I am off of an Alzheimer's diagnosed case, because they refused to accept my observations while administering Ativan to my patient. I am trained in the Field of Alzherimer's, and am also Med. Certified. Upon entering the situation in the home, I went directly to the medications that were prescribed to my new patient. I found conflicting drugs. Ativan, and RemRon. Ambien and Lunesta. the latter have very serious side effects when used in conjunction with each other.
I accompanied my patient, and her family to her Physician. I explained my observations of the patient, after taking Ativan for agitation. She began to have tremors, or what appeared to be restless legs. She had skin tears on her shins, from her recent stay at a skilled nursing facility before coming home. She was on a regimen of anti-depressants, blood pressure medication to keep the blood lowered. I assume their diagnoses of Alzheimer's was a Vascular Dementia.
Her Doctor insisted on administering Ativan for what they call " Sun-downing" A catch all phrase. After approximately 30 hours of episodes of crying, and other behaviors, non stop. The night Caregiver left immediately, stating he couldn't bare to see her suffer.( He panicked and felt helpless). I helped her son take her to the Emergency ward of a nearby Hospital. Immediately after our arrival to ER, she became very calm and lucid.
I described to the attending Physician my observations of my patient,while taking Ativan. At approximately 4:00 in the morning, the Dr. ordered an injection of slow acting Ativan, the drug of choice for Alzheimer's. Within one half hour, my patient had severe tremors, and the Cardiac Monitor showed her heart rhythm all over the charts. The decision to give her the Ativan, was supported by her family Dr., as well as the ER Dr. She was climbing out of bed, off the walls and having a major Neuronal Glitch. I feel that once a Dr. has diagnosed a patient with Alzheimer's, he/she is given Carte Blanche to use this Patient as their own personal Guinea Pig. Finding an above board Dr. is the most important factor.
One of the reasons for Conflict of Medication is the process of ordering and receiving them. Each time a Dr. orders, and then cancels a new drug, it is up to the Caregiver/family, to place the discontinued medication in a safe place. If a mail-order company is late in getting a medication to a patient, and the Dr. sends a Prescription to a Pharmacy, then these two companies have no protocol for alerting the Caregiver of the conflict of medication. Not knowing the other is filling the conflicting Prescription.
It is up to the Dr. to control the medication, and to keep the family informed of all changes that conflict with each other.
Hope this info. helps you in your decisions on Medication. This has to be the toughest job you can encounter in your life. Peace be with you.