I have a question regarding medications. My mum as you know has vascular dementia, she also has pelvic cysts, heart disease and circulation problems etc etc.
The medications she is on are:
Frusemide 40mg
Dipyridamole 150mg
Captopril 25mg
Risperdal 1mg
Felodipine 5mg
Ferro-gradumet 325mg
Aspirin 300mg
Omeprazole 40mg

I have a pretty good idea what each one is for, she has been on them all since January 03 with only a reduction in the captopril.
Recently I tried cutting down and getting rid of the risperdol but that didn't work out.

Mum has malignant hypertension but for the last 8 months her blood pressure has been averaging 117/60 Is this good???

Anyway I want to know do we as caregivers have the right to stop any or all of these medications?
It's just that lately I have been watching her and thinking well this is all that's keeping her alive and is it worth it when you look at the quality of life.

Have talked to the doctor about them all and he says he can't cut any others out or down.
Why? What will happen if we did stop them?

I guess at the same time I am thinking I want this over, so that may be affecting my train of thought. Also recently the doctor put me on fluoxetine (prozac) but they do not help so am considering stopping them... they are after all only a band aid. They don't take away the isolation and lack of caring from others do they.

Anyway any thoughts on this medication issue much appreciated please

Shinto, just wondering how you are doing? I hope you have gotten some relief!

Quality of life is a hot topic in my Hospice organization, where I'm a board member and Chair of the Ethics group. Assuming you're the designated decision maker, you have the right to engage the physician in quality/quantity of life conversations. Dementia is becoming one of the big Q/Q debates in care at the end of life, and the issues around routine medical management are yours for the asking!
John Hopkins

So sorry Shinto...(hug)
Know that you are in my prayers.
Have you a home health care program in your town? Sometimes just to get away for awhile helps tremendously and knowing that your Mum is in good hands while you are taking some time for yourself. I felt pretty much like you with the anti-depression pill and told my doctor and he switched me to another that has helped me tremendously. You can get to a point where you dont even know how fragile your emotions are and then you will break down. I did, so I know it can happen. Believe me it is not a bandaid.

Edyth Ann, great advise.From my personal experience, If I did not take mediciation to help my anxiety I would have made so many hasty decisions.I try never to make them under stress.

Shinto,

It is not uncommon for a CG to take and anti-depressant or an anti-anxiety medication in situations like you are finding yourself. THEY ARE NOT A BAND AID!!! Finding the one that works for you can make a huge difference. Remember the medication can take awhile to become effective and if that one is not working then it is vital for you and your Mom that you contact your Dr. make an appointment and go. Send her to respite and see the Dr. You really can not make a sound decission on her behalf untill you do something to take care of yourself and get yourself back in working order. It may be a good idea to place your Mom in care for several months so that you can get back on track so you can reassess the situation and make good decissions. In your current state (and I have been there) making a serious decission about medication or even care plans can leave you with a life time of regrets.

Dear Angela,

You are a wise woman put in a difficult position. And, if I may add, you are quite courageous to admit your own feelings while asking a very sensitive question. Quality of life over quantity of life is a hard balance to strike. However, you must also include your own life into the equation.

quote:

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Originally posted by shinto:
... Anyway I want to know do we as caregivers have the right to stop any or all of these medications? It's just that lately I have been watching her and thinking well this is all that's keeping her alive and is it worth it when you look at the quality of life.
... I guess at the same time I am thinking I want this over, so that may be affecting my train of thought. Also recently the doctor put me on fluoxetine (prozac) but they do not help so am considering stopping them... they are after all only a band aid. They don't take away the isolation and lack of caring from others do they.

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In my view, you have to consider what your mother would have wanted as much as what your mother's doctor is advising. Did she determine in her Advance Directives or even a private conversation with you what she wanted for herself, how she wanted to live, and what she expected from you? It is worth considering long-term placement for her but please know, in this country, medications are often withdrawn as part of the intake process and the regimen is redirected since her care would be evaluated and maintained 24/7 by an available and professional staff. Fortunately (or not), these decisions would no longer be solely in your court but your input (based on your mother's wishes) should be honored just the same.

As for your own treatment, Prozac may not be your only answer. In America, it's often the standard first anti-depressant offered but you may find another one suits you better even if it is limited to short-term use. Again, in my view, once you're free to get some genuine rest and regain your own sense of perspective, you may find the use of any anti-depressants do not meet your personal needs as much as finding your own life is valuable and worthwhile. Isolation and relentless stress can make anyone question themselves.

With all of that said, please start looking for alternative caregiving solutions... not only to enhance your mother's life but your own as well. Long-term placement does not always mean permanent placement. Perhaps you can find a facility which would allow you the freedom to take your mother home once in awhile or even stay with your mother on occasion.

Angela, please know more than a few of us are thinking of you and wishing you peace during this difficult time no matter what you decide to do. Although I'm sure it feels like it all to often, you are not alone.

Joan Marie

Shinto

If your mom has malginant hypertension, your wish to have this over with will not take too long without witholding your mom's medications. It is a serious and dangerous disease.

Witholding her medications is, at best, adult abuse/neglect, because her death would result fairly directly. At worst, if someone else is around, it is euthenasia..or even homicide. She is receiving things that have stabilized her blood pressure at 117/60 which is excellent.

I am not sure WHY you want to reduce her medications, but I am hearing one thing very very clearly. You are exhausted and depressed. I know that "letting your mom die" seems like a relatively simple solution..but would you really be able to live with yourself knowing you hastened your mom's death? And if other family members found out? Or the doctor? You could be in very deep legal hot water.

With all due respect, this home care situation is not working. When we start thinking about killing our loved ones, it is time for a change. It is time to seek placement aggressively. If you are thinking about ending your loved one's life, would she really be worse off in a nursing home?

I have been a caregiver and I know there were time when I hoped she would not suffer too much longer. But I had help. My loved one was in an excellent facility where she received respectful and loving care. There were times when I resented the staff because they loved her far more than I could....but in my heart I knew they were a special gift.

Please please take the prozac, do not reduce your mom's medications, and most important, it is time for placement.

With respect and understanding.

Ask the Dr.to replace the Resperidol,with Seroquel,a much better medication.
I take it to keep anger/agitation down.Works like a charm,& has little side effects..........

Hi May,
Thankyou I have researched all the meds and found the risperdol to be the nastiest. We did try cutting it down but the sundowning got quite bad.

Hi Gypsy,
Thanks for the thought gone into your response. No I wouldn't stop the meds without the doc's sayso, and I guess he isn't going to say yes so haven't asked.
No depression has never been an issue for me, only in the last 3 months the doctor decided that I was depressed. These fluoxetine are really messing with me though, I am constantly tired and every nerve in my body feels extra sensitive.
I don't feel 'depressed' just hurt by others lack of caring and so alone. In the last 14 months we have had 6 visitors, the last one 3 months ago so am not surprised at how I feel at the moment. yesterday I had trouble staying awake and felt pretty yuk. I tried to get someone to come and help with mum so I could call the doctor, but no-one would. That kinda sums up our situation.
No mum hates the time in respite, she cries whether I take her or she is picked up and does not participate in anything there. At least here she is happy watching television, there she won't even do that.
Mum's incontinence is a day and night thing, sometimes I get lucky in my timing to send her to the toilet but most times is a mess.
Yes I have thought of getting a baby monitor, would be helpful especially at night. I have trouble sleeping as am constantly listening for her.

Yes my daughter lives at home, she is home 4 nights a week, the rest she stays in town because of work.
Honestly though she is not capable of coping with her gran. I have tried leaving them together for half an hour and it is usually a mess when I get back. Poor girl can't figure out if someone needs changing you have to clean them up as well... stuff like that. And she forgets to give medications.
I find it really hard having to think for myself and mum without having to think for my daughter as well.

What did I enjoy before caregiving started??? Ummm Well all I did was work. Never really had a social life as such or hobbies, I am not artistic or anything. Alas I was a workaholic.
That has a lot to do with my feelings now. Boredom is something I don't do well neither is television 16 hours of the day.

Giving mum choices is a tricky one, she gets confused trying to make a choice. Or wants everything. Will try more though.
going out to lunch and stuff is a thing of the past for us, the mobility, incontinence, confusion and eating habits are a nightmare which makes the whole experience embarrassing for her and I both.

Anyway thanks for your input.
Angela

Hi Angela. I have thought alot about you and your Mom since I read your post. I started to reply last night but was interrupted. Please do not change any of your Mom's meds without the Dr. ok. Also how long has it been since YOU have had a through checkup? Have you had problems with depression before or is this new since you started caregiving. You mentioned that you get 4 days respite a month-how long before your next 4 days? Maybe the time has come to place your Mom. Maybe that would give you more time for yourself but still visit on a regular basis but not have the same responsibilities. Does she like her time in respite?Also in the facilities here it is possible to take a resident home for a night or 2 once in a while.I also used to take Mike out for lunch at least once a week once I had a lift in the van. Can your Mom still get in and out of the car. Can giving her choices help? Just be careful how you word it. eg. A while ago I asked Mike if he wanted to come out and feed the birds and have a nap later OR lay down now and I would go feed the birds while he was napping. He chose to come out first then nap. If I want to go out for lunch I will give him a choice of places, not whether to go or not. If I don't care if we go out then I will ask him if he wants to go out or stay home. I think all these questions give him some sense of control over his life. Sometimes I don't get an answer so have to try to be a mindreader. We also have problems with incontinance esp. at night. In the daytime I can usuallytell when he needs to go. I hate it when he just sniff instead of using a tissue-try to put one in his pocket and leave a box on the headboard, table and little table beside his chair. Do you have a baby monitor? someone here suggested one. If I have to go outside for a few min or am in the other room or even using the C when he is in bed it gives a little sense of security. I just stick the parent part in my pocket. I have worked in the garden right beside the house while he was sleeping-I can hear him snoring. He was always a worker so I try to find things he can do-eg-watering the garden, planting bulbs in planters, I bought him a long handled weeder-make sure I don't ask him to do between plants. What did you enjoy doing before your caregiving started? Does your daughter still live at home or at least come to visit even if she doesn't feel comfortable staying alone with your Mom? Gypsy

the one thing I would check is the respirdal.One is for water retension, one for iron , am not familiar with the others.Research them on line and you will get an idea of sides affects and any interaction with on another