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My uncle, age 84, who is not forthcoming with medical information, was diagnosed with dementia early last spring and prescribed Aricept and Namenda. My cousin (his daughter) who visited from out of state last week, discovered by accident that he had not been able to fill his Namenda prescription for at least three months. The local, small town pharmacy told him that they were not able to get it, and evidently did not contact the neurologist to ask about switching to Namenda XR. Now, my aunt has told my cousin that they got a new Rx on Tuesday and he is taking it again. Should he have had a new "starter pack" of increasing doses since he has not taken it for a period of time? Does anyone know why this med needs to be titrated? My uncle has not given permission for his doctor to give information to his children, and they do not know if the doctor is aware of this treatment gap.

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Yeah Pam, my cousins would love to be able to move them, but they are still able to do ADLs, mow the lawn, drive and have not been declared incompetent. They refuse to sign so that doctors can speak to their children. I went down this road with my MIL, so I know what they are dealing with. Kids want what is best for them, but their hands are tied until there is a crisis. Personally I think that the pharmacy dropped the ball on this one by not letting the doctor know that this med was unavailable, and my aunt and uncle are the type who don't question anything the pharmacy tells them. Now we are just trying to determine how it should be restarted. We have absolutely no say in what meds he takes, but we are trying to avoid possible negative effects from the treatment gap.

Your fire story was my nightmare when my MIL was still in her home. She had COPD, was on oxygen and continued to smoke, even in her car with the O2 tank on the seat next to her.
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Get uncle to Assisted Living where people keep track of meds, first and foremost. If he has been OK on just the Aricept, I would not add it back in at all. It sounds like Auntie can't keep track of things either.
An elderly couple down the street stayed in their house much longer than was safe for them to be there. In fact, they started a fire and did not know what all the smoke was so they called their out-of-town son. He called 911 and his sister who lived across the street from mom & dad. She got them out, the EMT's took them to the ER for smoke inhalation. The house was a total loss. Don't wait too late.
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