to work in a hospital setting this past fall). Namenda XR was not a good med for her- once again the side effects. She had bad side effects so she was taken off of it.
The Aricept was recently stopped as the Hospice RN that came the night of Mom's Fall discussed it with Mom's Hospice Dr who is also her PCP. Our Weekly Hospice RN came last Wednesday and said we can stop the Aricept.
So her meds right now are in the AM Atenonol, Lisinopril, Hydrochlorothiazide, 1 Tylenol, and 1 Meclizine. In evening by 8 PM she has Diazepam, Trazodone, 1 Tylenol and 1 Meclizine. Note: I started giving her 1 Meclizine AM and PM since she fell. Prior to her fall she did not take Meclizine on a regular basis -it is written "as needed".
There are to be two new prescriptions written that will be filled tomorrow. As Mom ages she is very physically touchy with new meds.
1 med is Remeron (a SNRI Antidepressant that usually leads to weight gain) to help with her appetite. I think this may be alright - as she does not want to eat much ever. The 2nd med is the one that I wonder about-- which is Norco for pain. Mom has not been grimacing, verbally saying oww, or moaning. She is not laying in bed for hours and never getting up. I think Norco might have been helpful for the day's immediately following her fall (December 12.) It's been 9 days since she fell so why Norco now- sounds like she will be taking them everyday. Had her PCP or an RN did a through examination and saw evidence (things an non-medical person could not see) I would be more confident about the Norco. Norco is a narcotic med for moderate to severe pain....
On the other hand she has lost the ability express pain to me verbally either - although I have heard an oww in the past.
Anyone have any thoughts? Am I just being hyper-vigilant about this?
(PS She has Hospice for Palliative care-- she is not to the point of needing Hospice yet- she has a very non-aggressive Ovarian Cancer- has not changed in size or spread since it was found on a CT Scan in February of this year. Took us totally by surprise as she was very vocal then and never had pain. She refused to have surgery for the cancer. Its her body and her life.. I respect her choice)