My mother has been in no fewer than five hospitals in the past three months along with two nursing homes! No one seems to have a clue. Before that, we made the rounds of neurologists, neurosurgeons, and general practicioners; each had a new drug to try, but nothing helped (or not for long). She would really need a PET, SPECT, or MRI for an accurate diagnosis, but she won't even hold still for a CT (we usually get "motion infarct"; the last time, she was yelling for the police the whole time). Believe me, she will be more peaceful in her quiet home with just a couple of familiar people (a paid caregiver and myself) than in even the BEST nursing home -- they wouldn't take her, anyway -- where bells and whistles are constantly going on, different staff is coming in at all hours, other patients are yelling or moaning, she can't control the temp, etc. I've read that Trazadone may be helpful and will keep that in my back pocket. Oy!!!
I understand your frustration All!! A diagnosis in the later stages is very difficult to get because the patient doesn't cooperate and doesn't understand. Is the stress the patient goes through worth what little we gain from a specific diagnosis? At this point a diagnosis is not critical... you are treating the symptoms since you can't cure the disease! It's nice to know a diagnosis but dementia is dementia. Each patient is different and you know your Mom better than anybody else. You know what she will tolerate and what you are willing to do to that end.
As I said in another post, Meg's Mom was on the same drug regime that mine is on and it worked for both. That is no indication that it will work for you Mom or that you even want to try it. One medication didn't work for my Mom. We tried many over a period of 18 months. It took a cocktail to do the trick. I was willing to place Mom in the Geriatric Behavioral Med Unit only because I knew the unit and what they do... and I was at the end of my rope with a Mom who was hysterical ALL the time. It is not a large psych unit treating whatever comes in the door. It is only 10 beds, run by a psychiatrist that has a sterling reputation for excellent results and only deals with dementia behavior. Their admissions are selective and they take only dementia patients with chronic behavioral management issues. I was lucky to find such a special place for Mom to go. I wish I could have managed mom's angst with a calmer setting or a single medication but she was just too far into her hysteria for that
For behavioral modification I do recommend a geriatric psychiatrist that specializes in dementia behavior if you can find one. That is your best bet. Physicians, even neurologist, treat the physical aspects of a disease but honestly they are not the best for emotional aspects or behavioral issues. You might want to ask for references from social workers at the hospital, care facilities, or rehab.... even from the Alzheimer's Association hot line. Then speak to the doctor's office and find out what his specialty is. Check out his credentials and references as well as patient recommendations if possible. I doctor shop to find the best for Mom.
Hope you can find an answer soon to Mom's anxiety.
My mother is now back on Seroquel, but also still on the Ativan (they wanted to keep it PRN "just in case" despite my wish to d/c it) and is, as a result, very sedated. I guess that's preferable to desperately agitated, or at least it's a change of pace for all of us...
After insisting we try Prozac (d'oh), I bothered to read up on it; "sleeplessness, increased nervousness, diarrhea, itching rash." Yup, just what we need (not)...
Am hoping the Seroquel (third try, but maybe her brain has changed yet again) helps; if not, trazadone in a therapeutic antidepressant dosage will be my next card to play, as it's mentioned often in the FTL literature and, having been around a long time, seems relatively innocuous compared to some of these scary new drugs that are "unknowns"...
All these different chemicals in such a short span of time... My poor mother's brain must be going SNAP CRACKLE POP; probably all she really needs is just some peace and quiet.
Changing meds so quickly is not a good idea because it takes at least a week or two to see the full effects. Yes the Seroquel will cause drowsiness at first but she will wake up from that as she becomes used to the medication. Hopefully she will wake up less agitated. I too have heard many good things about Trazadone so it's a good back up. Yep, Mom's facility wanted to keep the PRN Ativan as well. The first order to DC actually got lost. But I personally brought in a hard copy of the DC order and then made sure it was off the books. I'm a witch that way hehe