How do I know if my mother has dementia or is just taking too many prescription drugs?

Maggie, let's see if I've got this right. Your mother is on hospice care, as initiated by your sister. Your brother removed her from the nursing home (to his home, or hers?) and is continuing with hospice care. Brother has POA.

You think Mother is being over-medicated or inappropriately medicated.

Is that about it?

Since your brother is the primary caregiver, he is in charge of what drugs to give Mother. Since she is on hospice it makes sense that he is listening closely to what the hospice nurse advises.

Risperdal and Celexa are not particularly hospice drugs, as far as I know. Apparently Mother was having severe symptoms and those drugs were prescribed to reduce extreme anxiety and distress. Hospice would continue them if they are doing their job.

You do understand, I hope, that doctors have assessed your mom as being at the end of her life, and that the most likely outcome, in their opinion, is that she will die within 6 months. Given that, she will probably have a number of symptoms from her base diseases and from the dying process. These may have nothing to do with drugs she is given.

What you can do is talk to Kim and also ask to talk to the hospice social worker, and the chaplain if that suits you. Express your concerns and LISTEN to their explanations. Try to come to grips with what is going on with your mother.

You have no legal authority to take Mom off hospice or to insist that they change her medications.

Try to set aside your anger and frustration. Make the most of whatever time you have left. Hold Mom's hand. Read to her. Lightly brush her hair -- or have any contact she enjoys.

Help me , My mom has dementia supposedly though no actual tests were done , my sister got my mom hospice while she was in the nursing home and their drugging her up with Resperdol and Celexa ,now she can't eat or poop . My brother got her out but he's intimidated by Kim the Hospice nurse and she rudely insisted strongly when I said something about the side effects .What can I do legally, my brother has power of attorney .

I believe tylenol pm-which contains benadryl causes dementia like symptoms.

Wow. Amazing stories. I get ripped all the time for wanting my parents and my husband to get off these life threatening meds. I always crack up laughing when I see the commercials on tv for these drugs and the side effects are worse than the condition. I just got my husband to stop asking Crestor because his body ached all over and could barely walk. He had developed a fuzzy mind, forgot how to spell and was agitated all the time. We got into terrible arguments too. Finally, I told him that if this was going to be the quality of his life, then he would have to live it alone. The worst part is that he was on Crestor for having what the doctor called a perfect heart and an EKG of a newborn! I asked why he had to take Crestor and the doctor said he wanted to keep his heart that way. These aggressive script writers, as I call doctors, must be monitored constantly. I have had to deal with this for the last six years for both of my parents. When they came into my care, they were both on eleven to thirteen meds a piece. I was totally appalled. I started reading and educating myself about all of the meds. By the time my parents were settled in the ALF, the meds were reduced to five a piece. They were both more alert and thrived. They probably could have stayed at home for a while longer but my dad was driving erratically and was so forgetful, I could allow it anymore. My mom stopped taking the Aricept and Namenda so that sent her spinning out of control. She said she felt so bad by taking all of those meds, she just wanted it to stop. Some of the meds were necessary because of diabetes and GERD but the antidepressants were off the charts. I wonder if that is why there are so many crimes. People are out of control with anger, confusion and depression from taking these horrible drugs.

An infection can cause on again/ off again weird mental status. And often they cannot find the infection.

RJ:

As an HIV+ male on ARV meds, you do have an understanding about toxicity and the severity of side effects. 19 medications is an obscene amount. Her liver is overtaxed, she probably looks intoxicated, and her brain is having to create a virtual reality in order to maintain balance. Imagine your brain is a giant file cabinet; then someone (meds) comes in every day and shuffles the folders. The membrane that separates reality from pure imagination becomes blurred; you're not sure if you dreamed it or it really happened. Then people call you Looney Tunes, Cecil B. Demented, or a Horse long enough for you to put on a saddle. When you act as if long enough, you become; and eventually their perception becomes your reality.

Take an inventory of all the meds she's taking and research them on the Web, paying particular attention to side effects. Then consult with her doctor (who's primary concern will be getting paid -- no insurance, no service). There are many natural home remedies out there for some of her ailments, so check them out as well and discuss them with him/her. I wouldn't be surprised if she's on a cocktail of narcotics. Whatever pain she complained about at the beginning probably doesn't hurt anymore. Good luck.

-- ED

It is really bad how they prescribe for seniors.. and when they go into a nursing home it will get much worse. My dad was on about 30 -40 pills a day for diabetes and related preventative meds. plus insulin. He was doing okay mentally but had poor vision. He went into the nursing home and they started added numerous "low key" medications like several stool softeners, (they don't like it if you do not poop on schedule) (then added anti-diarrhea) then cough medicine, then allergy meds, and on and on until my dad was diagnosed with dementia... they they started adding all the alzheimers, anti-psych, etc,,, it was a heartbreaking decline. I thought he had LBD.

I really had to fight to get him off all the crap and within that time he developed a foot sore from being in a stupor and not feeling his feet... when he got off all the medications ''' and WOKE UP - he started complaining about his foot hurting and now it has been a year since he has walked trying to heal the sore.... what a nightmare..

Now he is off all the medications the nursing home put him on to control every sniffle & cough, not pooping to their satisfaction etc... and he is finally back to normal.

They had him headed from being a resident to putting him in the Alzheimers ward, which we fought each time they tried to move him, and it was all the cough and other medications they had added.

Now he is normal, if we'd let the nursing home doctor (directed by what the aids and nurses reported) keep prescribing to dad. He'd be a vegetable in the Alz ward right now.

You really have to be very adament and have your wits about you when you go into a nursing home. cough and allergy medication can be deadly to a senior.

My mother has had three brain MRI's in three years because of dementia symptoms. She is on about 15 medications for various medical issues and has remained in good physical health. Problems with arthritis, heart, diverticulosis, blood pressure, cholesterol, etc. have all improved dramatically.

In the first two years, acute confusion and delerium occurred in November and abated a great deal in January-February. This was noted by a psychiatrist. When the MRI each time showed no unusual problem. Increasing an anti-depressant medication worked well, but it was necessary to reduce the pain medications.

To make a long story short-- this has been the third year of this type of episode. The psychiatrist retired and we relied upon the nurse practitioner to evaluate her fully. When we thought she was suffering dementia, she was actually "stoned" on the pain medications and in need of increased anti-depressants and the addition of a low dose of Zyprexa (an anti-psychotic medication).

The change has been remarkable. In November, she refused to go anywhere or do anything. Her appearance, left to her own devices, was that of a bag lady. She is 84 and my father is in a nursing home with late stage Alzheimer's. Mom had verbalized that she was scared that she was getting Alzhheimer's as well.

The good ending is that she is pretty much normal again. There are some limitations which the nurse practitioner (and cooperating doctor) say definitely are age-related!! However she acts "born again" with the proper adjustments in medications.

I can only add that we feel it is never a good idea to not seek a consultation with another doctor.

ALSO-- my parents have excellent medical insurance which makes any and all care available. My family, and Mom herself, have supported the Obama Health Care Reform from the start. Mom has been at town hall meetings to loudly express her outrage with the "death panel" nonsense. She is a Roman Catholic, and she has also spoken out against pro-choice politicians being denied Communion, etc.

To go back-- our salvation for Mom came in getting care from a new provider. It seemed to be a case of a longtime doctor not really listening because she felt she had covered all the bases. Every doctor should be willing to allow the patient to seek a second or even third opinion-- and access to all the treatment history.

Here's video of my mother when I caught her coming off side effects of Ditropan, which she had taken for bladder control...at least for 7 years. I saw the ads for this drug on TV and realized she didn't have the bursting bladder symptoms, so asked doctor to try taking her off it. I think it was about 10 days that I noticed changes in her behavior for the better. I kept watching,a nd finally asked her if she noticed a change in herself. When I realized she was lucid, I quickly grabbed my camera and shot.

She improved a lot after this for a few weeks, then had dementia effect from newly prescribed Zocor. On/off/on/off/on/off, each time worse and better. we're off it, now, but Mom didn't really improve much after the Zocor experience.

I know first hand how medications can adversely effect someone. My dad has "dementia" and his doctor asked my mom if she had problems with him being aggressive or agitated. She said yes sometimes she did. Actually, my dad does was not "aggressive" or "agitated" - I would describe it as "uncooperative" and confused. With my mom answering the question this way, the dr. prescribed Risperdone.

I went to visit them and my dad was in a stupor. He could hardly get up by himself and could not feed himself. I didn't realize he was on new meds until my mom, as an after thought, wondered if it might be the new meds he started 4 or 5 days prior. I looked Risperdone up on the internet to find out what kind of medicine it was. It is an anti-psychoic that is used for schizophrenia, bi-polar and severe autism. Some doctors do use Risperdone for dementia patients, but there are many studies that show it can make the condition & symptoms worse for dementia patients.

My mom stopped giving him the Risperodone and made a follow up appt with the doctor a few days later. My dad got a little better and more coherent being off the meds for a few days, but was still not back to his previous condition. At the dr. visit my mom told him what had happened so he prescribed Geodon. I looked this up on the internet and it is the same type of drug as Risperodone, but a different name. I begged my mom not to start the meds, but she does everything the doctor says without question.

Within several days on the Geodon he was totally in a stupor again and was like an invalid. We contacted the doctor and thank god he then said to take him off of the Geodon. I explained to him that my dad was not getting aggressive with my mom that he sometimes did not cooperate. (My mom I think is hoping for a magic pill that will make him act normal again. Wish we had one!!!!)

After a week off of the meds, my dad was still like an invalid. My mom had to purchase a lift recliner, we had to install bars all over the house, we had to add rails to all of the exit doors and my mom was unable to get my dad in or out of the house alone. At this point, the doctor said that it probably wasn't the medication that his disease must have progressed rapidly. They had never seen anyone progress this quickly, but everyone is different. They had us call in hospice at this point. Needless to say this was very heartbreaking!!

FINALLY after 15 days off of the medicine, I called the caregiver to check on him and she said he was walking around looking for my mom because she went to the store. I said you mean you are helping him walk and she said no he is walking on his own. From that day forward he continued to improve until he was back to the condition he was in before starting the medication. It was very scary and thank god we figured out it was the medication. If not, I believe he would have been in an invalid state until he died. I wonder how many people this has happened to!!!

From this point on, me or my siblings have been to all doctor appointments and keep a close watch on all of their medications. I truly believe in managing your own health care and your families because doctors do not know everything. If you do everything they say without question - it can have very serious consequences.

The pharmacists specializing in Senior Care are excellent resources of getting advice on how to approach medication use and the overuse of medication. I would develop a relationship with such a pharmacist and ask them to be an advocate for your mother and their use of multiple medications, cumulative side effects and her body's declining ability to handle the multiple medications.

The pharmacist could also coach you to do the same. Some physicians are hesitant to stop medication unless there is full support of the family or medical power of attorney. If the physician won't consider stopping orders, ask if they would consider a drug holiday-not taking a medication for a period of time, sometimes it is called a hold order. It is a temporary stop and can be structured to meet the needs of your mother.

If your mother is in a nursing or assisted living facility, then enlist the assistance of their consultant pharmacist, attend care planning meetings, speak with the ombudsman or medical director to make you needs known.

Anyone experience this with Parkinson's patient? I think this is what my father is experiencing. I have tried to get the drs to change his medications and all they do is give me a run around. He also takes coumadin so the changes are more difficult to make to ensure don't impact thickness of blood.

RJK:
I cannot imagine the human body could process 19 medications and still be healthy...sounds toxic to me. A geriatric specialist is a great idea even if you have to try a few to get one who is knowledgeable and less concerned about her insurance.

My mother also has a wonderful pharmicist who takes the time to discuss her medications with her...they know more than physicians do about drug interactions.

My aunt who was diagnosed with dementia (doctors seem to be tossing around this term a little too freely) was actually having drug interactions. Once her medications were altered she was back to her old self.

The problem is that most doctors do not take the time to see if you should eliminate old prescription medicines before they prescribe new ones.

We must always be vigilant consumers...especially when it comes to our health.