What medications might help Mom relax at the dentist?
Recently my 95-year-old mother had her teeth cleaned and I doubt if she drew a full breath the entire time. I could tell she was extremely tense and have to give her credit for cooperating with the hygienist and the dentist. By the time we left, she was exhausted to the point she declined my suggestion to stop for ice cream, a first for her. She just wanted to get home.
Mom describes herself as a "worrier." On a normal day she is anxious and jittery, on top of the dementia. So it does little good to try and reason with her and actually can make it worse.
Meanwhile, we have an appointment later this month (August 2013) with Mom's primary care doctor to see about a medication which might help her through the dental appointments and other such situations. In the past, I’ve eagerly researched drugs and then cringed at the possible side effects and gave up the idea.
So, I would greatly appreciate hearing from other caregivers who have had similar experiences. Please tell about medications which have worked. All responses will be appreciated. Thank you.
I absolutely agree that there are many other natural solutions to your problem - like music etc.
Hylands (Standard) Homeopathic Calms - available at almost any health food store - could be of help prior to the dental appointment. They are non-toxic and don't interact with any prescription or over-the-counter medications, so they are safe. Mind you, they are not used like aspirin: have a headache, take an aspirin, headache gone in 30-60 mins. NO. You'd follow package directions for a couple of days before the appointment. Calms come in regular and Forte, which is supposed to be more for relaxing at night before bed time. In my experience, the Forte can be used for more relaxing if needed in the daytime. It does not put you to sleep.
Now, thyme has given the PERFECT answer. Nitrous Oxide was recently given to my 94 year old mother by our oral surgeon to have two lower molars removed. She new her teeth hurt and new she wanted them out but with her dementia became anxious and fidgety at the last moment. He had a very calming voice, put the apparatus on her nose, let it go to work a little bit, and everything was fine. He said it was perfectly safe and didn't interact with anybody's medications.
I had a problem just once many years ago at the dentist where the anesthetic injection wasn't taking so he gave me NO(2) to proceed. I don't know if all dentists use it but some do and you need an experienced one with the proper apparatus that goes over the nose and doesn't interfere with work on the mouth.
The only other thing I could suggest in addition to Calms and Nitrous is don't tell her you're going to the dentist. Just be getting her ready for some fun little outing. The more I would tell my mom what we were doing in advance of doing it, the more anxious she would become, if she were inclined to be anxious over what we were going to do. Just make the outing about something else and don't give her time to ruminate about it. Arrrrrgh, you have to get sooooo creative when it comes to managing a dementia patient's schedule.
Along the lines of the suggestion for nitrous, what about a small glass of wine? I guess my point is that if she is suffering, give her something for it.
Sometimes I really worry about these doctors, so many of them don't seem to know what they are doing, especially with the elderly.
Since I posted the question, Mom has been to her doctor who says giving something right before a dental appointment could backfire and make her worse, as some of you have noted.
Meanwhile, based on her other behaviors, the doctor prescribed Seroquel. During the time I’ve been here with Mom (10 years tomorrow), I've resisted this type of medication. However I agreed to try it because now she spends a lot of time in an agitated state, pacing around the house, trying to get out and go to her mother's, saying people are following her, etc. (Her mother, by the way, passed away 70 years ago and never left Pennsylvania. We now live in Florida.)
Mom has been on 25 mg of Seroquel three times a day. Last evening -- the 7th day -- her legs started to hurt badly and she looked awful. Her speech was slurred and she wasn’t able to focus on anything. So I'm stopping it to see if she gets better.
Her only other prescription is half a 25 mg Metropolol tablet twice a day for blood pressure. Plus I give her liquid children's Tylenol and Musinex with each meal and a liquid multi-vitamin each morning. She has Pepcid and/or Gas-X if needed. And that's it. (The Tylenol is for arthritis pain and Musinex to reduce phlegm which she gagged on regularly when I first got here after Dad died.)
The doctor also wants her to take Namenda so I guess we’ll try that after Mom has settled down from the other medication.
I appreciate all the cautions about strong drugs and I agree. I believe our help is going to come from herbal remedies and other alternative interventions. We’ll keep trying. Blessings to you for caring enough to contribute your thoughts and experiences.