Medication Roulette and Dementia

rouletteMy Mom is sliding into the deeper grasp of dementia. It is surprising to many people (and often to me) how one moment she can be so lucid, and the next, totally disjointed. She continues to try and join in the activities of the Independent Living community she was a member of for over a decade. Now, she’s confrontational and many of the residents are complaining. It’s sad that the community can’t deal with her, but even those that are well-trained are having a hard time re-directing her when she gets aggressive.

In my Mom’s community, Assisted Living is a hallway away from Independent Living. Now that my Mom’s full-time companion, my Dad, has passed, she is alone and really having a hard time finding a footing. The dementia is making it impossible. She’s very lonely, but on top of her grief, she is unable to make new friends and her friends are finding it hard to engage her now too.

Mom founded many of the bridge games and loves to play, but she can’t remember, nor does she recognize that she is no longer running the games. She’s short-tempered and rude with most of the other bridge players — a concept that would horrify the woman who raised me. However, this is the woman most of the bridge players see and don’t know the caring woman that formerly inhabited my mother’s being.

The doctor changed her medication and added the Exelon Patch (to help cognition) and Risperdal (to minimize anxiety and paranoia). They also asked us to hire personal assistants from 1 to 9 PM daily. The first two weeks went well and then things fell apart. The doctor is increasing her dosage and we have replaced the assistant that worked on the days I noticed my Mom having the most trouble. Risperdal is an off-label prescription and when we first got the recommendations, we did our research and gulped as read the side-effects. We have to try something new, because now, she is not doing well.

The current options outside of increasing her medication:

  • Move her to the section of Assisted Living and put on a Wander Guard. This prevents the doors from opening and the elevator from working. I can just visualize my Mom banging on the doors and confronting anyone that tries to use the doors if they don’t work. Both the AL staff and I don’t think this is the right solution.
  • Check her into a psychiatric facility so they can treat and manage her dosage and find the right mix. This could be a 2 to 3 week visit. The change is living arrangements alone will confuse and frighten my Mom and my biggest fear is that they will medicate her into a submissive state and she will return to just be admitted into the lock-down memory community.
  • Find a new facility that is dedicated to memory care and move her from the community she choose. This seems like the most logical next step for us to pursue.

Please let me know what your experience and suggestions maybe as we try to navigate this new transition in my Mom’s care. Pleaded.

Prior Related Topics include:

The Benefit of a Continuing Care Retirement Community

Your Parents Agreement with the Retirement Community is being Terminated

We are Ready to Move into the Retirement Community


11 thoughts on “Medication Roulette and Dementia

  1. Thank you for sharing your journey. Our family is just beginning the dementia trip with our mom, and it helps to have some “real life” stories of what we might encounter a little further down the road.

    I would encourage you to choose your next step based on “what is” and not “what used to be”. What your mom chose, or any requests/promises either of you made prior to today are not binding on you now. Now is what it is, and so you gather information, seek out advice, and make decisions to keep your mom as safe, calm and comfortable as you can.

    Wishing you lucid moments with your mom.

  2. I agree that it seems the next logical step is to move her to a dedicated memory care facility. While it is no doubt tough to move her away from the facility she chose, since it seems she is not getting along with residents there anymore, perhaps a change in environment will do her good.

    As for the Risperdal, yeah there are many horror stories about side effects. It turned my dad into a zombie, and one of his doctors even admitted that is what it is used for. Does it work in extreme cases to calm down residents when nothing else works? I’m sure there are success stories, and I hope your mother is one of them. My main complaint with Risperdal was that at the facility my dad was at, it seemed every resident was on it and instead of trying medications with less side effects or other behavior modification methods.

  3. Thank you Joy. I heard from another woman from South Africa that says it’s the ONLY drug they use there for Alzheimer’s patients. We are starting the search now.

  4. Kay, there does come a time when none of the choices are optimal. This is the real tragedy of this illness, because invariably the children and friends are left feeling distressed and guilty. You are lavishing care on your mother and doing as much, or more, as anyone could, as well as helping an entire world of readers to understand better what struggling with this illness is like for patient and carers. Be gentle with yourself.

    1. Steve – thank you for the note. As awful as the cancer diagnosis and complications were that we faced with my Dad, we recognized a quick end to life with Alzheimer’s was a blessing. We are learning how awful, tragic and difficult this illness becomes.

  5. As a nurse, I’ve had luck with Seroquel. It’s very hard to find the happy balance. I do see Risperdal given a lot, with some degrees of success. It’s very hit or miss, I feel. My mom is in a memory care unit/assisted living. She’s very passive but it’s still hard. Good luck, this area is somewhat my speciality. Ask away.

    1. Hi Jodi – My Mom’s community said they used to use Seroquel and are moving all the residents off of it. We (my siblings and I) have noticed my Mom seems much less anxious now. We are realizing we are just in an icky stage and are not sure if any drug is the right now. She seems to be more at peace but is definitely slowing down. She has been much easier to talk with and less combative, for now. The community isn’t sharing much, but I believe if this medication fails to help her (they bumped up the dose to the most they can give in Ass Living was my impression), we are looking at discharge or may consider a temporary visit in a medical facility designed to help treat and manage dementia.

      All suggestions or thoughts appreciated!

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