There have been lots of entries about the use/non-use of Black Box meds,; the excessive use of meds;and the concept of "drugging up our LOs for control. Caution in the use of any med is smart, especially when first introducing it, but also after they're on it for a while. We need to stay informed about the meds we use and their short and long term effects. We do, however, I believe need to develop a clear concept of how and why we use them. Also, that cirumstances can and do alter the need to use them or the quantity to use, and that it is not necessarily a bad thing. Knowing much of the brain works by passing electrical impulses from one neuron to another using chemicals, it makes sense that as the brain is attacked by Alz, VaD, etc. that whole system is derailed one part at a time, in varying order. To help our LOs we can us meds which slow the disruption and other med which balance the chemical disruptions, helping our LOs to function more normally. This could be equated with useing Diabetic meds for sugar control or seizure meds for Epilepsy. Why would we think a med to help our LO be less confused or agitated by reducing the chemical storm in their brain is any different? We don't like the idea of the strong meds or larger doses that may be use when our LOs are hospitalized or placed because they really flatten their abilities and responses. But, if you realize how traumtic hospitalization or placement is for them and that their ability to understand and process what's happening just isn't sufficient the med use to blunt the trauma makes sense. As caregivers, it's our job to monitor and make sure those meds are reduced as adjustment occurs. (Picure yourself being lifted from this life and plunked down in a totally foreign place--not knowing the language, the location, the people, or anything going on). Not every med works for every LO. This is a tough thing to get through. Sometimes getting the right med involves trials with one, and then maybe another. But the intent is never (or should be never) to "drug them up" for any reason. Using meds to help our LOs get through their remaining life somewhat peacefully and comfortably is a reasonable and responsible thinmg for us to do. Pharmacology is our friend.
I agree with you carosi. In a way, you could think of all AD patients, past a certain point, as hospice or palliative care patients. It's just that the palliative time is years instead of weeks or months, but we're used to that with AD. This is why we use therapeutic fibbing--learning to "speak Alzheimer's."
There is no reason for unnecessary emotional trauma for someone who cannot comprehend it, or ever get better, even if the term length for management of the person's comfort is years.
It's up to individual calls, and careful monitoring by caregivers, as you say.
I agree with this. Many of us have stated that we do not want our loved ones to be turned into zombies and that still stands for me, but I will have to admitt that when my husband is highly agitated, thrashing up and down the halls of the facility, sweating profusely , unable to tell us what has him upset but not any showing signs of physical pain or trauma either, I would rather have him sedated (up to a point) than watch him thrash around wildly and not be able to help him. I have tried talking to him quietly, rubbing his back and telling him I love him. It used to work pretty well, not so much anymore. I hate to see him sedated but I hate to see him in such anguish either.
My guidelines on meds is keeping him safe and content, keeping his caregivers safe and then hopefully they don't knock him out so much that he doesn't respond to me anymore. It isn't always easy and I have been there when he was medicated zombie status but it was worth everyone's safety even if I didn't like it. When he was no longer acting out, I asked if the meds could be reduced and they were.
We are their advocates in this and sometimes it truly is better to live with chemistry.
Recently, in the last few weeks, I've been dealing with my husband's anguish. And that really is the word for it. It has been especially bad the last few days as he has been wanting to "go out", probably to escape it. Going out is only going to make it worse, of course.