Need input on the treatment of AD related aggression

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Mom's Advocate
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Date Joined Sep 2009
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   Posted 9/28/2009 9:23 PM (GMT -7)   
Greetings all,
 
First-timer here.
 
I need some input please.
 
I was informed today by my mother's nursing home that due to Mom's increased aggression towards other residents in her nursing home, we either have to start her immediately on the drug Neurontin and get her aggression under control, or she will have to be moved to a psychiatric hospital.  Last Friday, they also told me that she has "Sundown Syndrome."
 
IS there anything else, some other method, some other way, some other drug??  She has congestive heart failure and the info I have seen on this drug, Neurontin, indicates it isn't recommended for patients with heart conditions.
 
I feel like they are rushing me.  Like I have been given an ultimatum, "do this or else!"  And I don't think it is the best option for her!!
 
Any suggestions??
 
Thank you for any information you are kind enough to share.

SnowyLynne
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   Posted 9/28/2009 10:19 PM (GMT -7)   
Is she on Seroquel??
SnowyLynne


Red_34
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   Posted 9/29/2009 5:28 AM (GMT -7)   
I wasn't aware that they used Neurontin for AD related aggression. I take Neurontin for nerve pain related issues. Has she been seen by her doctor? If not, do not take the recommendation of a nursing home but rather her doctor. There are a few medications out there that can help with AD. My grandmother is on Namenda for hers. There is also Aricept that has been shown be a good medication.

My grandmother also has Sundowners. This is a chemical imbalance in their brain that is affected by cloudy and rainy weather. It typically affects the person's mind after sundown. The sun is sort of "feel well and stablizing" sort of thing for them. When it goes down, it affects their mind. It is actually pretty typical with dementia and Alzheimers.
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SnowyLynne
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   Posted 9/29/2009 7:02 AM (GMT -7)   
I'm on Galentimine(Razadyne)
SnowyLynne


myrio
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Date Joined Aug 2009
Total Posts : 6
   Posted 10/2/2009 8:35 PM (GMT -7)   
Many people think that calming Alzheimer's medicines are just heavy duty tranquilizers, they fear that giving their loved ones these medicines will turn them into "zombies" who cannot think, feel or communicate. However, many calming medications actually give them a new lease on their lives by enabling them to approach problems and memory-related frustrations with little more equilibrium. Calming medicines for them serve one ultimate function is to calm the patient and prevent from injuring themselves or others, and these meds can help them continue to focus and function on their daily routines, and from harming themselves and those around them... there are different types of medications that are used to calm Alzheimer's patients. They say drugs used to treat schizophrenia can also help limit patients aggression and the idea that people are out to get them...

Mom's Advocate
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Date Joined Sep 2009
Total Posts : 5
   Posted 10/3/2009 10:06 AM (GMT -7)   

Thank you all!! :-)

Can't think where my other response went.

I understand about the "zombie" part.  I also don't want what has always made Mom unique (on SOOO many levels) to be squashed.  Since she is too far gone into the "sundowner's" and the aggession to try a non-pharmeceutical approach, we have determined that for now we will try using Zolaft daily and Ativan as needed.  Not happy about it, but really had no choice but to proceed with pharmeceutical intervention.

They also mentioned taking her off her Aricpet and Namenda because "it reaches the point where it doesn't work any more."  This I know also, but who or what determines when it's "not working anymore??"  Mom is still thrilled by the beauty of things around her, still loves to shop, still loves a good cup of tea, and a good meal eaten with her family.  Sounds to me like she isn't past the point of the meds working.  I am also taking her for a psych evaluation with a psychiatrist.

Any ideas, input or suggestions on the Aricept/Namenda

Thanking you all, I remain

M. A. 


SnowyLynne
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Date Joined Apr 2004
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   Posted 10/3/2009 10:10 AM (GMT -7)   
Ativan can cause worseing of the disease....

SnowyLynne


Mom's Advocate
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Date Joined Sep 2009
Total Posts : 5
   Posted 10/6/2009 11:30 AM (GMT -7)   
I know, but they didn't seem to have an alternative and they PROMISED it would only be used "as needed", like when the aggression seems to have reached the point where she is going to lash out at a resident.  Since they haven't been able to keep her calm, I am wondering if they will be a:) able to get to her in time, and b:) make her TAKE the med as it is an oral medication.  We will have to wait and see.
 
What would be a good altenative to Ativan??
 
Thanking you for your assistance,  I remain,
 
M.A.

SnowyLynne
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Date Joined Apr 2004
Total Posts : 1539
   Posted 10/6/2009 1:04 PM (GMT -7)   
I would refuse her being taken off Aricept/Namenda.......Sounds like she's doing good on them....Seroquel is a good substitue for ativan.It should calm her but not make her a zombie.Just remember it takes time to get into the system.........
SnowyLynne


Mom's Advocate
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Date Joined Sep 2009
Total Posts : 5
   Posted 10/7/2009 10:02 AM (GMT -7)   

Thank you, Snowylynne.

So far, I have managed to resist taking her off the Aricept/Namenda.  I have told them until she is apparently NOT enjoying anything, we are going to keep her on it.  She is failing quickly now that her roommate passed away.  They were attached at the hip and I know that Mom misses her.  Her roommate was so lively and kept Mom going.  To point out the hallucinations mom is having, they tell me Mom walks up and down the hallway alone, talking to somebody who isn't there.  HELLO!  She's doing the same thing she did everyday up to the point her roommate passed.  Mom is walking with her and talking with her, I'm sure.  BTW, they have told me Mom is at stage 6.

You mentioned the Seroquel in a previous email.  I didn't realize you were suggesting it as an alternative to the Ativan.  They are only suggesting the Ativan specifically for those times she needs it.  Which hasn't been any time since the incident two Fridays ago.  I will research the Seroquel as an alternative.  Do you have any particular information regarding the Seroquel as opposed to the Ativan.  If not, do you know a good site that may have the information??

As always, I appreciate the advice and the information.  I remain,
 
M.A.

SnowyLynne
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Date Joined Apr 2004
Total Posts : 1539
   Posted 10/7/2009 11:12 AM (GMT -7)   
I was on Seroquel for 2 months for serious agitation due to an inept caregiver at a rehab my hubby was in after knee surgery.......I have vascular Dementia but at the time we were told I had AD,which wasn't so.I asked my Neuro to be retested & he agreed I was doing too well for AD.....I now take Galentimine(generic Razadyne)It works for me......
SnowyLynne


Mom's Advocate
New Member


Date Joined Sep 2009
Total Posts : 5
   Posted 12/29/2009 10:14 AM (GMT -7)   
Greetings all,

Just wanted to update on my Mom and her situation. Aside from her "aggression" issues, the facility waited till she had lost 15 lbs before telling me that she wasn't eating at all.

As I mentioned above, I suggested Zoloft for her. This poor woman has suffered from depression since her 40's and because of the "stigma" of the era, never did anything about it. I do not know if at any time prior to me taking over her medical care, antidepressants were suggested by her Dr. Probably not, as I have no high opinion of his medical skills, but Mother has been known to get home from the Dr's and THROW OUT any written prescriptions he may have given her.....so I will give the Dr. the benefit of the doubt.

Since I took over her medical care in 2000, I have asked and asked and ASKED for an antidepressant for her and finally, in 2009 .. SOMEONE listened! She has been taking Zoloft since October and it is now the end of December and they have only had recourse to the Ativan THREE times. I am quite pleased. She seems happier and more lively mentally and that is FABULOUS! Also, I did take over her menus and so far, it seems that all is going well and she is eating again. The facility is giving me full credit for her increased appetite. I think it is the Zoloft (who wants to eat when they're depressed?) but if they want to give me credit for the change, who am I to argue?

So Mom is doing better mentally with no major psychotics being used frequently. She and her new roommate are getting along famously, but there is no replacement for her old roommate and I can see her failing physically. She has given up tapdancing for the residents. But she is 87 and even she admits she is getting old, God bless her heart.

For all who responded and offered their assistance, I give you my sincere thanks for your efforts on my mom's behalf. I appreciate it so much.

Sincerely,

M.A.

SnowyLynne
Veteran Member


Date Joined Apr 2004
Total Posts : 1539
   Posted 12/29/2009 4:34 PM (GMT -7)   
Ativan is in the Benzo family NOT good for dementia of any type......
SnowyLynne


Howlyncat
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Date Joined Jan 2005
Total Posts : 24909
   Posted 12/31/2009 1:18 PM (GMT -7)   
I am so happy to hear your mom is doing better..i hv to agree with snowy on the ativan though there are other meds that wont cause as many problems with ad peeps as ativan does..keep us posted..lyn


                          
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Post Edited (Howlyncat) : 1/1/2010 11:16:11 AM (GMT-7)


Howlyncat
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Date Joined Jan 2005
Total Posts : 24909
   Posted 1/1/2010 10:20 AM (GMT -7)   
..Like SHERRY ..I have not heard of neurotin being used for AD patient and agression issues..i too take it for nerve pain...i hope you will continue to keep us posted on your Mom and what is going on with her...huggles..lyn
                          
                                Co Mod for Crohns, Anxiety/Panic, Alzheimers
   Crohns..Pyoderma gangrenosum,..Anxiety / panic..Fibromyalgia,,Neuropathy...Deaf...Seizures
 
                        I DONT COMPLAIN...OTHERS ARE WORSE OFF THAN I AM                                   
                                                     .....LYN.......
                                Donate to..www..healingwell.com.
                                                    
                             No BETTER GIFT than FRIENDS N FAMILY                                               
                            Happy Holidays from my home to yours
                              
 

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