Is Act-Donepezil effective?

[ztrezzed]

My 74 year old mother is extremely confused, has blurred vision, is not able to wipe properly in the bathroom and can't remember very much, if anything at all. I do everything for her 24/7, on my own (I am completely frantic and have zero free time). I plan to sell my house because it isn't safe for her, so that I can put her in a long-term care facility and I guess I'll rent an apartment. Family doctor just gave her the Alzheimer's verbal/written test and the score must have been very poor, because she failed every test except for folding paper in half.
Rather than sending us to a specialist, who would have put me in touch with my local Alzheimer's Society for a social worker (I'm in Canada), etc., he prescribed 5mg of Act-Donepezil, once a day and to re-visit after 3 months (blood & urine were taken and hospital scans were requisitioned). The doctor is good and his reviews show him to be a very competent doctor with elderly patients, however, I would rather hear it from experienced caregivers because I know from glancing at other web sites that other people with AD take more than one medication. Please advise. Thank you!

 

[Beate]

Donepezil is the medication given for Alzheimer's. There are others like Memantine but they are usually given if Donepezil is not tolerated or there are behavioural problems. 5mg is the correct initial dosis, it will be upped to 10mg after a few months.
There's another thread here: http://forum.alzheimers.org.uk/showthread.php?83782-Should-my-partner-start-Donepezil

 

[100 miles]

hi xtrezzed,

My mum also started off on a 5mg dose which was increased to 10 mg after a couple of months. I think it did halt the decline for a while.

I don't know what the arrangements are in Canada - but if you want a referral to a specialist unit together with access to social services, can you go back to the dr and request the referral?

Also, Have you thought through all options short of selling your home. (I am assuming it is your home and you haven't moved into your mum's home to care for her.) Can you get help in the home for a while? Would that be an acceptable and affordable option for a while? You need to speak to experts to understand what help is available before you make big changes in your life. If there is external support for your mum, hopefully you can keep your house.

 

[Spamar]

Hi
Donepezil is effective for Alzheimer's in many, but not all, cases. Given, as has been stated, at 5 mg, upped to 10 mg after a few months. I don't know if it was effective for OH, but he did not deteriorate much for several years. Other drugs may be added depending on presentation. In OHs case, he had violent delusions, so an anti psychotic was added, later changed to Memantine.

 

[Kevinl]

Hi ztrezzed, welcome to TP
Sorry you're in such a lousy place at the moment, I can only sympathise being in the same position myself, 24/7 with my wife in my case.
All the science says Donepezil can in most but not all people slow down the rate of decline so don't expect any improvement in her condition.
I guess your situation is made worse by having to sell you house to pay for her care in the UK if someone has very little the state picks up the bills for care, likewise you seem to say you need a specialist's referral to the AZ society and a social worker, in the UK everyone has the right to an assessment you just have to ask and the AZ society is open to all as are AgeUK and a number of other organisations.
The AZ society in Canada does have a forum you might be able to find some info on there re: help with care costs there are topics on it.
http://forum.alzheimer.ca/
K

 

[ztrezzed]

Thank you all for your informative and kind words.

After a few days of being on the Donepezil, the mass confusion disappeared. I realized it had been too soon for the drugs to have taken effect (and to such positive degree), which is why I got some (presumably) great news that I really wanted to hear. The doctor's office called to say that my mother had a bladder infection and that we needed to pick up the meds ASAP, since it causes confusion in the elderly. A couple of days ago (when there were only a few pills left in her 2 week bladder infection treatment), she was confused, again and told me that she thought the bladder infection had returned. Tomorrow, we're dropping off another urine sample to be tested. In the meantime, I have no idea if my mother has Alzheimer's, but we both agreed she should continue the meds. She has all the symptoms, but she swears that she's fine and refused to go to her catscan (which turned out fine 4.5years ago when I asked her to inquire with her doc about Alzheimer's meds) and a Brain Profusion Scan (nuclear medicine) because she told me that I'd be at fault if anything happened to her because the scans would make her sick. So those are cancelled, now. She was up all night, petrified of taking the tests.

Her mother had Alzheimer's and I'm very worried. As of a few weeks ago, she now needs to link arms with me and walk slower because her eye sight is so bad that she would probably trip on walks. This new development did not change after the confusion went away. Also, she wears all of her clothing inside out and/or backwards. Last year, I took her to a good optometrist, but her prescription was pretty much unchanged.

As of a few weeks ago, when her confusion first started, she lost interest in television and I'm exhausted from all the "babysitting", entertaining, etc. 24/7. In the winter, she will be house-bound because of sensitivity to cold, so I am trying to take her out as much as possible.

Is there a chance that she does not have Alzheimer's??? My brother is in denial and tells me that she's always been scatterbrained, etc., but I see how she blends houses together (sees 3 garage doors instead of 2), doesn't recognize our house, couldn't find her way back home after a 5 second walk, can't make tea, can't cook, can barely unpeel a banana, can't remember phone calls, can't make phone calls, can't recall the days of the week, only tells the same old stories every day, etc.

 

[Linbrusco]

My Mum has always been a bit of a scatter brain also, but 3 yrs ago when she start having gaps in her memory, forgetting appointments, repeating herself, forgetting conversations we knew something was up.
She also showed increased anxiety and agitation.
Following surgery for bowel cancer in Jan 13, she had a massive decline which we know now can be attributed to anaesthesia.
Aug 13 she was diagnosed with Alzheimers, and finally in Dec 13 started Donepezil.
The major difference we noticed in Mum was less confusion, anxiety and agitation.
An increase to 10 mg gave her stomach upsets, so back to 5mg.

At times when we have thought she may have had a UTI, because of increased confusion tests showed she didn't.
Now she has issues interpreting what she sees.
Leaves on a tree were balloons, pattern in the carpet was bits of fluff, TV storylines not make much sense unless its a singing or dancing, and confuses fiction with reality, confuses people in photos.
When my father is watching TV, she often thinks the voices are people who have been in the room.

If your Mum has had all other blood tests to rule out any other cause, only a CT scan would show any other possible physical causes.

 

[ztrezzed]

If your Mum has had all other blood tests to rule out any other cause, only a CT scan would show any other possible physical causes.

Yeah, mom is already starting to see weird shapes. But, again, we are not 100% sure, since her confusion is gone and she did test positive for a bladder infection. She's in denial and frankly, I'd like to believe that her memory issues and horrible vision are a "normal" part of ageing, even though I know it's not normal.

Silly question, but is there no such thing as standard elderly mental decline? I know it's not normal to mentally decline, but a lot of people become odd and forgetful in their old age. Could my mom's condition just be a slow decline and not Alzheimer's? Are you saying if blood tests (and scans) don't show anything physical then it's definitely Alzheimer's?

 

[nita]

If your mother has continual UTIs, the doctor might prescribe a low dose antibiotic to be taken continuously as he did for my mother.

I would say that what your mother is experiencing, is not a normal old age decline. The MMSE test is designed to pick up dementia and, if the score is less than 30, then it is assumed to be the cause of the confusion/memory problems, etc. I imagine the doctor has tested your mother for other possible causes such as hypothyroidism, etc. Also, is she on any medication that could cause side-effects? I was concerned initially that my mother's symptoms were caused by the steroids she was taking but this was found not to be the case after she ceased to take them and the symptoms persisted.

Does your mother have cataracts or any other eye disease? Is your optician good at picking up these things. Otherwise, it could be down to the Alzheimer's. When a person has a scan, I believe it is to rule out vascular dementia and then Alzheimer's is just assumed to be the type of dementia present if the symptoms suggest it.

I would encourage your mother to have the scans as they can rule out other possible causes of her symptoms. That will be difficult if she is so scared of them.

You definitely need some support. I hope you can get a social worker quickly. Are there any day care facilities where you live? I expect you will get a lot of information from your local Alz. society. If her UTIs clear up, you will then have an idea whether she needs the Donezepil or not but I would continue it in any case if it seems to be helping her.