How do I make the right decision?

[PatA]

Hello everyone,
Haven't had time to post lately as Mum has been a bit of a handful and I have been totally exhausted. However things have been moving along. Out of the blue we had a phone call and made arrangements for a CPN to come and see Mum. I wasn't able to be there but she rang me immediately afterwards and said that there is definitely some form of dementia and we now have an assessment appointment on 31st May. It's for the whole afternoon and Mum will see a doctor, a psychotherapist, a psychiatrist and a physiotherapist - it's going to be quite an afternoon! They have asked that I attend and they explained very nicely that there is no cure for dementia but that there are drugs available which can slow the deterioration down, and which they will discuss with me. This is where I have a problem and I would appreciate other people's thoughts.
Mum is 90. She has arthritis and walks with 2 sticks and she is incontinent (although she still denies this).She has no other physical problems and takes no medication for anything. To a great extent the dementia does not affect her life because she does not acknowledge it. The caring, the worry and the extra work falls on my Dad, my sister and myself. If I agree to her being prescribed drugs will the benefit to her outweigh the additional strain on my Dad, as he will be the person who has to administer them? I apologise if this line of thought offends anyone but I feel that my Dad has to be considered as well and the strain really does show on him these days. This has been on my mind since the appointment was made and I feel like I am being asked to play God with their lives. If anyone else has been in this position I would be grateful to know how you dealt with it.

 

[Sheila]

Hi Pat, well it certainly doesn't offend me. The thing with dementia is, in my eyes anyway, at present there is no cure. I think you are very brave to voice your concerns. Very often, the illness is more painful to the carer than the sufferer. I think the thing is to find a balance. Every case will be different, as will every solution. We know this illness will rob us of our loved ones, we have to accept that. We also have to find the right path for our own situation. Your father is himself elderly. No dementia drug will compensate for the age of either he or your Mum, nor will it make them 21 again. You need to discuss with the medical team, the best possible way of coping for both of them. If the drugs would make your Mum easier for your Dad and your sister and you to cope with, then it might be worthwhile. If on the other hand you would all be extremely stressed if she would not co-operate to take them, the question I would ask is what are we trying to achieve and is it working. It may be, that just love and kindness is the way that is right for your situation, or it may be that a calming medication or a sleeping pill would ease things. I don't know, it is down to you as a family to discuss these things with the medical team, look at all the options and make your decision with love in your hearts for both of them. Thinking of you, love She. XX

 

[Norman]

Hi PatA
I would think only one tablet will be involved.My wife has 10 mg Aricept daily.
It can be a problem,I have a routine now.
With the last drink before bed I pop the tablet in Peg's mouth,that way I am sure it is taken.
The last prescriptio gave 2x5 mg Aricept,it seems they were out of 10mm!!
I popped in 2 tablets.
You are so right in saying Dad has to be considered,he can do without extra problems.
From a Dad who knows
best wishes
Norman

 

[Sandy]

Hi Pat,

No too long ago I went along with my mother-in-law (who is 80) and father-in-law (who is 84) for an appointment at the memory clinic. The consultant psychiatrist diagnosed my father-in-law as having Alzheimer's and vascular dementia.

What I found reassuring was there was no definitive statement of "He must be put on medication" or "Medication would be of no use", but there was a much more helpful discussion about his health in general and his current symptoms of dementia.

A consensus quickly formed that as my father-in-law was in the middle/late stages of dementia and was physically quite frail (he also has myeloma - a form of cancer) that medication for his dementia would not be appropriate. This was based on the doctor's opinion that medication would be of limited effectivness and given his frailty, the potential side effects could affect his appetite and sleeping (both of which are fine at the moment) which could have a serious impact on his overall state of health.

So hopefully you will not have the full burden of deciding about medication on Wednesday. This will be something that can be fully discussed with the medical team, taking all the factors into account.

And I would echo what Sheila said, even if it turns out that medication is not appropriate for your mother's dementia, other types of medication might be appropriate for some of the symptoms related to her condition, now or in the future.

Take care,

Sandy

 

[PatA]

Many thanks for your replies. I'm hoping that the answer/decision is going to be simple and straightforward. Will let you know.