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

April 8, 2010 at 12:54 am Leave a comment

Patient is a 78 year old Caucasian female with a past medical history of Alzheimer’s /Dementia and Non-Hodgkin’s B cell lymphoma of right breast and bladder in remission since 1 year ago whose daughter complains that the chemotherapeutic regimen which included Adriamycin, Rituxan, Cytoxan, and Vincristine worsened her mother’s Dementia. Daughter states that due to this, the maintenance therapy was discontinued. Patient was diagnosed with Alzheimer’s/ Dementia in May 2008 and a one month later went for a mammography and a tumor was seen in her right breast. It was automatically assumed that the patient had breast cancer, but upon tissue biopsy it came back as Non-Hodgkin’s B cell Lymphoma. Patient then had a PET scan and another tumor was discovered in her bladder. Chemotherapy was then started and continued once a month for 5 months.

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

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Entry filed under: Alzheimer, Dementia. Tags: .

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