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By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington. Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services. APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid. We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour. APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment. You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints. Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights. APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.I agree that: A.I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information"). B.APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink. C.APFM may send all communications to me electronically via e-mail or by access to an APFM web site. D.If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records. E.This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year. F.You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
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MD prescribed 7.5 mg once daily to assuage wife's constant need for attention/go for drive/anxiety and impatience. She really resents my attention to this laptop. Something has to give!
I have but this comment since I did not use this for my Husband... If it works...GREAT. If it does not work...another medication might. Give it time. Keep notes of any changes you notice good or bad. With the number of medications available something is going to work. But like with a lot of medications you have to give them time to work.
Well, an antidepressant should work pretty quick, I would think. Doesn't have to get the system adjusted. But the low dose may be slower. I think 15 MG is normal starting dosage. This is 7.5
OldArkie, prescribing meds for challenging dementia behaviors is something of a trial and error process. I have been told that by several geriatric psychiatrists; you try it and if it doesn't work, you try something else.
What worked for my mom was a combination of Mirtazapine (Remeron) and Lexapro (a different class if antidepressant from Remeron) and a very small dose of Klonopin. These worked in keeping her calm, not agitated and happy-- but not "drugged".
Doctors resist prescribing drugs to treat these situations and I appreciate why! But I am not comfortable trying things I don't know about. What strength was your mirtazapine?
OA, why would a doctor (I am assuming you are talking about a geriatric Psychiatrist) resist prescribing medications that will allow a dementia patient some peace?
I promised my mom one thing in her old age and that was that she would not be in pain. I took that to mean psychic as well as physical pain, so I took her anxiety, agitation and depression every bit as seriously as I did her arthritis and CHF.
I don't have mom's medical records any longer, so I can't tell you anything about dosage.
Remeron can take up to two weeks to START to work:
I have yet to research the drug to know what to expect. Doctor warned me it was not sure to work but a place to start trying. Sadly, as you probably know, every day is a new day and her likes and dislikes, and personality often makes abrupt changes. Her memory is very, very limited so she can't function as someone who remembers how good their food was yesterday. She just doesn't remember!
Mom's doctor prescribed mirtazapine to help her (and me!) sleep through the night, which worked very well. I'm not sure if it was the drug itself or the fact she was better rested (or maybe both) but she was also definitely more herself during the day. I never noticed any increase in her appetite, but that would have been welcome as well.
Do you think she might be able to use a tablet of her own while you are on yours? I'm not tech savvy but I know there are games for seniors available plus lots of music or nature or funny videos on YouTube.
You’re asking if anyone has tried this drug, then you say that MD prescribed 7.5 mg per day.
In a response to Barb, you say that you are hesitant to try something that you don’t know about.
My question to you is, did you decide to try what your wife’s doctor recommended for her?
Drugs will react differently in every individual. So, what works for one person may not work for your wife.
What works for her may not work for others. You have to be willing to test recommendations and see if it works. If it doesn’t, then you choose another option.
Good luck in finding the best solution for your wife. It can be challenging.
Yes, I certainly intend to try doctor's prescription... having never used it before, I wondered if others on this group may have had success with it or not! That is one of the highlights of this group, to learn what experiences others may have had! I disagree that drugs will react differently in every individual. If there wasn't some consistency in drug performance, doctors would have no idea what drug to prescribe!
I stopped giving Benadryl to my husband and I stopped taking Benadryl when I realized how "foggy" it made me in the morning. I figure if it made me feel that foggy I could just imagine what it was doing to my Husband with his dementia brain.
Not giving medical advice here, but my mom (86 w/dementia and a host of other issues and permanently in a NH) has been on Mirtazapine (Remeron) for 2+ years. She also takes another Rx for depression. The Mirtazapine was added as it also for her, helps keep her appetite up. She had a significant weight loss (20 lbs in about 2 months) which can be very dangerous for the elderly. She was refusing to eat much of anything, always said she was not hungry. The Mirtazapine had helped both with her mood as well as with her appetite. The two Rx meds together also helped her get her "days and nights" back in more "normal" cycle. Previously, should be up all night often sundowning for hours in the evening. Now she sleeps better at night and through the night w/less anxiety.
Working with her geriatric internist and the geriatric psychiatrist on staff at her NH, they were able to figure out what worked best. All to say, the experts can often -- trying things, different combo of things -- can hopefully figure out what works best for you LO.
Hugs, this is not fun to work through. Hopefully your LO's care team can come up with approaches that work best for you and your LO.
Everyone is correct that we can't give our medical "advice". What I can share is my experience with my mom. Because the brain is deteriorating, the anxiety levels are very high. It is a medical fact that the amygdala is dying out and the person's "fight or flight" response is elevated which causes extremely high levels of anxiety. There is a tendency to want to sedate residents in facilities so that they "behave". This is not appropriate and you should always ask the question whether they are being sedated to make things easier on the staff or on the resident.
I was fortunate that my moms psychiatrist put her foot down when the facility recommended anti-psychotics. She said it was absolutely not appropriate for her behaviors and that the diagnosis is extreme anxiety. She informed them that her medical evaluation indicated that an antipsychotic would only keep her sleeping all day and lead to falls and declining health. In other words, it would help the staff but not my mom.
What she did recommend and put my mom on was an SSRI, anti-anxiety meds (benzos), and a very low dose of Remeron at night to help with eating issues. These have worked great for my mom.
There is no one size fits all for medications and everyone on the forum is right that you need an experienced geriatric psychiatrist to help treat the anxiety caused by alzheimer's/dementia.
I do know from much research and issues I had with my mom in a facility that using antipsychotic drugs should be heavily researched and talked through with your doctor.
"While ongoing efforts by the Centers for Medicare & Medicaid Services have helped reduce the risky off-label use of antipsychotic drugs among dementia patients living in nursing homes, the use of these drugs has increased slightly among dementia patients living in the community, according to a new AARP Public Policy Institute report."
The answer to this is not a one-size fits all. Every person is different. Sometimes it takes a while to find the right mix and dosage. There are also side effects.
My own situation with Mom which I thought was dire during the Pandemic has done a complete 360. It took time but Mom can now walk around, eat, dress herself, has an appetite but does sleep a lot--Lewy Body Dementia.
At one time mother was like a statue. The brain inhibitors needed something, some serotonin to the brain. I have my mother on a schedule, routine.
My goal is not to have her nights be days and vise-versa. I realize there will be a time when all mother may be able to do is sleep. She was recently discharged from Palliative Care as the insurance companies change the guidelines along with the top Executive's pay. Basically, there is a longer duration and needs to be more of a steady decline for this program.
I am not a doctor but a good Geriatric Neuro-Psy doc and if you think it's possible Home Care services--occupational therapist, physical therapist, speech therapist--all of this was a benefit to my mother.
Mom gets out every day in the fresh air on her Up Walker Lite. She has a good pair of shoes and this week was the hair salon, hearing aid cleaning and dentist. I'm exhausted. Tomorrow, Sunday the Eucharistic Minister comes from our Church and brings Communion, says a prayer and brings a Bulletin so Mom knows what's going on in the parish.
Medications, a routine, socialization and fresh air, exercise, nutritious meals all help. Give the Mrs. little chores to do--folding facecloths, snapping off the ends of strings beans, little projects, putting frosting on cupcakes. That way your wife feels included.
Have good lighting in your home. The color lavender calms loved ones with Dementia. I bought my mother a lavender bed comforter. Music of their era can also be calming.
Put mattress covers under the sheets but over your mattress in case of any accidents. A lot of things come with your wife's health insurance--study this through and through.
You sound like a good husband. You will learn along the way and most people here on the forum we are in it too and I hope I was of some help to you.
If you can sign up for the doctor's "portal" on your computer so you will have your wife's test results at the tip of your fingers. The technology is the way to go now. Try to a snag a millennial in the neighborhood to help you on this. It will save a lot of time and waiting by the phone. You can email the doctor office at any time. It's very convenient.
Also, you may want to look into a "day" respite program in the neighborhood in case your wife cannot be left alone. The primary care doc can write a script for this. Some offer transportation--continental breakfast, hot lunch, exercise, an RN on duty and with health insurance physical, occupational and speech therapy. My mother went for 1/2 a day one day a week.
I needed a place for Mom to be safe so I could run errands. In the hot weather during the Summertime in the Northeast, I couldn't leave my mother in the car so I had to find a place. The people were wonderful! They planted tomato plants, decorated baked goods, painted, etc. Supervised 1 attendant per 5 people. Some people were non-responsive because their cognitive skills were gone others were more vocal. It was sad to hear about what their life was before the disease.
But my point is, you are going to have to find a fall back place. A what if plan-- that you can call on. You can do all of this online. Your wife's primary care doctor, the Nurse manager will help.
I’m sorry you are going through this but I humbly ask that you turn to natural forms of medicine for anxiety and depression, fresh air, sunshine and prayer. Unfortunately pharmaceuticals have way to many side effects and your taking a big risk. Also I have my Mom eating more healthy days and upping her protein which is helping her with same issues. Breathing exercises are great too! Go to Youtube and you’ll find so many resources. God bless you!
My husband takes this drug to stop his mind from racing it has helped him. He takes it at night for him to sleep. He has been taking this medication since he worked swing shifts.
Did a quick read on this one since I am not a psych RN. Seems like it should help with her symptoms. Expect her to get hungry and to have a dry mouth (chewing gum, hard candy or sucking on ice will help).
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
If it works...GREAT.
If it does not work...another medication might.
Give it time.
Keep notes of any changes you notice good or bad.
With the number of medications available something is going to work. But like with a lot of medications you have to give them time to work.
What worked for my mom was a combination of Mirtazapine (Remeron) and Lexapro (a different class if antidepressant from Remeron) and a very small dose of Klonopin. These worked in keeping her calm, not agitated and happy-- but not "drugged".
I promised my mom one thing in her old age and that was that she would not be in pain. I took that to mean psychic as well as physical pain, so I took her anxiety, agitation and depression every bit as seriously as I did her arthritis and CHF.
I don't have mom's medical records any longer, so I can't tell you anything about dosage.
Remeron can take up to two weeks to START to work:
https://www.google.com/search?q=how+long+does+remeron+take+to+work&oq=how+long+does+remeron&aqs=chrome.0.0i512l2j69i57j0i512l11.13877j0j4&client=ms-android-tmus-us-rvc3&sourceid=chrome-mobile&ie=UTF-8
You’re asking if anyone has tried this drug, then you say that MD prescribed 7.5 mg per day.
In a response to Barb, you say that you are hesitant to try something that you don’t know about.
My question to you is, did you decide to try what your wife’s doctor recommended for her?
Drugs will react differently in every individual. So, what works for one person may not work for your wife.
What works for her may not work for others. You have to be willing to test recommendations and see if it works. If it doesn’t, then you choose another option.
Good luck in finding the best solution for your wife. It can be challenging.
having never used it before, I wondered if others on this group may have had success with it or not! That is one of the highlights of this group, to learn what experiences others may have had! I disagree that drugs will react differently in every individual. If there wasn't some consistency in drug performance, doctors would have no idea what drug to prescribe!
Working with her geriatric internist and the geriatric psychiatrist on staff at her NH, they were able to figure out what worked best. All to say, the experts can often -- trying things, different combo of things -- can hopefully figure out what works best for you LO.
Hugs, this is not fun to work through. Hopefully your LO's care team can come up with approaches that work best for you and your LO.
I was fortunate that my moms psychiatrist put her foot down when the facility recommended anti-psychotics. She said it was absolutely not appropriate for her behaviors and that the diagnosis is extreme anxiety. She informed them that her medical evaluation indicated that an antipsychotic would only keep her sleeping all day and lead to falls and declining health. In other words, it would help the staff but not my mom.
What she did recommend and put my mom on was an SSRI, anti-anxiety meds (benzos), and a very low dose of Remeron at night to help with eating issues. These have worked great for my mom.
There is no one size fits all for medications and everyone on the forum is right that you need an experienced geriatric psychiatrist to help treat the anxiety caused by alzheimer's/dementia.
I do know from much research and issues I had with my mom in a facility that using antipsychotic drugs should be heavily researched and talked through with your doctor.
"While ongoing efforts by the Centers for Medicare & Medicaid Services have helped reduce the risky off-label use of antipsychotic drugs among dementia patients living in nursing homes, the use of these drugs has increased slightly among dementia patients living in the community, according to a new AARP Public Policy Institute report."
The answer to this is not a one-size fits all. Every person is different. Sometimes it takes a while to find the right mix and dosage. There are also side effects.
My own situation with Mom which I thought was dire during the Pandemic has done a complete 360. It took time but Mom can now walk around, eat, dress herself, has an appetite but does sleep a lot--Lewy Body Dementia.
At one time mother was like a statue. The brain inhibitors needed something, some serotonin to the brain. I have my mother on a schedule, routine.
My goal is not to have her nights be days and vise-versa. I realize there will be a time when all mother may be able to do is sleep. She was recently discharged from Palliative Care as the insurance companies change the guidelines along with the top Executive's pay. Basically, there is a longer duration and needs to be more of a steady decline for this program.
I am not a doctor but a good Geriatric Neuro-Psy doc and if you think it's possible Home Care services--occupational therapist, physical therapist, speech therapist--all of this was a benefit to my mother.
Mom gets out every day in the fresh air on her Up Walker Lite. She has a good pair of shoes and this week was the hair salon, hearing aid cleaning and dentist. I'm exhausted. Tomorrow, Sunday the Eucharistic Minister comes from our Church and brings Communion, says a prayer and brings a Bulletin so Mom knows what's going on in the parish.
Medications, a routine, socialization and fresh air, exercise, nutritious meals all help. Give the Mrs. little chores to do--folding facecloths, snapping off the ends of strings beans, little projects, putting frosting on cupcakes. That way your wife feels included.
Have good lighting in your home. The color lavender calms loved ones with Dementia. I bought my mother a lavender bed comforter. Music of their era can also be calming.
Put mattress covers under the sheets but over your mattress in case of any accidents. A lot of things come with your wife's health insurance--study this through and through.
You sound like a good husband. You will learn along the way and most people here on the forum we are in it too and I hope I was of some help to you.
If you can sign up for the doctor's "portal" on your computer so you will have your wife's test results at the tip of your fingers. The technology is the way to go now. Try to a snag a millennial in the neighborhood to help you on this. It will save a lot of time and waiting by the phone. You can email the doctor office at any time. It's very convenient.
Also, you may want to look into a "day" respite program in the neighborhood in case your wife cannot be left alone. The primary care doc can write a script for this. Some offer transportation--continental breakfast, hot lunch, exercise, an RN on duty and with health insurance physical, occupational and speech therapy. My mother went for 1/2 a day one day a week.
I needed a place for Mom to be safe so I could run errands. In the hot weather during the Summertime in the Northeast, I couldn't leave my mother in the car so I had to find a place. The people were wonderful! They planted tomato plants, decorated baked goods, painted, etc. Supervised 1 attendant per 5 people. Some people were non-responsive because their cognitive skills were gone others were more vocal. It was sad to hear about what their life was before the disease.
But my point is, you are going to have to find a fall back place. A what if plan-- that you can call on. You can do all of this online. Your wife's primary care doctor, the Nurse manager will help.
Prayers that it works for your situation.