I’ve already decided that once I’m 83 (71 now)I’m going to stop medications. I only take bp meds now so hopefully I can keep it at those. I have a good life and I don’t have a death wish, but I don’t want my kids to use their senior years stressing over me like I do with my mother.
Mom, age 95, Stage 5-6 dementia takes 22 pills a day and has no major physical health issues. Her labs are better than mine. Her meds are mostly anxiety, incontinence, dementia related, pain (arthritis), GERD, BP, cholesterol, neuropathy (not diabetes related). She can’t see, can’t hear, can barely string a sentence/thought together and wants to die. I told her my plan about not wanting to live as long as she has and she agreed saying I didn’t want you kids to go through this and I told her that was my reason too. Except for the obvious (big Pharma) why do doctors insist on all these drugs? Mom is too far gone mentally to make the decision to stop the meds (she lives for her 8,2,8 drug runs). Years ago people died of heart disease, stroke, and natural causes. Not anymore. Everything gets fixed, rehabilitated or medicated only to be returned to their wheelchairs to sit out their days. Quality of life doesn’t seem to be a factor. I know there are no answers for this. But thanks for letting me vent Hope everyone has a good day.
You might want to review this list of medications, or do further searching online (this is from 2008).
http://www.dementiacarestrategies.com/Medications_to_Avoid_in_People_with_Dementia.pdf
My mom had been on detrol for years for her weak bladder. That's contraindicated in patient's with dementia. Quite frankly, she was at a stage in her incontinence that it would have had little effect anyway--full blown incontenence is not going to be controlled by a med. We stopped the detrol and moved her to disposable underwear and frequent bathroom trips.
One of the things that can happen is that the specialists add meds to the list but then let the PCP manage them. Explain your goals to her provider--that is removing or reducing the amount of pills, and having anything contraindicated for dementia removed.
One day I was watching her do this and I asked "what is the actual POINT of this exercise in futility, mom?" She just looked at me with this 'huh?' look in her eyes. The chol. meds were discontinued that day. SMH, still after 17 years.
At that point, all he wanted was the morphine and Valium.
I would ask that the dementia related pills be stopped. They do no good after a certain point. Also the cholesterol. She's 95 and it has been proven statins contribute to dementia. They also eventually effect the liver and should be stopped when the enzymes are ellivated. Is she still walking? If in a wheelchair, I would have the neuropathy meds stopped too unless for pain. But then she is getting pain meds for arthritus. I would also have labs done to make sure the meds are leaving her body. Elderly don't seem to get rid of meds like younger people so they build up in the system. She may be able to take a lower dose.
Just read they build up because of kidney problems and dehydration.
Medications for dementia do not work forever. At some point they can be discontinued as there is no longer a benefit to them. (If you do decide to discontinue it consult the doctor as some have to be discontinued slowly)
If mom is incontinent is a medication for incontinence actually helping? If not talk to the doctor about discontinuing that as well.
When I signed my Husband up with Hospice they gave the option of continuing medications he was on or discontinuing them I decided to discontinue Cholesterol medication and the Aricept (dementia med). He was on Hospice for 3 years after discontinuing the meds and it was a "routine" decline for what I presume to be Vascular dementia as well as the Alzheimer's. Discontinuing the meds did not seem to be detrimental to him.
But since, I presume you are POA for m om it can be your decision to discontinue meds and other treatments.
If your mother isn't competent to make those decisions, who is making them for her? After consulting with my mother's hospice nurse about whether we were doing too much for my mother, I made the decision to discontinue her meds, except for those relating to comfort care. After stopping the blood pressure meds and diuretics, her edema disappeared rather than worsened, her BP remained steady, and she was finally COMFORTABLE because her body wasn't being forced medically to do things it really couldn't any longer. She lived another three weeks, and her death came naturally.
While I don't really advocate setting a random date like turning 83 as the time to stop using medications or seeing doctors, it is important for both doctor and patient to understand when the body is no longer metabolizing those medications properly and they're no longer working. My mother was on Lasix for seven years, and it didn't do anything for at least the last three years. I'm no doctor, so I didn't know that it was probably pointless to keep pouring that stuff into her, and the BP and blood thinning medications she took were more preventative to keep her from throwing a clot that anything else. She never had high blood pressure a day in her life, nor did she ever throw a clot either before or after being taken off those meds.
Make sure you're clear with your doctor and on the same page about what quality of life means to you. You're absolutely correct that once upon a time we would go along with our lives, then have a catastrophic event like a stroke or heart attack, then die. I don't care how much technology and medical advancements there are, I don't believe our bodies were meant to last 95 or 100 years, and we shouldn't keep pouring drugs into our systems to pretend they were.
So in my mother's case, it isn't the doctor who's insisting on all the drugs, it's HER! While she claims daily she wants to die and we should 'throw her out in the street' and yada yada, here she is, doing everything in her power to cling TO life, only to complain bitterly about it every single day. Makes NO sense to anyone.
I feel like the doctors are damned if they do, and damned if they don't. If they help the elders, they're the bad guy & in cahoots with Big Pharma. If they don't, then they're accused of leaving them to die. I'm glad I'm not a doctor myself, personally. And I'm glad I'm not 95, too.
Medicare.
This why a 95 year old can have a team of specialists. Access to every kind of medication. All kinds of expensive medical equipment along with physical/occupational rehab therapy just to be returned to their wheelchairs to sit out the rest of their days. It's because these old folks generate a lot of money. Throw in if they have Medicaid as their secondary insurance, and sky's the limit.
Of course none of this is for say a younger person with lesser insurance who would actually benefit from it. This of course is because a younger person may recover and the medical industry wants repeat customers. Especially ones who they can bill to Medicare and Medicaid.
I don't think it's necessarily a blessing for people to live as long as they do. You are right people did die of things like heart disease, stroke, or just plain old age.
People did not live long enough to get to the point where they became so out of it from dementia as to be totally invalid and require a professional facility staff to care for them.
It's all about the money. It's almost guaranteed today that if a person lives long enough they will be on Medicaid. This is so because every cent or asset they ever had in their life had to be spent on their "care". Finally, when they are completely beggared they go on the state for a nursing home. Quality of life is not a factor. Quality of insurance is what matters now.
As cwillie says, it's time to discuss palliative care for your mom.
- your profile says your mom is in IL, even with "stage 5-6 dementia"... how is this possible?
- Are you your mom's PoA? If not, who is? If no one, then is someone pursuing guardianship for her?
- who is taking her to the doctor for every ache and mention?
- who is administering her meds to her?
Thanks for clarifying your post!
They have a PA that comes in every two months for visits (more if needed). Once mom mentions a disorder then they either prescribe something or call me to suggest I take her to a specialist for whatever ails her. I am the final authority on how they treat her and what she takes but if mom hears, ‘well maybe we can give you something’ that’s all she dwells on. They administer her drugs. Maybe what I’m feeling is the guilt associated with taking her off the drugs and what it would make me look like in the face of the homecare facility. The PA is coming on the 30th (flu shots (eye roll)). Perhaps I can slip down and talk to her then.
thanks for your reply.