Mom is 78, has no idea who her only two children are and believes she has been put in prison against her will. She has been "living" in the memory care center of a very upscale assisted living facility since 2008. The doctor has prescribed zetia and lipitor for her. I just don't get it. What is the point of keeping her body healthy while her brain turns to mush? I'm only interested in the legal ramifications. Maybe I'm demented, but I don't have a problem with her dying of a heart attack. My mom loved to "live" life. She is miserable. I have already informed all of my loved ones, not to keep administering body saving meds to me if my fate is the same as my mother's.
So sorry for this situation-it is painful to watch a loved one go through this disease.
I agree with Carol completely. Another option is to request that your mother be seen by a palliative care specialist. Hospice is a form of palliative care, but hospice is restricted to patients whose physicians certify that they are likely in the last 6 months of life. This is something over which you have no control.
Palliative care more generally, is for anyone with a serious/life-limiting illness. Dementia definitely qualifies.
Although far too few dementia patients receive palliative care-it is absolutely appropriate for your mother.
A good palliative care physician will work with you regarding meds. And you can make a good argument that the more meds you mother is on-the more likely she is to have a complication/unpleasant side effect without demonstrably improving her life.
Best of luck
When my mother in law was signed up for hospice they took her off of all “maintenance meds.”
I do wish they would’ve allowed her to stay on her thyroid medicine because taking her off of it made her a bit confused (she was completely coherent before that.). The rest of the meds wouldn’t have helped her in the long run (Lipitor, etc)
So I think if something is helping her quality of life, like an antidepressant or anti anxiety drug, let her stay on it. The rest can go.
Lipitor and Zetia are for managing cholesterol. I'd say so what? But they also help prevent a stroke. (A stroke is a "brain attack" and often does not result in death but in major disabilities.) Under the circumstances I'd say a stroke is worse than a fatal heart event. After talking to a heart doctor I kept my husband on his cholesterol medications until he went on hospice.
I suggest discussing this with the prescribing doctor. If you still feel you don't want her on those drugs, ask the doc to discontinue them. Do you have healthcare POA? If so, it should be your decision.
Oh dear. I just realized this question is from 2013! I wish these old posts didn't accept new responses!
At the end, when my MIL consistently refused food and mist drinks, we were criticized for not making the meal and trying to feed her, too. It was disturbing, and we are still very angry about being treated like we were not providing proper care for her.
The only thing is - and this is more for others to consider than you and your sister - controlling heart disease, stroke, osteoporosis and so on in comparatively fit elders with dementia is still something that must be thought through thoroughly. Perhaps it's even that the physically fitter the person, the harder the decision becomes. Because what if a heart disease or stroke maims but doesn't kill? Both of these can result in extreme, chronic pain as well as the risk of death. And not treating osteoporosis? How is it easier for a person with dementia to endure fractures? - I don't understand.
I realise that it sounds as if I'm holding out for a nice, peaceful, comfy kind of death for my mother, like anybody is ever given any choice about it, and I know that makes me Pollyanna. But I just wanted to make the point that doctors prescribing apparently irrelevant meds aren't necessarily doing it out of habit or aiming to prolong life at all costs. I think we, as caregivers and family members, should always feel free to ask what purpose is being served; but I also think there is probably/usually is a good reason behind most prescribing.
First of all "Do no harm" That means not force feeding unessessary pills to the dying and I do stress here the dyng. Grinding up a vitamin pill is not going to make anyone more comfortable. It is really a question about whether the patien takes the meds willingly, wants to continue or will have nasty side effects if they are stopped as in the case of anti epilectics. It is a process of selection and some may need to be tapered gradually. The steroids for the brain tumor of course should not be stopped and are in fact often started near the end of life. Pain and anxiety meds should be continued as should anti nausia. pain meds are still necessary even if the patient becomes unconscious, the pain is still there.
Just because a Dr prescribes something he is not giving an order that is unlawful to disobey. But please don't stop things out of ignorance or because a family member says you should. Hospice nurses routinely review a patient's medications and with the approval of the caregiver will request the Dr to stop them. If the patient really needs something there are often other ways that it can be given. pain medications for example can be given by, mouth as a pill or liquid, injection (not recommended) IV rarely in the home, patch or as a suppository. it is important tcheck whether or not something is safe to crush and mix in jam etc. Some are long acting and will give a 12 hour dose at once and others have a bad taste such as prednisone. Sorry if I have repeated other answers but let common sence prevail.
is turning to mush. It is so hard to watch them mentally waste away yet their
bodies keep struggling along I always pray that God will gently take my M I L
in her sleep, which is what she wants. It is not a quality of life anymore when
they lose everything that made them a viable vibrant person and they are reduced to a helpless miserable being.
I guess I still think the best thing is to provide whatever medication gives someone the best function and quality of life, but not to hasten death...and realize that prolonging life and improving it may not be mutually exclusive. But when push comes to shove and they seem to be, I would also say go with quality over quantity in these circumsstances. A goal of just being alive as long as possible really makes no sense in this situation (and I'm not sure if it makes sense in any!) There were a few little things we would have liked to do, like go to the zoo and see the penguins, that we never did get to though and a little more time would have been good as long as it was not just nothing but suffering.
I can also identify with the family and young person with an inoperable recurrent brain tumor when the facility wanted to stop the dexamethasone that was keeping brain swelling temporarily at bay because "it will just prolong things" ...their reply was, "uh, that's what we want!"
Our elders who have Alzheimers / dementia will never recover and will not survive. They are not likely eligible for hospice until they are considered appropriate by medical evaluation as being within the last 6 months of their lives.
Again, just my opinion, but I think a realistic talk with the doctor to stop the body saving medications will allow them to reach that 6 months criteria a little sooner. The Medical and societal mindset today is so often life extension which makes no sense to me when you're dealing with Alzheimer's or dementia.
Each individual and family must evaluate this for themselves on a case by case leve basis, ascertaining the elders functionality, ability to appreciate life and the families' capability to let the person go.
When it becomes crystal clear that there is no way out of this condition, that body saving medications are facilitating a crawl to the finish line, perhaps the decision can be made with a clear conscience to discontinue these medications and allow the patient a merciful and speedy your trip to the conclusion of this existence.
A living will is another type of advance directive. It is a written, legal document where individuals can specify what sort of medical intervention they want (or don't want) if they are seriously or terminally injured or ill. Individuals can also specify if they want medical treatments to keep them alive, including feeding tubes and resuscitation. Living wills can spell out individual's wishes regarding complicated medical decisions at a later time when there is disagreement or confusion among family members. However, it should be noted that having a living will does not guarantee that doctors, hospitals, or family members will follow an individual's wishes.
A living will establishes in advance what the individual would wish regarding certain medical interventions and treatments.
I will be having her checked for C-Diff, just can't figure out where she would have gotten it from, she has only been to the doc's on May 20th, diarrhea started May 27th. She hasn't been on any antibiotics for almost a year now. I an waiting for her to have another bout so I can collect a sample. Of course she hasn't gone since Saturday due to Imodium! I will keep everyone posted!
Chimonger -- Never did hear of the mannose. I have been giving Judy the cranberry capsules since March, 1 at each meal. Saturday I increased that 2 to 2 at each meal. I have also been giving her the Jen-3 Probiotic because that is what the doctor recommended. It probably took me a couple years to figure out all of Judy's allergies, milk was the first one and I figured out a number of others. About a year and a half ago I took Judy in for her quarterly checkup and she was down to 117 pounds from 140. When the blood test results came back the doctor told me her fasting blood sugar was too low, down to 63 and she was starving to death.
My comment was, "That was not fasting, she probably had at least a thousand calories for breakfast, I am a big eater and she eats much more than I do and I weigh almost 200 pounds".
A few days later I wondered if soy might be the problem and I eliminated soy products. Almost everything has soy in it. It took almost a month in which she lost 3 more pounds but then she started putting on about a pound a week. It took me several hours the first several months in the grocery store because about 95 percent of the product being sold has soy additives. One night I made tuna and noodles for supper and she had a really bad night. The next day at the store I picked up another can of tuna and from force of habit, looked at the label. The number 1 ingredient was soy sauce.
I have become a firm believer in food causing many of the problems we are having. I have been trying to get Judy's gout cleared up since February so she gets the same meal just about every day until I get her regulated well enough to add some new things.
If you want to know more about her diet I can add that later.
There are effective ways to deal with UTI's without using drugs.
And without bad side effects.
Cranberry juice concentrate, UNsweatened--usually in caplets,works well--if one gets enough into the system, and contains d-mannose, but some prefer D-mannose by itself.
Also, adding daily mixed Probiotics helps prevent infections, as it helps bowel health overall. It diminishes UTI's, vaginal yeast infections, and helps the body's entire immune function.
The Berkeley Women's Clinic used to recommend using plain live-cultures yogurt to relieve and stop vaginal yeast infections and reduce UTI's.
Something in the full-fat versions of that, soothes and helps heal the painful, irritated tissues too, applied locally.
Acidophilus, alone, helps reduce/stop diarrhea, is listed in the PDR, and can be prescribed by the Doc, and covered by insurance, I think
--some of our patients in the NH had this....though compound Probiotics were not on their list, a number of families brought those in for use. .
Carob powder, in milk or juice, helps stop diarrhea. The raw carob tastes sweet, and the toasted carob tastes a bit nut-like. I like the raw carob, and keep some in the freezer for long-term storage. Have mixed it into cranberry juice, and it tastes decent--but then, maybe my tastebuds are weird--!
Carob = St. John's Bread, of Biblical mention; it's been used for thousands of years for a number of things, including bowel issues.
A fat-heavy meal works like a laxative, and can cause explosive diarrhea--particularly if the person has not been eating much fats for some time.
A number of foods can trigger irritation in the intestines, resulting in diarrhea.
It might be worth exploring if she's sensitive to wheat, barley, rye...gluten containing foods. Or if dairy is the culprit? There are things being put into even dairy milk, that people have become very sensitive to, and now get bowel upsets from it, where they never used to. Same for Genetically Engineered grains and other GMO foods.
Sure hope you can find ways more comfortable--going through multiple episodes is crazy-making--so hard!
You are a saint to deal with it so long!!
Hard to hear of Docs doing as they have to your wife, these days....but guess it depends where one is--too many Docs are still clueless about some better, more humane alternatives/complimentary methods.
Hope you get things working better, soon! Hard enuf for those things to happen on someone who can take care of themselves, it's terrible for anyone who is impaired at all.