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My grandpa is in MC. He’s been there since Feb, and his vascular dementia has just gone from bad to worse. They keep changing his meds because of how anxious and mission driven he is at night. Since the new medication change he’s been REALLY out of it, you can’t wake him even to eat or drink. They tell me he’s awake for most of the night though.



Tonight they told me they are worried he’s becoming dehydrated and were thinking of sending him out to the hospital for fluids so his meds didn’t become toxic to him. They are going to hold meds for 24 hours and the staff were able to get food/fluids in so they aren’t sending him out tonight.



Im worried the dose is too high, but I don’t know how to advocate for him. When I mentioned this possibility they tell me he just falls constantly because he won’t stop wandering. Which I believe is true.



Have any of you been in a similar situation? What would you do?



This is an MC in AL not a SNF

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As my daughter told me its like quality over quantity thing. It takes a month to really see if a med works. If not, a new med is introduced so another month. I would wonder, though if its a GP who is ordering these drugs. If so, is he really qualified. I personally would want a neurologist at least. You have a right to take him to one.
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They are not trying to kill him. When a patient with dementia becomes unruly, wonders around or becomes agitated, they use medications to sedate him for his own protection. However, psychotic medicines have a negative effect oh his dementia and on his body. The dementia will eventually kill him despite the medications. It's a sad situation, but vascular dementia is a killer. Vascular dementia patients die sooner than those with Alzheimer's. However, prolonging the lives of people with dementia is cruel. Breathing doesn't make them live people anymore. They die many years before they are buried.
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Sounds like his situation is between a rock and a hard place. So, he's going to be semi-sedated or anxious and falling. I guess I would go with pretty much trusting what they are doing in MC. It's not their first rodeo. If he was 20 years younger, my response would be different but 94 is also quite advanced and he's going to start his downward journey at some point. I guess I would rather have my LO calm as opposed to anxiety ridden. There are no easy answers.
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This is an age old dilemma and I call it being "between the devil and the deep blue". There are tons of medications and medications "cocktails" (a mix) that are tried. It is terribly hard because those judging effect are usually aids, not medically trained personnel, and a patient is often either too medicated or not medicated enough, that is to say "almost comatose and non reactive" or "still acting out of control". It is almost impossible to monitor and that they are actually watching for dehydration means he is getting better than average care.
Dehydration is another problem for elders at best of times. Almost every elder who comes into ER comes in dehydrated. We lose our drive to take in fluids. Esp in warm climes this can be a terrible problem.
I wish everyone luck with this one. Even when the right meds, the right doses are found they work often for only a while and then no longer work. I wish I could be of more help. As a nurse I know this dilemma and it's a tough one.
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Lost313 Apr 2022
Thank you. My knee jerk reaction was that I needed to move him to a more of a SNF. I think the staff is doing right by him, it’s just a hard situation for everyone involved.
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Vascular dementia is incurable. The progression of vascular dementia can be vey rapid. Survival time is shorter than in other dementias. The medications he receives are for controlling his behavior and not his dementia, because there are none. The medications they give him are sedatives and anti-psychotics which knock him out and aggravate his dementia. Those drugs can potentially kill him, but if he doesn't get sedated he can hurt himself wandering around. It's a helpless situation. Don't hold many hopes.
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Lost313 Apr 2022
Thank you. All if this has happened so rapidly that it has been shocking. I just wanted to confirm that they aren’t over prescribing so they don’t have to deal with him.
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