here is a link to a very good article in the New York Times along with a number of comments from caregiv ers. I found it very logical information.. bill
I read the artaicle and found it quite enlightening. My DH had blood work done on Tuesday. The reports came in that his cholesterol and triglicerides are too high. Howeer, our PCP said he didn't think he would prescribe any meds to lower it. He did suggest more exercise might help. The article mentioned high cholesterol drugs as one reatment not necessary for AD patients.
His Chol was 216 total. That's a bit high but not startlingly so. I know our PCP is a very caring man and would not withold treatment from DH.
The cholesterol med and Plavix are the first mes I think we should be done with. Whn prescribed the Cholesterol med back around 1990, his Combined reading was 234 and the split nbetween good c, badc, and triglyserides wasn't that great. This last May his reading was 159 with a beautiful balance of the 3. He was prescribed the Plavix in early 2007, "to help protect his vascular system and try to delay progression of his Vascular Dementia". In Aug.-Sept. of 2006 he was Dx'd and beginning Stage 5. He was checked for significant suspected TIAs 3 times during the first 6 months after Dx. He has had more extremely small (I can tell,not confirmed)ones since. In the last 10 months he has started showing a mild degree of all Stage 6 symptoms, still whie on these meds. I have asked both his Neuro-Psych and PCP about taking these 2 meds away. Neuro-psych says the idea makes sense, but to talk to the PCP. PCP says continuing won't hurt him; the meds can still help ward off a heart attack or stroke; and we can't predict if/when those could occur, knowig the system is impaired. He said that if there is or becomes a good argument for stopping them---like excessive cost---then yes. He will go along with me,but it's up to me to decide. DH has Medicare/Medicaid--our out of pocket is very little.
On the flip side, in our talks years ago, DH told me he wants no extreme measures taken. If he becomes impaired to let him go, he doesn't want to linger in a nonfunctioning condition.
So, here I am, trying to figure out whether to let him float along on these meds which are given to protect him from any earlier demise--potential extending the time he lingers in a VaD decline, or stop them--and possibly allow a sooner demise. Nothings for sure, but i want to honor his wishes. Maybe I need to just wait a bit longer?
One of the things I found interesting were the comments. Almost all of the ones from caregivers who's LOs had died said that they would have used even less medical attention, but more hospice attention. There were a few snarky remarks from people who just did not "get it" and one early on in the comments from someone who needed to justify the aggressive medical tests and therapies s/he had put their mother through before her death.
One thing is absolutely true. Most people who haven't dealt directly with dementia don't realize that the patient is terminal or that the disease (whichever one it is) has physical as well and memory aspects.
I think the one you are referring to Dr Sach's who as a teenager watched his grandmother die from dementia they used all they could treating infections, etc. He now knows that was not the loving thing to do - more hospice less medicine is better. I agree. I read here about some of your spouses in the later stages who keep being treated for UTI's. I don't think I would prolong his life if it is no life - just existing. I would not. I would let the infection take its course which I know will lead to kidney infection and death.
Over and over, the Hospice Nurse has reminded me that we are here to keep him comfortable and safe. He wants to sleep, and she said he needs to sleep. He isn't as hungry, and that is perfectly OK. She didn't believe he needed all the tests for the UTI we "guessed he had",..and trust me! in 3 days after starting Cipro, he was a diferent person. She said they see so many UTI's, they just call for Cipro without testing iirst. Right or wrong in other people's eyes..it worked or us.
He still has a lot of trouble ambulating. Getting up out of the chair is so hard and he SO DOES NOT want me to help him. I almost always get my hands slapped when I try. But if I don't, he can't get up. I'm almost deaf to his cussin' and fussin'. NOT entirely, just almost.
My wife is stage 6>>7. She takes plavix, Hyzar, Namenda, Aricept & several mood medicines. I will talk to Dr about Plavix but wondered what you'll thought about the multi,vitemens, calcium, folic acid, etc. Where do they fit in this logic??? bill
Bluedaze, I agree with you totally re: the UTI, - but Bill, darlin',..... oh Bill! Why would you want to give your dear wife all of those other pills... are they going to help her get well? Others may disagree, but personal experience with our doctors has us taking away the meds. For example, both doctors agree that after Stage 6, Aracept and Namenda have no effect. They were formulated to slow the progression of the disease in the early stages. Mood medicines are always important, ..to keep them peaceful and calm.
You' are a dear husband and a loving caregiver. I cannot tell you what to do, - perhaps you can ask your wife's doctor if he believes the Aracept and Namenda are helping her. As an aside, we stopped Foster cold turkey on these two drugs and there was not a single bit of difference afterward. Dr. Lesch said that was a good indication that it was no longer having an effect on him.
At first I gave my DH a plethora of drugs, vitamins, herbs, supplements, minerals. You name it, and if I heard anyplace that it could help the AZ I got it. I can't see that they helped all that much so I gradually tapered off. Now he gets vitamin D3, and C, both of which I will stop when the supply runs out. He also gets piroxicam for his shoulder pain, 81 mg asprin, lisinopril for his high blood pressure and risperidone and sertraline for his moods. When he went off the namenda and razodine his anger and agitation went away, and as far as the others I think I was just throwing money away.
OT: I love the word PLETHORA. - Gmaewok. and Serendipity and Moriority. .....................just like saying them...and noticing how they wind around in my mouth while they are being pronounced. (call in the guys in the white coats!!)
waaaay off topic. Sit in front of a mirror and watch ... When you silently mouth the words "elephant shoes", it will appear as if you are saying "I Love You!"
And, if you buy Wintergreen Life Savers, - go into a PITCH DARK room (like a bathroom) and chomp on them with your mouth open wide. the Wintergreen life savers make bright green sparks in your mouth between your teeth. That will win you lots of points with your grandhildren.
How can you chomp with your back teeth with your mouth wide open? I can't figure out how to do it, and I'm not buying the life savers until I am sure I can do it.
Okay, I tried it in a completely dark closet and didn't see anything. Janet, you have to sorta smile big and then chomp to keep your mouth open. After all those years of our parents preaching to chew with our mouths closed, it does not come naturally LOL