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Having cared for my husband and my mother with dementia, the increased risk of death would not deter me from trying a way to improve the quality of the life that remains to them. I would rather that they (or I) live another 2 years in relative contentment than suffer another 3 in agitated turmoil. I'm not talking about having benign hallucinations -- that can actually add interest to their lives -- but severe disorientation, anxiety, fear, and general misery.
I agree with Veronica that close observation should follow the prescription of ANY drug, for any population, for adverse side effects and for effectiveness.
I once took a medication that solved the problem it was prescribed for, but also made my vision so blurred I could not use the computer! I was competent to discuss this with the pharmacist and with the doctor, and the med was stopped. A person with dementia may not be able to make these kinds of connections and so continues with the side effects.
It is critical that people who cannot advocate for their own health care have someone to advocate on their behalf. I congratulate sewingsh for this advocacy.
I was frequently asked where I was.
Once I was asked the time of day. Well the clock said 3 o'clock. However the room was painted bright yellow and brightly lit so no way did I know if it was am or pm. It was always dark out side as the only view was a brick wall.
I agree that great care should be taken with antipsychotic medications as with all meds in the elderly population, as they frequently have nasty side effects and can have the opposite effect than desired.
Another hospice nurse and I decided that when we reached the end we wanted a huge bottle of liquid morphine ordered. I recently received a couple of separate doses of morphine and both times became very nauseated so I will have to research a different drug!!!!!!!!!
I used to be a lactation consultant in another life and I will tell you that there were medications that could be used to increase a mother's milk supply but that was not a reason for the medication so doctors did not want to prescribe against "label" use. Why? They were worried about the effect on the babies and on the formula industry's bottom line. The cynical me believes that the whole statute of limitations with the pediatric population plays into effect here. Lots of time to start a lawsuit, so docs are VERY careful with how they prescribe in the peds population.
In the elderly population? Not so much. Are they more disposable? Do we WANT them to die? To put them out of their misery? Of course not. Well, maybe? No, of course not. So why do we think it's ok to give a drug that is KNOWN to increase the risk of death if you take it? Benefits outweigh the risks? Maybe.
But again, in the peds population that is not an argument for giving a drug. Or at least those benefits better be overwhelmingly large and the risks better be overwhelmingly small. In the elderly population, if there is the slightest benefit to be had (and even if that benefit is only to produce docility and sleepiness) then we go for it. And if the risk if death, well then what the heck, they are going to die soon anyway, right?
I'm not saying that I don't think the elderly population with dementia should NOT get anti-psychotics for agitation and aggression.
I'm just pointing out the inconsistencies that I see with the arguments for prescribing these drugs.
The reason being, my experience is that the facility will try to medicate to their convenience
I unknowingly allowed the facility to start an antipsychotic when mom entered a memory care center and when I saw what it did to her I ordered it stopped - when I got her to an independent neurologist he shook his head and said they should not have been giving her that med in that manner
All that said, it took a couple of tries to find the right anti psychotic med for mom and I delayed as long as possible from starting one in respect of her wishes - she'll barely take a Tylenol
These are dangerous drugs but it's the lesser of two evils in mom's case
My husband was willing and eager to seek improvements through medications. For him I would (and did) go along with all prescriptions and just watched closely for side effects.
Personally, I believe in better living through chemistry. I would want responsible pro-active use of medications, but with a loved one advocating on my behalf to ensure that no drugs were given just for the convenience of the facility.
Hallucinations are very hard to treat, and if they do not bother your mother I'm surprised a doctor would prescribe something for them. Are you sure that is the only symptom that concerns the doctor? Are there other, less benign symptoms, that might be involved?
My husband's hallucinations did not bother him and we did not specifically seek treatment for them. But Aricept did seem to diminish them.
Sissy, I hope you can have a conversation with the doctor who wants to prescribe the anti-psychotic to understand the full reasoning behind that recommendation and to discuss possible side effects and interactions with the other drugs she is taking.
I don't think there is a one-size-fits-all answer to should an elderly person take anti-psychotics.