Agitation and Confusion
I previously talked about anti-psychotic medications used in the elderly, and how they may increase confusion in dementia patients.
I told you about the first night in the hospital when he was given the anti-psychotic medication.
The other time he received this medication was in the first nursing home.
I was headed out-of-town to a work conference. Our normally mild-mannered Dad was becoming more and more agitated and resistant. There was one nurse I’ll call Pauline we didn’t particularly care for. Pauline was a no-nonsense kind of person. She knew they were supposed to call me first when they were changing meds, but I was on an airplane and out of touch for several hours. She also could not reach my youngest sister, the alternative person named in the health-care directive.
So instead she reached another family member who hesitatingly gave consent. (I may have agreed to give the medication also, but it annoyed me they couldn’t wait an hour or two to talk to me first.)
Yes, the meds did calm him down, but the sad part was he became more rigid and withdrawn. And it took many months to get him off the anti-psych medication.
Loss of Control
You quickly lose control when a family member enters the care system.
The medical team at this nursing home were primarily kind and caring individuals, but I imagine taking care of sick, declining patients day after day takes a toll. And the most common way to handle agitation in an institution seems to be to medicate.
It is stressful for all involved.
Why Medicate the Elderly?
My sister Terri and I attended an excellent dementia conference at the University of Minnesota during my dad’s illness. A geriatric physician gave an example of an elderly man (well over 80) on virtually no medications. The man was hospitalized for heart issues, and came home on blood pressure pills, diabetes medications, thyroid pills, blood thinners, and more.
The physician asked WHY? Why give an elderly person all those meds? What if he didn’t receive the blood pressure pills or the blood thinners, and died of a heart attack? Would that be so bad?
Was this physician advocating withholding treatment from a person because they are older? “Let them die, don’t waste money on pills.” Of course not! Many medications improve the quality of life for people of all ages. I personally take several prescriptions to improve my quality of life. (Better living through chemistry, we like to say.) This is a deeper more philosophical question.
When my father was nearing the end of life, upon careful consultation with his medical practitioners, we gradually pulled him off nearly all his medications, including blood pressure pills, thyroid meds, and more. At the end of his life we agreed we would ONLY give antibiotics for infections such as an eye or bladder infection.
I understand if you think this sounds heartless, there was a time I would have thought so also. Believe me, if he died from not having a blood pressure pill, it would have been a blessing.
(You will read later about his end of life and the mental turmoil surrounding end of life issues.)
The burden of being a caregiver is difficult. Having to make decisions about medications is tough, even with advice from caring practitioners. At times I felt useless, guilty, frustrated and helpless.