Is Your Mother on Drugs? Dementia Drugs?

You need to have knowledge of the meds your loved one is taking.

If your aging parent has dementia or shows signs of it—short term memory loss, inability to balance the check book, confusion over daily tasks—you may become involved with administering or helping with medications.

First have your parent examined by a physician familiar with other conditions that can cause dementia-like behavior: hypothyroidism, vitamin deficiency, or infections are the common ones and therefore thyroid medication, vitamins like B 12 or antibiotics might be prescribed.

If your loved one has the beginning of an irreversible dementia, here’s a quick list of some of the drugs you may encounter:

Donepezil (Aricept), Galatamine (Reminyl) and Ravastigmine (Exelon) are often used to help patients with dementia.  Called cholinesterase inhibitors these drugs were developed for Alzheimer’s patients but are also used for other dementias.  Having few side effects, they sometimes help maintain mental function.  They cannot stop dementia and it is not clear as to how long they will work in a given individual.

Another drug, Menantime (Namenda) has been known to slow the later stages of Alzheimer’s and it may help those with vascular dementia, a disease caused by silent strokes or infarcts in the brain that block brain signals obscuring memory.  A person with vascular dementia might also be on an anticoagulant like Clopidogrel (Plavix) to prevent future blood clots from forming and causing silent strokes in the brain.

The cholinesterase inhibitors are often used at the beginning stages of dementia.  When the dementia progresses, reevaluate the use of these medications with your relative’s provider as they are expensive and may no longer be helping your loved one.

Medications to combat high blood pressure and high cholesterol levels might also be on your parent’s medication list as controlling these conditions helps prevent worsening of vascular dementia.

Mirtazapine (Remeron) is an antidepressant often used in elder patients with dementia.  It stimulates the appetite, helps depression, and induces sleep, preventing dangerous waking and roaming at night.

Many facilities use this drug to insure that their clients are eating well and sleeping through the night.  The latter was of major concern to me as my mother would often try to get out of bed and then fall.  One of these falls caused a hip fracture.

Divalproex (Depakote) is an anticonvulsant and mood stimulator that helps with agitation.  The American Family Physician Journal recommends it as being well tolerated with little side effects.

I was against having my mother use this drug, but when she was interacting negatively with other clients at her facility, I had to agree to it.  These are very tough decisions.

As your loved one’s dementia progresses, either you or a visiting nurse or nurse’s aid in a facility will be dispensing these medications.  People with dementia don’t remember when or if they took a pill.

Keep a list of everything your parent is taking and check frequently with the provider as to what is truly helping the patient and what can be added or discontinued.

Thanks to Gaetan Lee Photostream


How to Combine Celebration and Sorrow

We need small miracles during the holidays

Most of us are familiar with the downside of the coming holidays: if there is sorrow in life it’s hard to get through these times when wherever you go people are wishing you happy holidays and almost insisting on joy for everyone.

People lose family members all year long—even during the holidays.  And people with chronic illness or those who care for someone who is chronically ill do not experience a sudden cure just because it’s December.  People lose jobs every day as bills pile up and the idea of buying presents creates anxiety and worry.

Our culture’s involvement in twinkling lights, carols, and endless decorations can bring smiles to many faces.  After all, it is December and bitterly cold in many parts of the globe and these traditions date back to bringing warmth and solace to a dark and frozen world.

But the opposite affect can happen when people who are dealing with sorrow or anxiety struggle to put a bright face on things.  Then holidays can exacerbate feelings of loneliness and isolation and life becomes even more difficult.

But you knew this.  What you might not have is solutions: how to help someone in your family, or a close friend, or even yourself approach the holidays when there is struggle in your life.        

Practicing inclusion.  This is a wonderful path to follow: opening yourself up to others during this time of year can make your empty and sad heart feel full.  If finances are your problem, going to a shelter and helping others can make your inability to buy a sleigh-full of presents insignificant.  Again: if you are feeling bad about yourself—go help someone else.

Looking at reality.  Toni Bernhard’s advice for people with a chronic illness may be difficult, but it’s factual.  Because they fear others won’t understand about their illness, people in this situation often let family and friends drift away.  At the holidays “…the increase in activity exacerbates physical symptoms, while coping with sadness, frustration, and maybe even guilt about physical limitations gives rise to emotional pain.”

Bernard says if you don’t look sick, your family might need an email or a letter ahead of time making your condition visible.  You are not complaining, but giving a quick outline of your disease to insure when you arrive at a gathering, you’re not asked to frost 30 cookies or hand out drinks.

Why is this necessary?  Often people who love you want to be in denial.  If you appear to feel fine, they will go with that—it’s so much easier.  But your family needs to honor your situation and make allowances for the rest and quiet that you may need.

Finding comfort.  Though the holidays are the time of year when presents signify gifts of love and salvation, you may have to gift yourself during a particular time of your life.  Instead of buying gifts for others, you might have to gather to yourself the gift of comfort, the simple joy of another day of life.  Or you may have to pull away from past patterns, creating and enjoying a new celebration, one that offers you solace in your struggle—whatever that struggle is.  If a loved one dies, the traditions of past holidays will fall away.  Illness might limit or rework the holiday experience. Though it may be hard, go with the changes.  Life is a change artist.  Financial problems will certainly recreate the holiday experience.  You don’t want to go into debt trying to do what you have done in the past.

Making your own miracles. A recently divorced friend didn’t plan any experience with others on Christmas Day.  She suffered greatly from this decision and now will gather friends in similar situations to celebrate and be together.  She is recreating her holiday and making her own small miracle.  In a time of year when many long for warm sunshine and know that snowfall will after a time lose it luster, it’s important to bring something warm and cheerful into your life in a way that suits you.  Theologian Karl Rahner was once asked if he believed in miracles.  “I don’t believe in them, “he answered, “I rely on them to get through each day!”

Thank you to Rev. Ron Rolheiser and to Toni Bernhard, How to Be Sick: A Buddhist-Inspired Guide for the Chronically Ill and Their Caregivers

 Thank you to Ollie T Photostream

One Small Step for Boomers

Feeling overwhelmed?  I am.  The boomer highway is full of worries and tasks and when I’m on the net or tuning into TV or radio it’s job loss, foreclosures, floods, tornadoes and our sick economy.  Though I know I am very fortunate, I want some good news for our country and lots of good news for those who are struggling.

A very wise woman once told me that if you are feeling down the best cure is: do something for someone else.  A great nugget of truth.  Though the problems ahead of us are big, I recently came across an article in the AARP Bulletin that listed five small steps each of us can take to help the economy.  Yes, it’s a Washington problem, but it is also our country and we as citizens can make a difference–it’s called doing something for someone else.  Below are those steps.  I then added a few more to help you brighten your own personal day.

(thanks to Jim Toedtman, AARP editor)

  1. Cut 150 calories a day from your diet.  No more cookies!  If we can get our health care costs in line, we can begin to solve our fiscal problems.  Binge eating leads to obesity and often diabetes—a disease that has no cure, causes debilitating complications and is projected to cost 3.4 trillion in the decade ending in 2020.  More than 60 percent of that cost will be paid by the federal government.  So you can help the economy by watching your calories so you don’t become pre-diabetic or diabetic.
  2. Pay your debts.  Borrowing has led us to this economic crisis.  Household borrowing is part of the problem too; it’s acute for older Americans.  The average U.S. family with a head of household age 60-70 has saved only 25 percent of what will be needed for retirement.  New borrowing puts pressure on future interest rates.  But trimming eases pressure on interest rates, which will reduce the amount of interest to be paid on the national debt.
  3. Walk a mile a day.  Heart disease is the nation’s leading killer, with more than 40 percent of U.S. adults expected to develop cardiovascular disease by 2030.  Cost?  Exceeding 1 trillion and more than half of those costs to be borne by Medicare.  Exercise, whether it’s walking, swimming, aerobic dancing etc burns calories, strengthens the heart and cuts the nation’s medical bill.
  4. Plan to work an extra year or two. If you can, this step helps in a number of ways: you’ll contribute to the Social Security trust fund.  You’ll add to your retirement fund. And a delay in cashing out will bolster the Social Security fund and increase your personal benefit.
  5. Give Uncle Sam a gift.  Would you believe other folks do?  Taxpayers’ gifts to the U.S. Treasury so far this year total $2, 429, 800.03.  It’s just an idea that some people will be able to act on.
  6. Put music in your day.  “Feeling Good” sung by Nina Simone is a special look at a new day.  The following You Tube version provides interesting art by Jacek Yerka
  7. Turn off the computer. Give yourself at least one hour in the day for quiet and self-focus.  Make email, bill-paying, idle chat and research wait!
  8. Read a novel.  Fiction is not only a great escape, it also opens up doors and windows, allows you to travel and experience lives different from your own.  Often fiction allows your heart to understand and your soul to forgive.
  9. Be kind to a stranger. At least once a day make a concerted effort to extend warmth and friendliness to someone out in your world.  I find I usually get a smile in return.  Pay it forward.
  10. Pay attention to nature–flora and fauna.  Walk a dog, pet a cat, listen to the birds, embrace the sky, stare at the trees, smell a flower, watch the sun sparkle on the water, wait for the moon to rise.

Can you take some of these small steps?  Feel better?

Thanks to Emy Marie’s Photostream