Hello All,

My mother has recently been dx'd with dementia after a hospitalization for her physical issues with weakness/being unable to walk from her neuropathy also resulted in profound confusion with periods of delerium and hallucinations.

During her physical rehabilitation at a rehab facility, many of her cognitive issues did clear considerably. She is technically alert and oriented to person, time, and place, but she is NOT "all there". Our biggest issues in managing her at home are not because of her physical needs, but more about her mental needs and considerations. For over a year now, she has had difficulties with reasoning, made many mistakes with meds and appointments, has inappropriate affect/responses at times, is increasingly irritable, and just plain a "biatch" to be around. That is NOT her normal personality. The persistent anger and irritability was a big change last year.

We've had issues with her primary doctor not addressing our concerns, her primary feels she is "just an angry old woman who wants to be left alone until she dies." I don't believe that's an accurate assessment of who my mom is, it's just how she's acting now.....I believe there is a cause for these changes in her personality and behavior. I think the recent dx of dementia makes sense, but now we are home and my mom and my dad are reluctant to change primary docs (my dad sees the same doc and really likes her)

Mom had been on Prozac for over 20 years. Last year we took her to a psychiatrist who changed her to Effexor last summer. By fall, we saw a significant change and she was happier some of the time. In December, she saw that doc and said she didn't feel she was depressed and wanted to stop the medication and seeing that doc.

Since her last hospitalization, mom is on Aricept and is using Ativan 1mg at bedtime and 0.5 mg at 4 pm to decrease the sundowning issues. She will be seeing a new neurologist next week.

I'm wondering if my fellow caregivers out there have found effective meds to help with some of these troubling symptoms. What type of doctor helped you the most in working on managing the symptoms of dementia ? What types of meds did they try and what helped/didn't help ?

Thanks for any suggestions.

First of all, a primary care doctor is not always the best to deal with the variables of this disease.
I would suggest a consultation with a neurologist who is familiar or who specializes in dementia/Alzheimer's.
My MIL is in the late mid stage of Alz...she's on a boat load of meds, starting with an Exelon patch. She is also on mirtazipine and alprazolam as well as quietapine. She is hallucinating more now, and gets quite cranky, quite unlike her "real" self.

All of these meds keep her from getting up in the middle of the night and undressing, talking through the night, etc. She is beginning a downward slope now since my father in law died in January. She is not eating or drinking much...she is also in hospice as she is exhibiting signs of heart failure.

The one thing to watch out for are Urinary Tract Infections. If dementia patients get dehydrated, they are more likely to get them, and it exacerbates the symptoms. Make sure she drinks plenty of water/liquids each day.

Also, there's lots of info on alz.org...

You are in my prayers. This is not a fun journey by any means. Patience is the most important virtue for caregivers. That and a good doctor to help manage the symptoms. Again, get her to a neuro...

Thanks Debbie.

Gosh, you have your hands full right now ! I hope that you are able to keep your mil comfortable.

We did get our appt with a neurologist. She said that she would be the one managing my Mom's Parkinson's, but not directly managing the dementia. She did book an appt for a neuro psych eval in a few months and got out appt with a geriatric psych MD moved up to last week. The psych doc changed many of her meds around and most importantly added quitiapine.....that has made a HUGE difference.

Quietapine does work well. Atavan does too, but she is only given that at night when she won't sleep. She has a 24 hr a day caregiver in assisted living, which is such a blessing.
She is increasing her Sundowning symptoms though, so we might have to have the doc increase her meds. We worry that so many meds for her symptoms will hasten her towards a comotose state. She is having a lot more difficulty with word retrieval now and gets very frustrated.
We visit a few times per week...it's more difficult for DH to see his mom, who was the rock of the family, declining so now, but he is a wonderful son and takes care of her finances and is devoted to her. I pray that she passes peacefully at night before this horrible disease does it's dirty work...