Is medication necessary?

Discussion in 'I care for a person with dementia' started by jstmcm, Dec 28, 2015.

  1. jstmcm

    jstmcm Registered User

    Apr 19, 2012
    48
    Until 10 days ago my mother was living at home with 24 hour live-in care. However, for the last few weeks things were beginning to break down and she has now moved to a care home near me.

    The care home is good - my mother-in-law has lived there for 2 years and we are very happy with the quality of care, although she does not have dementia. My mother is in a dedicated dementia unit within the home. Although Mum's dementia is advanced, physically she is normally very fit and active. She was in hospital immediately before the move, and for the first few days needed support from 2 people to move, but she is now physically fit again and for the last couple of days she has been back to how she was before - fully able to walk independently, without so much as a stick.

    Today I was told that the staff are concerned that she is now spending all her time walking around the dementia area talking to herself, although what she says usually makes no sense to anyone else. They want to talk to the GP tomorrow about giving her medication to "calm" her, to stop the constant wandering and talking. The thing is, she has been wandering and talking like this for the last year - I thought it was a normal part of dementia and I don't see why medication is needed to stop it. She can't get out of the home as the dementia unit is locked, so she is quite safe. I know that she is very resistant to taking any medication, which is proving to be a big problem for the staff and no doubt some medication to calm her might enable her to get other medication into her - always assuming they could find a way to get her to have the calming medication in the first place. But my question is, shouldn't dementia care homes be able to accept that some people like to wander all day talking? Is it a problem that needs to be solved, or just her preferred way of being at the moment which should be respected?
     
  2. tigerlady

    tigerlady Registered User

    Nov 29, 2015
    427
    If there are no other reasons to give her medication - ie aggression or extreme agitation - I don't know why they want to stop her walking. My husband was a very fit and active man when he went into care and he wanders most of the time, so he is still quite fit, but recently he has been given medication to try and control his aggression, which is working to some extent, but he does sleep more now. I wish he didn't have to have it, but he does seem more settled, and he is less of a danger to the staff and other residents now. There are a few other residents who wander about quite happily and the staff don't mind.

    Maybe ask the staff if there are any other reasons to "calm" her -for example - is she getting upset or agitated whilst walking.
     
  3. Amy in the US

    Amy in the US Registered User

    Feb 28, 2015
    4,619
    USA
    I'm hardly an expert but for what it's worth, I would tend to agree with you.

    I can see that not being able to give your mother medication would be an issue for the staff (even if not an immediate large concern I can see where this could be a problem at some point).

    But as far as the wandering and talking goes, I think they are jumping the gun. She has only been there 10 days, which is not enough time for anyone to settle, especially given the drastic move/change she has made. Some dementia/memory care units are, in fact, built so as to physically accommodate those who wander/walk often.

    If she is agitated and upset, or presents a danger to herself or anyone else, then I would be willing to discuss medication. However, if she is okay with the walking, and is able to eat and sleep, and if the staff are able to provide needed care (toileting, bathing, invitations to participate in appropriate activities, whatever), then frankly I would leave her alone and let her get on with it and staff can like it or lump it.

    I would also wait for her to have been in this care home for a longer period of time, say at least 6-8 weeks, before I would worry about it at all. After she's been there longer, this behaviour may change without any interference.

    I don't think this is of much use to you, and of course it's just my opinion, but perhaps others will have personal experience with this and be able to weigh in.

    If you have a good relationship with her GP, old and/or new, or memory clinic, or social worker, or anyone else you feel comfortable asking advice of, you might run it past them and see what they think?
     
  4. LadyA

    LadyA Registered User

    Oct 19, 2009
    13,529
    Ireland
    My late husband used to walk around the nursing home for hours, although he didn't talk. He wasn't agitated, he just liked to walk. The nursing home dealt with it by observing him until they knew his route, and by tagging him so they could keep track of him. The only concern his walking caused was that he was losing too much weight, so they gave him supplements.
     
  5. Quilty

    Quilty Registered User

    Aug 28, 2014
    1,051
    GLASGOW
    My mums care home has a few wanderers. Its just part of normal life now. A couple of them aquire things as they go but again we are all quite relaxed about it. I would agree with you - ask why and ask them to wait.
     
  6. TinaT

    TinaT Registered User

    Sep 27, 2006
    7,095
    Bolton
    In answer to your question YES the care home should be quite able to cater for a 'wanderer' I've been in many care homes over the years and haven't heard that this causes the staff to request medication for this.

    In fact I chose the care home where my husband was cared for precisely because it had many corridors so he could wander as he wanted. The only problem I had was when his walking became unstable and he had the most awful bruises to his face and body because of falls. Even then there was never any mention of medication to stop him walking.

    xxTinaT
     
  7. lin1

    lin1 Registered User

    Jan 14, 2010
    9,320
    Female
    East Kent
    #7 lin1, Dec 28, 2015
    Last edited: Dec 28, 2015
    I would be very concerned about this.
    Speaking personally , I'm wondering if they want an easier life or if they are really Dementia aware.
    If you wish you can arrange to speak to the GP that visits to not only voice your concerns over this but also to make yourself known to him/her.
     
  8. fizzie

    fizzie Registered User

    Jul 20, 2011
    2,731
    The care home should not be medicating someone who is only wandering and chattering and not upset or distressed. Most worrying that a specialist dementia unit is even suggesting this. I know numerous homes where residents who prefer to walk are encouraged to do so and staff actively engage with them as well wherever possible.

    I would ask to speak to the manager about this and see why they think medication is essential and then register an objection if they can't give a good reason.

    Good luck, keep posting
     
  9. jstmcm

    jstmcm Registered User

    Apr 19, 2012
    48
    Many thanks to everyone for your replies, they were really helpful.

    I managed to have a good conversation with the nurse before the GP arrived to see Mum, and the nurse explained that they are not concerned about Mum's wandering and non-stop talking, but that she is becoming quite aggressive when anyone tries to give her medicine or do personal care tasks, and that is why they want to give her valium. Her non-co-operation with these things was one of the reasons why caring for her at home was breaking down, so I am not surprised. The conversation with the GP was quite rushed, as he was running very late, but I have agreed to them trying valium, and also to trying to give medicine covertly in her food or drink.

    Thanks again for everyone's support.
     
  10. cat6214

    cat6214 Registered User

    Jan 2, 2016
    10
    Central New Jersey
    #10 cat6214, Jan 2, 2016
    Last edited: Jan 2, 2016
    Do not take their word about mom's aggressiveness


    Unless you have personally seen the aggressiveness, you may be getting another excuse for the staff to medicate your mom so that they do not have to work as hard. There may also be a not so good aide who is not treating your mom gently, and that's why mom is resisting. Please go there during one of the so-called problem times so you can witness her behavior for yourself. With most nursing homes, you really have to be diligent.

    Ask them what drugs they have tried or want to try on your mom, and get a second opinion from a neurologist who specializes in dementia and ALZ.
     

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