• August 5, 2008 at 2:42 pm

    hello,my mother after a 16 day in facility stay ,was diagnosed with dementia not specifically specified,with psychotic delusions ……..
    she was prescribed Aricept and an anti-psychotic called (Abilify)/aripripazole…….
    after going to the fda web site i read their posting saying Abilify
    is not approved for treatment of elderly persons with dementia……..
    due to increased risk of death……..
    I am uncertain as to what i should do about it……………
    the antipsychotic (abilify) seems to reduce the amount of delusions she experiences……….
    when she didn’t take it ….she would argue and converse repeatedly with non present persons both day and night, walk the floors at night ,and lye awake conversing and depriving herself of rest ………..
    so the abilify seems to be effective for that ………….
    has anyone had similar experience? or knowledge of these medications?
    i seemed to be faced with dilemmas of letting her destroy her health from lack of rest and suffer ongoing delusional state…..or…….
    place her at risk of death from medicating with an antipsychotic which isn’t approved for her diagnosed *(dementia)condition………
    or possible option three ……..allow her to be delusional in they day and administer sleeping medication for night rest…..
    has anyone been faced with similar circumstances or have knowledge or experience with these medications?……….
    any ideas will be appreciated!

  • August 6, 2008 at 5:01 am

    Tim—I should probably not be answering this…My loved one has not had the need for any medications other than his normal blood pressure one.

    From what I have read there does not seem to be any perfect anti-psychotic. They all seem to come with risks and most (to some degree) increase the risk of death in the elderly. I’m not trying to minimize the risk…but…Alzheimer’s is a fatal disease that shortens one’s life. If an anti-psychotic keeps your mother happy and enables her to stay out of a facility longer…read past the early death warning and learn about the side effects and watch for them. Be aware of the fact that jerking and twitching can cause falling. Falling can cause physical pain, cuts, and broken bones.

    I think that there are some alternate ways of dealing with some of the conditions you have described….

    Learn to ignore them.

    Try to think of pacing as exercise as long as your mother is not upset while doing it. It may be bizarre for her to be talking to nothing…but…It does not hurt her unless she is upset. What she is seeing is her reality…With some adjustment on your part…Her reality can co-exist with yours.
    Telling your mother that there is no one else in the room or what she sees is not there (unless she feels threatened by it) is going to upset her. If my loved one told me that there was an elephant in the living room, I would probably say something like: Thank goodness he is quiet and well behaved. If he is bothering you I’ll shoo him out but until then we’ll ignore it. If told me that his long dead father was there, I would probably offer him a seat. Telling him that his father was dead would serve no purpose and only make him sad.

    Try and figure out what triggers the events.
    Sometimes reflections in mirrors, framed pictures and windows are the culprits. Draw curtains at night and if necessary cover mirrors and pictures.

    Do not underestimate the value of sleep
    Lack of sleep can trigger all kinds of not nice things.

    If you decide to slowly wean your mother of Abilify, you might want to try a supplement melatonin. In addition to helping our loved ones sleep (if given approximately 1/2 before bed). it is reported to help stop sundowning and aggressiveness during the day. If you try it…Allow about 2 weeks for it to kick in and stop using it for a few days if the system builds up an immunity. Once again…I have no experience with this…but have heard of many caregivers of individuals with dementia or autism using it with success.

    No matter what you decide, I wish you well.

  • August 6, 2008 at 12:31 pm

    i appreciate your view expressed in your response , i had a four month 24/7 desensitising to the delusions while acting as her caregiver before having to have her removed from her home by means of emergency guardianship because she wouldn’t cooperate for her own care and something had to be done………
    so the bizzarness has pretty much lost its shock factor……
    i don’t argue with her about her delusions anymore it doesn’t serve much purpose………..any conclusion arrived at from discussing them is only forgotten anyway……….
    for awhile she had me thinking or believing that she had crossed over to another demension(dementia-sion) and was actually visiting with the ghosts of our deceased relatives…..her delusions also include some childhood friends and an x man friend which she dated in adulthood,whom she believes to be her spouse………
    all of it is pretty bizzare but harmless…..the only action she has ever attempted or/exercise of will in association with thought/delusion was expressing desire to go visit the x man friend……
    she has to be motivated to be out of bed and taking meals doesn’t want to go anywhere or outside even, maintains everyone is stealing her money……doesn’t desire to communicate by phone to anyone…..she watches tv sometimes and likes my girlfriend and will talk to her and maintains a sense of humor with me and is amused by my girlfriends chihauha dog and will feed it and pet it some….
    she doesn’t pace as much as she used to and the sundowner syndrome seems to be alleviated by the medications ………
    there doesn’t seem to be any real triggering mechanisms……
    she just lye’s in bed argueing with whomever and cursing them and directing them to do things or accusing them of stealing her money or eating all the food……
    and it’s uncanny how she just turns it on and off like a light switch back and forth between conversing with us in reality and conversing in delusions……….
    she has no real aggresion ,she was always a sensible logical and passive person in her sanity…… and she doesn’t attempt to wander off or leave the home……..
    for awhile she was maintaining she had a couple of infant babies
    there seems to have been one main triggering incidence that pushed her over the edge……..in 12 of 07……..her brother promised to make sure she was transported to a first cousins funeral services …….we were waiting for his kids to all come in from out of town …..i kept calling to make sure he was going to take her because my residence was 250 miles away and i was working ……after four days i called her brother only to find out he had just got back from the services without calling her or myself and without taking her as promised……….
    she became very distraught and angry and may have suffered some mini strokes …..despite me taking her to the grave to place flowers and talking with her and telling her mom let it go you are going to make yourself sick over it…….i got her calmed down then a week later she went over the edge and started being delusional……..and has never been the same since……
    july of 07 i lost my father to renal failure he and my mother had been divorced 17 years and then six months later this happened to my mother…….back to back tragedy …..
    i don’t know how long i will be able to provide the level of care my mother needs but i will keep my word to her as long as possible she has no other major health issues other than blood pressure…..
    i just don’t like wondering what all the medicine is doing to her physically ………
    but there doesn’t really seem to be any choice in the matter and it’s difficult at times wishing there was something more that could be done.
    one day at a time we just do what we have to i guess……..
    and try and leave the rest in god’s hands…….