Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
I definitely think there is an issue with doctors pushing pills on the elderly to sedate them - especially in institutions. Because sedate patients are much less work for the understaffed aides.
].
Actually, while people do believe that to be true, that's actually debatable. It is incredibly hard to care for a patient who can't participate in their care. The professional caregivers and nurses (and docs) I have been involved with over 2 decades say that an over-sedated patient is not what you want.
That's why when we were caring for Mom at home we always had our radar on to make sure her Rx was calibrated to ensure it didn't get to the point of over-sedation. It can easily swing that way depending on hydration levels, food intake, other meds that may be given for other reasons, etc. so we always kept an eye on it.
Anyway, that's really not the point of this thread, so I'm not going to take it off track, but I wanted to comment on that because that statement gets stated a lot on this forum.
I definitely think there is an issue with doctors pushing pills on the elderly to sedate them - especially in institutions. Because sedate patients are much less work for the understaffed aides.
However, I think that's very different than an elderly man who is not sleeping, and who's lack of sleep is affecting his other illnesses and who's family has specifically inquired about something to help with sleeping. (and has enough knowledge to specify what that something might be).
Right, and the carer said there are better options, so it doesn't seem the request was being ignored. It seems that the OP is just frustrated that THAT medication is being denied (although he never said it was being denied either, just that there are better options.) Why does it have to be valium if there is something better?
It seems that the the post is just venting about frustration (which is OK), more than truly being about having to "play a game" with medical staff, because there IS NO game, or there doens't seem to be.
Well, in my particular case with my Dad I view it this way.
He appears to be in the later stages of dementia. He needs help eating, he's caught in a 10-minute loop (just guessing here) unless people are with him and distract him from the loop. His sleep habits went south post hip surgery. He's not eating, losing weight, falling asleep here and there from exhaustion, yet up through most of the night. Sun downing is bad at night.
Part of the reason he's not eating (IMO) is his exhaustion caused by sleep malfunctioning. It could also simply be the later stage of dementia where eating just doesn't click. But at this point in rehab, it's my opinion that getting back to a "normal" sleep pattern is most important which "may" help with the eating. He's had an "as needed" Diazepam prescription for a very long time for anxiety. I myself have a script for "as needed" for sleep, for which when I need it only 1/2 pill (2.5mg) is needed.
I'm dealing with the back end of my Dad's life. I'd take a chance on a low dosage (5mg) of Diazepam to see if it readjusts his sleep. If he doesn't eat, he'll die, something I recently went through with my Mom when she made the conscious decision to quit where eating was the first thing to go.
Well, in my particular case with my Dad I view it this way.
He appears to be in the later stages of dementia. He needs help eating, he's caught in a 10-minute loop (just guessing here) unless people are with him and distract him from the loop. His sleep habits went south post hip surgery. He's not eating, losing weight, falling asleep here and there from exhaustion, yet up through most of the night. Sun downing is bad at night.
Part of the reason he's not eating (IMO) is his exhaustion caused by sleep malfunctioning. It could also simply be the later stage of dementia where eating just doesn't click. But at this point in rehab, it's my opinion that getting back to a "normal" sleep pattern is most important which "may" help with the eating. He's had an "as needed" Diazepam prescription for a very long time for anxiety. I myself have a script for "as needed" for sleep, for which when I need it only 1/2 pill (2.5mg) is needed.
I'm dealing with the back end of my Dad's life. I'd take a chance on a low dosage (5mg) of Diazepam to see if it readjusts his sleep. If he doesn't eat, he'll die, something I recently went through with my Mom when she made the conscious decision to quit where eating was the first thing to go.
It is a tough situation, what your Dad is going through. It seems that since there are no other medication options for him, your best hope is to file a formal complaint with the agency in charge of his care and in the meantime administer the Valium to him yourself from your own Rx stash.
I am now considering a very difficult decision with my Dad, that is to keep him at home or to transfer him to assisted living. So many factors, and dementia as always makes the decision more clouded.
From everything I have read, mental stimulation is considered the top factor in hoping to slow the progress of dementia. No matter how I feel about the caregivers currently with my Dad at home, that is a 1 on 1 situation. I don't think caregivers are well-trained in dealing with dementia patients per se, understanding the level of effort it takes during the day to deal with a later stage dementia patient.
Moving to assisted living with save thousands of dollars a month, but that is not the reason I would move him. I'm really wondering what is best for Dad, and my gut (along with my nurse daughter who is studying for her doctorate to become a nurse practitioner in mental health) tells me he would get more stimulation in a group setting. The assisted living place I am looking at has a specific memory care section. Yes there will be times he is unattended (like in his room), but he fell at home and twice at rehab, and I do not expect someone tied to his hip 24/7.
My father was living alone in his house until moving into assisted living last summer. Things are so much better for him now. Although he still spends a good part of his day in his recliner in front of the tv, aides come in daily, all of his meals are in the dining room with other people, and he attends in-house activities, such as trivia games and mini concerts. He seems much happier, and isn't as fearful as he was when he lived in the house.
Assisted living might be the best place for your father, and you will likely find that you will be able to relax a bit, knowing that your father is being well cared for.
My husband has been in memory care for 3 1/2 months...he is in year 14 of dementia. I agree that stimulation really helps to SLOW down dementia. He went to day care for five days a week for two years...he loved it. But the disease does not stop and it was time for memory care. At memory care the residents sing, play very simple bingo, do very simple crafts, but do not go off campus to Walmart or anything which would upset the simple, quiet routine which they seem to need. I would think your loved one would be ready for the right type of memory care. After a bout with flu/cold in December, my husband is now unable to walk, feed himself (without supervision), is incontinent, and totally dependent on the staff. The change can come rapidly. Again I question assistant living vs GOOD memory care. I see the facility you are considering has memory care. Will they feed him?
I am sure the admitting evaluation will give you guidance as to the appropriate level of care. Peace to you and your family. You are caring and want the best for your dad.
A while back I made a post here regarding my father. Sitting here right now so many things have changed with my parents (now 87 & 84). I live 1/2-hour away, but am not an in-home 24-hour caregiver. I manage their financial affairs, and have proxy for when I need it (which I have not overrode my Mom's decisions because she still has her faculties).
Two and a half years ago my Dad got a bad blood infection. The infection accelerated what was early stage dementia to become full-on dementia, and he continues his mental downward slide. When he was about to return home I went with my parents wishes and contracted home care, not the higher level medical care but a body in the house 24/7 to assist. Neither of my parents ever wanted to go to a nursing home or assisted living. This really devastated my mother because she had her vision of retirement, and having her husband of 60+ years who took care of everything disappear was hard for her.
Near the end of 2016 my Mom was diagnosed with non-Hodgkin's lymphoma. She went through chemo which really battered and weakened her. After chemo there was one stubborn lymph-node under the arm which required direct radiation treatment. She was tired and slowed down from all the treatment. A couple of months ago she began not to eat and drink and was lying in bed a lot. Finally to the hospital (I forced her to go to ER), and she had a UTI which was probably there for several weeks untreated. She spent 1.5 weeks in the hospital and then moved to a rehab facility. In the hospital, a scan revealed her lymphoma had returned, but to this day I am not sure of how far along (again) it is and how aggressive it is. A couple of days ago, the rehab signed off on the reason she was there, reconditioning. But for many other personal reasons (phobias or whatever), mentally she had pretty much lost interest in doing anything. Yesterday, after consult with the rehab I took her home and set up visiting nurse company to come in.
Today I get a call from Mom. To give you a gist of the conversation, paraphrasing she said she didn't know what to do, always in pain (which quite possibly is from lymphoma and/or other things), shouldn't have left rehab (even though medically they really weren't doing anything for her), and said (and I do quote) - "I just want to die but don't know how". With Dad at home basically useless with dementia, and me only with the power to lead her to water (can't force her to drink), it's just pure frustration. I mentioned to her my thoughts, like calling her PCP and her favorite oncology nurse to get the medical ball rolling, but she won't. I left a message with the oncology nurse to call me so I could at least discuss with somebody.
I can't talk with my Dad who used to be her and the family's pillar. I have a brother, but mentally he in no way can help me deal with this. He does manual labor jobs to help like food shopping and dump runs. I have no support from my wife because she is chronically ill with her own pain issue, not working and on disability. So here I am, a CPA with my own practice trying to stay afloat, on an island by myself trying to do the best I can for my parents. I will not give up everything just to stay 24/7 with my parents because I just can't for myself to survive. But I basically have to mentally deal with my parents on my own.
OK. Vent done. Back to my island. I just wish it had white sand, blue water, palm trees, and readily available rum.
EDIT: 1/2 hour after I posted this, the visiting nurse called from my parents house. She had spoken with the oncology nurse already and they are sending her to ER (ambulance will be called) and back to the hospital to evaluate what to do next. That's what I was going to discuss with the nurse so glad the visiting nurse acted accordingly.
If your mom has had enough, has she considered palliative or hospice care?
I am now considering a very difficult decision with my Dad, that is to keep him at home or to transfer him to assisted living. So many factors, and dementia as always makes the decision more clouded.
From everything I have read, mental stimulation is considered the top factor in hoping to slow the progress of dementia. No matter how I feel about the caregivers currently with my Dad at home, that is a 1 on 1 situation. I don't think caregivers are well-trained in dealing with dementia patients per se, understanding the level of effort it takes during the day to deal with a later stage dementia patient.
Moving to assisted living with save thousands of dollars a month, but that is not the reason I would move him. I'm really wondering what is best for Dad, and my gut (along with my nurse daughter who is studying for her doctorate to become a nurse practitioner in mental health) tells me he would get more stimulation in a group setting. The assisted living place I am looking at has a specific memory care section. Yes there will be times he is unattended (like in his room), but he fell at home and twice at rehab, and I do not expect someone tied to his hip 24/7.
As you probably know, I moved my mom to a memory care facility in November, from independent (quasi independent - more like assisted) living. She griped and complained and schemed and all that good stuff, but now three months later, she is obviously doing better physically and she is more engaged mentally.
So if you choose to move your dad, just keep in mind that there is about a 30 day "settling in" period in which he is likely to be unhappy, full of guilt trips for you, etc. My advice would be NOT to take him out of the facility for visits or jaunts or whatever during that time period, but visit him fairly often for short visits.
My mom seems a lot calmer and more engaged with her community now that three months have passed but the first month or so she was very unhappy. Change is hard on anyone but especially someone with dementia, who is easily confused anyway.
That's my two cents' worth anyway!
Please register to post and access all features of our very popular forum. It is free and quick. Over $68,000 in prizes has already been given out to active posters on our forum. Additional giveaways are planned.
Detailed information about all U.S. cities, counties, and zip codes on our site: City-data.com.