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