Research has shown that listening to music is very important for your loved one suffering with this illness.  The ability to appreciate music comes from a part of the brain that dementia/Alzheimer’s is not affected.  Music from their younger years would probably be soothing and calming for them.

Fish Oil Capsules

            It appears by different clinical studies that patients taking Omega-3 capsules (fish oil) does not seem to have an affect on this disease.

Bilingual

            Research suggests that mastering a second language can delay getting Alzheimer’s later in life.  The research shows that the delay can be up to 4-5 years later than those speaking only one language.

Aricept 23mg

            A larger dose of Aricept is available- 23mg.  Discuss with your doctor if is this is beneficial for your loved one.

Parkinson’s Disease Associated With Dementia/Alzheimer’s

            Some of your loved ones may develop Parkinson’s Disease.  There is a percentage of patients in which this occurs.  It is possible it is due to an adverse reaction to their medications.  Another explanation is that it is just a progression of the disease.  Consult your physician for advice.

We see what others do not or care not to understand and see

We see you struggling for your life and the sadness we know you feel

After all, we are your daughters and who loves you more than we

We watch your cognitive decline and don’t know how this could happen

Your life is changing and very challenging with every passing day

There is no cure and though we pray there will be one soon

The things that are supposed to be natural are no longer that way

One who’s life was full of laughter, compassion and dreams

Something changed and we saw that your reactions were not quite right

All the doctors’ appointments and medications you need

Sadly, the emotion left your face and your future is no longer bright

We wish we could bring your memories and feelings into today

But with each passing day, we understand that it just can’t be

Your family, job, friends and your art, you can’t remember

We wish we could restore your life and memories for you to see

We truly suffer daily with all your problems

You see, we are the children of a dementia mother

We pray for all those who are suffering like our mother

This prayer is also for the caregiver, child, spouse, sister or brother

By RW and MW

Click on the table above for a full sized printable medication card.

We would like to discuss some of the issues that our mother is having. It is difficult for her to eat and drink while her hands are shaking. There are dining utensils that have weights on them which might help. Remember an occupational therapist and your physician will decide if these products are right for your loved one.  Weighted utensils look like regular dinnerware but the weights in them might have the potential to decrease tremors. Many are dishwasher safe, which is a plus. There are also weighted cups to help patients with spillage. Most of these cups come with lids. Some even have double handles.  Just remember, patients might need help in using these utensils, so please get professional help.

The studies are usually done in major medical universities and hospitals and the outcomes could provide the medical field with important information to help fight the disease and possibly even prevent it.  The trials are advertised on television, in newspapers, and also by calling the large university hospitals in your area for information.  Remember that without research and volunteers, there will be no hope in curing this devastating disease.

Alzheimer/Dementia: The Caregiver Burnout

When the initial cancer treatment regimen was finished the patient had another PET scan which showed no tumors. The Oncologist wanted to continue with maintenance therapy, but family refused due to rapid progression of Dementia which was a result of the chemotherapeutic agents. Daughter states that her mother’s dementia began with a loss of interest in many of her hobbies which no one really thought much of at the time. She was an artist for the majority of her life and gradually lost interest in painting. She also was an active tennis player and stopped having interest in wanting to play. At around the same time she was thrown off her bridge game which she played for years many times a week with her friends because they said she could not play at their level anymore. Daughter assumed that the bridge players were just too competitive and she was better off not playing, but her daughter stated that she became concerned when all these different issues starting occurring.

Patient had a complete work up done by a neurologist and was diagnosed with Alzheimer’s Dementia. Daughter reports that her mother began to seem unemotional about everything and barely spoke and when she did would only speak of her mother who died 10 years ago. She also began losing complete interest in her grandchildren. Daughter reports that mother developed a blank stare and her mother stated that she said she felt like her mind was shrinking. However, daughter states that she was still able to take care of herself at this time. Once chemotherapy began mother’s dementia rapidly worsened. Her mother became completely incapable of caring for herself and developed compulsive and inappropriate behaviors. She became obsessed with her teeth and was constantly using dental floss. She also would go to the bathroom and would forget to dress herself before exiting the restroom.

Daughter also stated that she became completely unable to do her favorite activity which was crossword puzzles. She also reported that at night time her mother’s Dementia symptoms would worsen and she would constantly pace and would continuously open and close her closet doors. She was just not able to relax. She also stated that her mother would become very anxious in unfamiliar places and with unfamiliar surroundings. Daughter decided that it would be best for her mother to be admitted to Long term care because she needed constant assistance and she was afraid that this would be too stressful for father, but her father visits daily. This was a very hard decision for the family to make. They thought that being in a facility would increase the quality of life of patient because a certain amount of stress would be off of her. They felt that being in normal situations with other family members and friends was becoming too stressful for patient.

Patient was admitted on December 10, 2009. Daughter also reports that she has short term memory loss and sometimes will not even remember what she ate for a previous meal, but will still remember all her children and grandchildren’s names, careers and their social relationships.

Current medications-
1. Aricpet 10 mg PO daily at bedtime
2. Zoloft 50 mg PO every morning
3. Seroquel 12.5 mg PO two times daily and as needed
4. Namenda 5 mg PO twice daily
5. Tenormin 50 mg PO daily

It is important to remember that not everyone has to go this route. There are many families that keep their loved ones at home, but it is important to get help. The caregiver also will need a break and whether the family decides to hire aides from an agency or take turns helping, it is very important that one person can not totally take care of a dementia patient. Never feel that by putting your loved one in a long term care facility means that you do not care, it just might be too much work for some people. Some patients are easier to deal with than others, it is important to remember that also. Every situation is different and research all your options before you make a decision.

Alzheimer/Dementia: When a Family Decides to Place Patient in Long Term Care Facility

The first line of medications in treating this disorder is a class of drugs known as the Cholinesterase Inhibitors. These medications block the breakdown of acetylcholine, thus, increasing the amount of it in the brain. This increase in the brain should improve cognitive function.

Aricept (donepezil) is one of the cholinesterase inhibitors. It recommended to be taken at bedtime, with or without food. If the patient experiences strange dreams or nightmares, tell your physician and he will probably suggest taking the medication in the morning to lessen or avoid this side effect. The most common side effect is nausea, vomiting, diarrhea and dizziness. The starting dose is 5mg daily and if tolerated your physician will increase the medication to 10mg daily after 4-6 weeks. If upon the increase, the patient is not tolerating it well, tell the doctor because the dose may have to be decreased. If the patient is experiencing side effects with the 5mg dose, your doctor may decrease the dose to 2.5mg or lower and increase it much slower while observing how the patient tolerates it. Sometimes the total daily dose may be divided into 2 doses, 6 hours apart. It is important to remember that if side affects occur; starting with a small dose and slowly increasing the dose can help to minimize this problem.

Another medication that is also in the class of cholinesterase inhibitors is Razadyne (galantamine). If you are taking the IR form which is the immediate release form of the medication, the usual dose is 4mg twice daily. After 4 weeks it is usually increased to 8mg twice daily. The medication can be increased to 12mg twice daily after another 4 weeks, under your doctor’s supervision. The medication should be taken in the morning and evening with food and water. Some doctors prefer using Razadyne ER, which is the extended release form of the medication and is only taken once daily. Your doctor will decide which the best form is for you.

Another commonly used cholinesterase inhibitor is Exelon (rivastigmine). Exelon is available to be taken by mouth in capsule or liquid form and also available in patch form. The oral form is usually 1.5mg capsule twice daily. If tolerating it well your doctor will probably increase it slowly over 4-8 weeks to the final dose of 6mg twice daily. Take this medication with morning and evening meals. The patch can be used in place of oral medication. This can help reduce some side effects. The patch is applied daily and is started at a low dose and gradually increased. The patch should be applied to different areas daily to prevent irritation. It can be placed on the back, upper arm, or the chest. Remember not to cut the patch. The patch is very helpful with patients who are experiencing gastrointestinal side effects.

Another medication used in treatment is Namenda (memantine). Namenda’s mechanism of action is different from above medications. This medication works by blocking a receptor, thus, it can prevent over-stimulation of the receptor which can result in neuron injury and death. The manufacturer recommends starting at 5mg daily. Usually, if tolerated, an increase of 5mg per week divided into 2 doses. Meaning that by week 2, the patient is taking 5mg twice daily. The following week, the patient is taking 15mg (5mg and 10mg in 2 separate doses). Finally, if tolerated, the patient will be taking 10mg twice daily. This medication may be taken with or without food. Not all patients will be able to tolerate the increasing of dosing. Some patients will only be able to tolerate 5mg once daily. Discuss this with your doctor and decide which is best for your loved one.

Alzheimer/Dementia: Dosing and Dealing With Side Effects