My Mom has been on Namenda and Aricept which worked wonders for her mood and attitude. The doctor says they are no longer effective in slowing her cognitive decline because she is in the end stages of Alzheimer's. We are trying to decide whether or not to take her off these meds for fear her once difficult and unmanageable personality will return. However, these drugs can subdue appetite and she no longer has an appetite. We are in a quandary as to what to do.
Do you visualize a point in her decline that you would call upon hospice to care for her?
Grace & Peace,
Bob
It is funny when Namend was prescribed for my Husband with each dose increase he had a difficult time and his personality became worse. I finally discontinued it.
As for the Aricept it "works" to slow the decline in mild and maybe moderate. If your Mom is in late-mid or late stage the drug is not doing much. Is she on any other medication? If so I think those are what is helping more with her mood.
I noticed no difference at all when I made the decision to discontinue the Aricept for my Husband. I did that when he went on Hospice. He did continue to decline for another almost 3 years. There were no changes that I could tell in his personality, mood, eating and the decline continued at about the same rate as previously.
Everyone is different. Doctors do hesitate (rightly) to take someone off a medicine for fear they can not then bring them back up to the point they were when they came off. However, on balance, my experience is that at the End of Life stage, as one of these responses has said, Aricept is not making much difference. (It is generally thought to be effective for only two years, but few doctors will bring someone off.) My wife was on a similar medicine here in England; and I withdrew it several months ago, and it does not seem to have had much effect. One guideline that makes sense which a Consultant Psychiatrist said to me here in England was, "We only change medicines when there is some indication they are not working." If someone with dementia is often agitated and upset that often needs to be treated, which several correspondents have pointed out.
There is no single answer. You know the person living with dementia best, so
you have to seek advice, weigh up the options and then make (in prayer, I would
add) the best decision you can. I hope this helps.
Definitely these drugs help in their behavior and mood. Do not stop.
successful in managing mood/behavior, especially since it usually takes 2-3 weeks before the results take effect in the first place. Starting all over with something else, can be hard on everyone. Maybe encourage mom's appetite with healthy snacks she might enjoy?
Since my mom's been on Namenda, her appetite isn't as big as before, but her weight is still good, and she snacks here & there.
Best wises
If she is not suffering adverse side effects, there is no reason to take her off the medication. Get Doctor and Nursing notes on her mood and take her to a Geriatric Psychiatrist if needed to have him verify for insurance the fact that she is still benefiting from these drugs.
Also talk to both doctors about how dosage should be adjusted when they become less beneficial.
Should you try a higher dose. What is safest schedule to reduce dosage to do controlled discontinuation considering all of her health factors. Should any other medications be adjusted at that time?
Again, the words "no longer beneficial" will trigger insurance not to cover. Work with your doctor, ALZ Assoc., Geriatric Psychiatrist, and other medical staff to show she is still benefiting!
When she is no longer benefiting, or side effects she experiences outweighs benefits, then step her down off the medicines.
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