Thanks for posting this, briegull. It's put clearly here. Horrible, all those wasted health care resources, just to make the suffering last longer. I'm going to file this article for future use.
I've been wondering: Dh has a pill for high cholesterol. His cholesterol never has been very high, but the med was given as a preventive measure, standard procedure here for diabetics (it started about 5 years ago). He doesn't like taking so many pills and I'm wondering if I could just drop this one. I'd have to speak to the assistant PCP who does his diabetes check-up and I'm not really eager to have that conversation. She is knowledgeable about diabetes and cooperative in helping me with the situation but I don't know how much she really knows about AD.
My wife was put on simvastatin by her PCP for slightly elevated cholesterol and diabetes. She was seen by an Alzheimer specialist who put her on Lipitor (MUCH more expensive). I switched PCP's and discussed the issue with the new one. We agreed that it made no sense to have her on any cholesterol lowering drugs given that she is in the late stages of AD. So now her only meds are Hyzaar for high blood pressure, Metformin and glipizide for diabetes, Exelon and Namenda for AD, and citalopram for "depression". I'm not sure she needs the citalopram, but it is cheap and easy to give (ground up in applesauce) so I guess I will continue it. I'm going to discuss all the drugs with her PCP at the next visit next month.
My husband was on Lipitor for high cholesterol for years. This April at his annual physical the PCP told me that there was no need to continue it since he is in the late stages of AD. I didn't refill his Razadyne ER this week. He's been chewing the capsule every day for the last two weeks, no matter how we try to give it to him or coax him or bribe him, or what time of day we try. He chews all his pills, but this is the only one that is capsule only. We even found Prevacid that comes in chewable form. So, from this point on, he won't have the Razadyne ER. He still takes his Namenda....he can chew it.
My DH has all the symptoms of Stage 6, but none are severe. Among his 10 Rxs and 2 OTC, he is taking Lovastatin for cholesterol and Plavix to protect the heart and vessels. His Dx is Vascular Dementia. He was on Lipitor, then moved to lovastatin, total time has been close to 19 years. Original cholesterol was 234. Current is 159 with ideal balance between Triglyserides, good and bad cholesterols. I asked his neuro-psych Dr. about dropping these 2, considering he has move from mid Stage 5 to full 6 in the last 10 months. The meds don't seem to be protecting or delaying him from progression. That Dr. agreed, not a lot of sense to continuing those 2. Sent info in report to PCP, who he said I should consult with on this. PCP says they are doing their job, protecting heart and vessels, helping avoid heart attack or stroke. No way to predict if/when those could happen. That justifies keeping the meds. If there might be other strong reasons not to keep them--cost being one- the choice might be different. For us the out of pocket is next to none. Finally, the bottom line--It's up to me.
My DH has LBD and is only 52. He was on both Enalapril for high blood pressure and a cholesterol medicine (Vytorin) together with fish oil and Garlique. We dropped the Enalapril when my DH's resting BP and pulse suddenly dropped almost 6 months ago. We dropped the cholesterol meds and supplements about 4 1/2 months ago because of his rapid progression and his liver enzymes were high. The neuro explained that, with LBD, medicines and supplements can have a significant adverse impact on the patient's liver. Tests over time showed that his liver enzymes did, in fact, go down over time. We haven't checked them in a couple of months, and I don't expect to check for them soon. Frankly, I was glad the liver enzymes went up because I was already questioning the validity of keeping my DH on medicines that are designed for long-term benefits when he will not be here in the long term. I dreaded making the decision and was glad for the excuse. The liver issue also made it much easier for me to take my DH off of the medicine without causing him additional anxiety.
My husband is on pravastatin for his cholesterol and I have kept him on it because it is very cheap ($10 for three months at Walmart) but his neurologist told me that I could stop it if I wanted to. As he said, to die by a heart attack is much easier than dying from FTD. My husband doesn't have any cardiac problems, so for now I will continue to give it to him as long as his liver enzyme tests don't show any problem.