do drugs help or hinder?

Discussion in 'ARCHIVE FORUM: Support discussions' started by Annley, Jul 18, 2004.

  1. Annley

    Annley Registered User

    Jun 30, 2004
    8
    my dad as both vascular dementia and AD. About 2 months ago he became very aggressive, and was put on drugs. The first drug made him worse, and now he is on, I think it is called, Haloperedin. Since being on this drug, he seems to have deteriorated very quickly, becoming incontinent and not understanding what is going on around him. He doesn't recognise the toilet at all, and is wetting the bed at night. The doses have been altered to less than he was on before, but then he is unable to settle and is very restless. My sister thinks the drugs have made him worse. I am not sure whether he has just deteriorated with the vascular dementia - can anyone help? annley
     
  2. Brucie

    Brucie Registered User

    Jan 31, 2004
    12,413
    near London
    I'm not medically qualified to answer this, but my experience has been that identifying the appropriate medication for a given person - i.e. my wife - has been a question of
    • identifying a medication
    • selecting the particular dosage
    • watching for interaction with other medications in use
    • deciding the timing of the giving of the medication
    • the stage of the development of her illness

    Never has it been a situation that Jan has immediately been given the right medication in the right dosage, not interacting with other medications, with the stuff being given at the right time for the stage of development of the illness.

    It is always a case of trying it, observing, adjusting - or discontinuing - then adjusting again over a period of time.

    Medications can have a major beneficial effect - or they can have an effect that makes the condition worse.

    If your Dad is at home and his condition has deteriorated since the prescribing of the medication, then keep hammering at the doctors to find something that does not cause a deterioration.

    Keep records of how he is, from day to day, to use as evidence that will help them.

    It is, of course possible with vascular dementia that a major change can happen quickly, so keep that in mind as well.

    One way to check if it is the medication causing the problems is to ask the doctor to reduce the medication and/or discontinue it. If the effects are reversed, then they can try something else. But with aggressive behaviour you also need to watch out for that.

    Best of luck
     
  3. jools

    jools Registered User

    Jun 29, 2004
    39
    Hi,

    If I were you, I would go back to the doctor and tell him. It may be the condition, but it could easily be the medicine as well.
    My dad was put on a water tablet called Frusimide last year. he doesn't have AD, but has a heart condition and needs water tablets to stop fluid gathering. He was very dodgy health wise and finally ended up with a minor stroke just before Christmas. When I was in the hospital, I mentioned to the doctor that I thought the frusimide was causing this, he changed him to another water tablet and he hasn't looked back.
    The trouble is when there's a lot wrong with a person, like there is with my dad, it's easier to put it down to that rather than the medicine.I would see the doctor again; he'll not be offended, because a lot of this is trial and error;that's why they do a review of a persons medication every six months cos side effects and toxins can build up. Hope this helps,
    Jools
     
  4. Annley

    Annley Registered User

    Jun 30, 2004
    8
    I mentioned to the sister at the day care that I thought the drugs might be causing my dads incontinence. She seemed to think that it was just the illness progressing. She then went on to say that if we wished to change the medication, we would have to reduce the medication and his aggressive behavious might return and his aggitation. Then we would have to find another drug, and that would take time to get into his system. In the meantime, my mum says she cannot cope with that and she prefers to keep things as they are. His incontinence is much worse and he is wearing pads day and night.
    The professionals are concerned for my mothers health, and I said I thought mum needed help in the mornings to help shower and dress dad. This help is available at a price - they are both pensioners, and on small incomes, but the government want to know all their assets to pehaps give them a small discount off the £8.50 per hour for a carer. I bet mum wishes that she were paid £8.50 per hour for the 24 hour job she has got at the moment!

    I am horrified at the lack of help for carers in the community. I think the government are just waiting for for mum to burn out, then they can take dad and just let him die. Then they will be happy.

    Feeling a bit fed up today! annley
     
  5. jools

    jools Registered User

    Jun 29, 2004
    39
    Know the feeling. Everything you've got to keep asking and asking for, and there doesn't seem to be any joined up thinking between the social, medical and benefits agencies (or they just don't want there to be.) Go and see the doctor though. Everyone has given their opinion apart from the doctor, who's the expert, and it might just take a change of medication to correct it. It might even be as simple as a urinary infection that could be cleared up by antibiotics. That happened with my mum on one occasion. Get some of your family in on the act as well, with regard to phoning the social and arranging care. If you can get enough pester power together to phone, they will listen to you. I arranged with two of my sisters to keep phoning when I couldn't get hold of the person in the department I needed. It took a month of phoning, but we did get her, and we did get care provision from the council. It can be done, but you got to keep asking!

    Good luck,

    Jools
     
  6. Brucie

    Brucie Registered User

    Jan 31, 2004
    12,413
    near London
    I agree with Jools, don't take medical advice from sisters at care homes.... go to the doctor and be firm.

    Some nursing staff are more clued up than the doctors, so one doesn't want to generalise, but the doctors are the ones who have the power to change things.

    Staff in care homes naturally want their residents not to disturb things, and incontinence pads can be left on residents until they need changing. It makes no difference to them that we don't want our loved ones to be incontinent unnecessarily. If an inappropriate medication means a resident is quiet, but incontinent, then they will go with that unless we make a fuss.

    Changing medications does not always work, and there are always problems of weaning off one and weaning onto another - which may itself provide a heap of other side effects, but that is what assessment is all about. It IS worth doing, because there will be a best option.
     
  7. HELEN

    HELEN Registered User

    Jul 16, 2004
    36
    wales
    Hi all,

    Its so nice to be able to post as I've had such terrible trouble posting over the last few weeks. Thanks again Nada for your patience. Hope you don't mind me asking Jools , but what water tablet did the doctor change your dad to. Only my mum has heart problems & takes water tablets as a result. Family are convinced these make the confusion worse. confusion is listed as a side effect on the packet. Mum takes co-amilofruse which i believe is frusimide with added ingredient. When they were stopped for a week mum seemed mentally much better but the swelling was really severe so had to go back on them. Would be interested to know so perhaps could discuss again with gp. Its so hard to give her something that you now will cause her to suffer mentally but if we don't she is in a mess physically, turning blue & breathless.As if her dementia isn't enough to cope with shes got all her other problems to cope with as well. I think my mums so brave.

    Take care all

    Helen
     
  8. jools

    jools Registered User

    Jun 29, 2004
    39
    Hi Helen,

    The water tablet my dad was changed to is called bumetanide. I looked it up and it seems to be related to frusemide as well, but certainly hasn't had the same effect on my dad. You can ask the doc about it. Good luck!

    Jools
     
  9. Annley

    Annley Registered User

    Jun 30, 2004
    8
    It seems that the wrong medication can have very severe implications. Our GP called last week and when I mentioned about the tablets, he said that they were very well tried and tested, and that what was happening to my dad was a deterioration in his health due to the AD and the Vascular Dementia. When I asked about services such as a physiotherapist - because dad has suddenly become bent in half - and a nutritionist - because we cannot get dad to eat much - the GP said it was a waste of time because my dad has got a terminal illness, and we were just prolonging the agony. Eventually, and indeed in the very near future, he thought, my dad will get a chest infection and that will probably be it We haven't met the doctor at the hospital. My mum has spoken to her once on the telephone, and so have I, to discuss how many tablets to give dad. She seemed to leave everything to our judgement as regards the medication - just not to exceed 6 tabs in a day. Since on the medication he has become incontinent, is bent in half but not as aggressive. If we ask her is it the tabs she will just say no its the AD or Vascular Dementia. We are just going round in circles. What next? Annley
     
  10. jools

    jools Registered User

    Jun 29, 2004
    39
    hi annley,

    I think the attitude of your GP is shocking. Maybe your dad is terminally ill, but that is no reason to allow someone to suffer from malnutrition, and believe me he will suffer. My dad as I already mentioned, has a heart problem, he also has auto immune liver disease, and last year when he was on those water tablets he had a terrible time because he could eat very little and he was also dehydrated P(though we didn't know that till he landed in hospital). Get another doctor to look at your dad. I looked up the medicine you mentioned, and I found one called haloperidol.If that's the one your dads on, one of its side effects is 'extra pyramidal symptoms'; that is muscle tremor and rigidity. Constipation is mentioned, but not incontinence.It also says 'administer with care to patients with vascular dementia'. There should be a leaflet with the medicine box listing the side effects.Pursue it, and get your sister to phone as well, so that you aren't a lone voice objecting. LOL, Jools
     
  11. HELEN

    HELEN Registered User

    Jul 16, 2004
    36
    wales
    Thanks Jools,

    I'll check that out, i don't have a lot of faith when tablets are prescribed & always tend to look them up. Mum has several health problems which makes things more complicated. One of which i feel is due to the wrong medication being prescribed. For some time mum was prescribed quinine for leg cramps (side effect of one of her other medications) & nefedipine for heart problem/hypertension. Even though the leaflet for both tablets said they should not be taken together. Gp did not change & it was not until she was seen privately by a cardiologist that they were stopped. He agreed & immediately changed to other medication. However mum was then diagnosed with the blood condition ITP (blood won't clot properly)caused by an allergy to quinine?Mum still has this but it is improving . So she is now at extra risk of internal bleeding etc particularly if she fails. She also had to go through all the tests for cancer to rule that out first . Bone marrow biopsy etc as she has had cancer in the past. Mum had forgotten about the cancer due to her dementia so when they mentioned it it was as if they had told her for the first time. Mum was frightened & upset & we think this is what caused another mild stroke. Result of the stroke dementia worse.Things just seem to snowball, hence my tendancy to double check.

    Take care all

    Helen
     
  12. Annley

    Annley Registered User

    Jun 30, 2004
    8
    Thanks Jules for your posting. I rang the consulatants secretary and asked for an appointment to discuss the side effects of the tablets. I looked on the internet for more information, and loss of bladder control was another side effect - surprise! The consultant visited my dad in the day care centre today and has prescribed another tablet to take away the unwanted effects of the haloperidol. She said I can see her next Wednesday if things do not improve. The more I think about it - my dad looked about ten years younger about two months ago - its got to be something to do with the tablets. I will keep on at them and hope to get a result. Thanks again for your help. Annley
     
  13. jools

    jools Registered User

    Jun 29, 2004
    39
    Hi annley,

    Best news I've heard today; I really felt for you. It was so difficult for me to get hold of the social worker initially, that my sisters thought that I wasn't phoning! After they tried, and got similar results they believed me!Hope the medication works out.LOL

    Jools
     

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