How to choose meds?

[sueb2b]

Ok you guys, apparently this message board is walking me (and mom) through every step of this process!!!!

I'm feeling a little hopeful today after a tough couple of weeks. While at the hospital I talked to a couple of nurses/techs about my difficulty getting mom into NH (plus, most of them around us are full!!!). They HIGHLY recommended a group home for mom rather than NH...so I looked at just 2 and decided to give one a shot. We'll move mom there Monday and stay with her as much as we can and keep our fingers crossed.

My dilemna now is: which meds to keep her on? When I first broached the topic of meds last week, they put her on Ativan which seemed to work well. The geripsychiatrist said he didn't want her on a benzo so he switched her to Haldol - seemed extreme to me but he said it would really help with reality testing and then we could evaluate her for depression, help her walk, etc. Well, one of the group homes I looked at today suggested Seroquel and the other suggested Xanax. How do you make such a big decision??? And, I almost feel like I could make the decision myself and just tell the dr what I want. Which is fine since I don't want to just blindly follow his instructions.

Thanks again everyone...

[BarbaraH]

Hi Sue,

Haldol used to be the big gun (talking 20 years), but that may have changed. I'd suggest you ask a pharmacist what the meds are that do the same thing and which is weakest to strongest. Dose also matters, of course.

You didn't ask this, but often AD units and homes ask the family to stay away for several days to let the new resident become accustomed to the new surroundings. When I move Mom into the ALF, she had her own apartment, so I did stay the first 2 nights. When she had to be moved to the locked unit, I arranged her new room and left. The staff unpacked her clothes. As was their rule, I was asked to stay away for a week (but I could call as often as I wanted to check on Mom). Be sure to ask the staff what their policy is about you staying or what they've found to work best.

When I went to visit Mom, she was happy to see me and said she was having such a good time on the ship. Huh????! I deduced that the only place she'd had a roommate was on an Alaska cruise, so she thought she was back on that ship! She wasn't the least bit curious about how I got onto the ship or why the view never changed!!

You'll find that brief morning visits and quick, cheerful departures will likely work best. AD folks are comfortable with a schedule and it's common for them to doze or be cranky in the afternoons. You may also find your mother is fine until she sees you and then she's unhappy or upset - very typical of a child. As my mother declined, she did become very child-like.

Remember, you're doing the best that you can for your mother. That's all anyone can do.

(((((((((((((hugs))))))))))))))) Barbara

[sueb2b]

Oh, Thanks Barbara!

I was so worried about leaving mom the first night - was imagining myself sleeping over with her or waiting until very late to leave. I'm so very protective of her. So I will definitely ask the owner of the group home. I also considered spying in the window or listening through open windows to hear how they're speaking to her, lol...imagine her confusion when she see's me being arrested for being a peeping tom!!!

Good idea to check with the pharmacist, they're always such a wealth of information and so accessible.

Thanks again

[Glenna]

Sue, I'm struggling with the meds question too.

So many conflicting opinions/experiences. I've read that no matter what, never let them give your loved one Haldol because that turns them into a zombie. Then I read never give them a benzo because it makes them more confused. Then I read (ack it doesn't matter--all so confusing/conflicting and everyone seems to have a different experience).

So far the only thing that has helped my mom in panic is a low dose of xanax. Her geriatrician wanted to give her Zyprexa and her neuro said risperdal--I was afraid of both because she has strokes and heart disease. So I went for a low dose of seroquel after reading it was the best tolerated of the antipsychotics (she's not psychotic, was just trying to stop the anxiety and panic). Doc said the xanax could be taken for panic and was not contraindicated if she was also on seroquel.

So, on a very low dose of seroquel she is more confused than ever and has no idea how to use a fork to eat her birthday cake. Eating every 5 minutes was her last remaining skill, yet suddenly she doesn't know how to use a fork? Ack. She complains something is wrong and her head does not feel right. Then grabbing of her chest saying she's having very bad pain in her heart. More ack.

So far she's not been able to tolerate aricept, celexa, zoloft and now seroquel, and I'm forgetting what other drugs due to adverse effects, so it's back to xanax--the benzo I keep reading should not be given for dementia. But so far it's the only thing that helps, but does not give her an even state of calmness which I had hoped for from the seroquel.

Every time I read someone's loved one is now calm and happy after getting the meds right, I scream at my monitor...WHAT ARE THEY? Which drugs, what combination, what dose, what time of day or night...help?!

Sorry, Sue, as I realize this is no help. Just commiserating...

[janeslk]

Every time I read someone's loved one is now calm and happy after getting the meds right, I scream at my monitor...WHAT ARE THEY? Which drugs, what combination, what dose, what time of day or night...help?!


My FIL is on so many medications, but they seem to be making him calm and he is more alert now. The medications he is taking are: Lorazepam (injectible 2mg), depakote ER (500mg tab), Zoloft (50mg tab), buspirone (15mg tab), temazepam (30mg cap), Lorazepam (0.5 mg) and I noticed the doctor has prescribed seroquel 25 mg again although that one alone did not seem to help much. Some of these are for anxiety and help sleeping.

When he first started taking some of these meds he was really out of it and adjustments were made. He also has high blood pressure so he is taking three things for that as well. I think the ones listed above are all for his depression and anxiety. I don't know how he often he takes each of these per day.

Hope this helps or gives you something to take to your doctor.

Jane