Did dementia meds?

[Anonymous]

Mom's short term memory is declining - forgetting appointments, day of the week, being able to recall what she ate or who came over on which day, etc. She also has lost weight over the past several months and is underweight at this point. Doctor thinks she is forgetting to eat or not realizing she is hungry. Doctor suggested starting dementia meds and/or an antidepressant to stimulate appetite. There are apparently side effects for both.

She is homebound and a fall risk (uses a walker). I take care of all accounting/paperwork/groceries and she has a housekeeper and caregiver for maintaining the home and bathing.

Will dementia meds help?

[Anonymous]

They might help for a while but probably not enough that she doesn’t need someone helping her with/monitoring meals.

[Anonymous]

Based on my experience personally and professionally- but please discuss with a geriatric psych or your parents pcp:

They only work for a little while, then plateau, and only once… if you try them again a year later it doesn’t improve.
They (aricept and namenda) are best used when you know a transition is coming - like a move to assisted living, a surgery, a move to nursing home. Those transitions often result in a sudden loss in function, and drugs help prevent that.

[Anonymous]

The namenda helped my mom in mid stages. Later stages she needed anxiety/antipsychotic meds…

[Anonymous]

OP here, would the antidepressant - remeron - be a better way to go at this point? To at least stimulate appetite? She's under 100 pounds at this point from a high of 115.

[Anonymous]

You said she's homebound and a fall risk-her original home or a care facility? I would be focused on the right med to help her to transition to AL or Memory care (if it's one that has people at different stages).

[Anonymous]

Anonymous wrote:You said she's homebound and a fall risk-her original home or a care facility? I would be focused on the right med to help her to transition to AL or Memory care (if it's one that has people at different stages).

She's at home in an apartment. She can manage with her walker around the house - still makes herself breakfast, wash a dish ,can cook some basic things, dresses herself, etc. She is very resistant to moving so we're trying to support her wishes as long as possible knowing that it may take a fall or something else to make the next transition. Not sure if that's the best way to go about it but...

[Anonymous]

I have read that the supplement MCT Oil (basically coconut oil) can be effective in slowing down cognitive decline in these circumstances. Also exogenous ketones.

[Anonymous]

OP, what doctor recommended this. Is it just her PCP? First off, she needs to be tested for a silent UTI which can cause all of those dementia like symptoms (and exacerbate actual dementia). Next, if she isn't seeing a neurologist, get her to one. There are many kinds of dementia and how to care for your mom if she has dementia will vary based on the type and other factors.

[Anonymous]

Help what? Why on earth would you want to drag this out?

[Anonymous]

Remeron is also good for staying asleep which could keep her in her home situation longer...

[Anonymous]

Anonymous wrote:OP, what doctor recommended this. Is it just her PCP? First off, she needs to be tested for a silent UTI which can cause all of those dementia like symptoms (and exacerbate actual dementia). Next, if she isn't seeing a neurologist, get her to one. There are many kinds of dementia and how to care for your mom if she has dementia will vary based on the type and other factors.

Yes, her pcp. I was wondering about a UTI but can you have one for months on end without the UTI getting worse? Her regular bloodwork has been fine though I know that doesn't test for a UTI.

[Anonymous]

Anonymous wrote:

Anonymous wrote:OP, what doctor recommended this. Is it just her PCP? First off, she needs to be tested for a silent UTI which can cause all of those dementia like symptoms (and exacerbate actual dementia). Next, if she isn't seeing a neurologist, get her to one. There are many kinds of dementia and how to care for your mom if she has dementia will vary based on the type and other factors.

Yes, her pcp. I was wondering about a UTI but can you have one for months on end without the UTI getting worse? Her regular bloodwork has been fine though I know that doesn't test for a UTI.

Yes, these silent UTIs can go on for a long time because they are either symptomless, or the symptoms are so vague and so different from the UTIs that we’ve all had they go unnoticed and undiagnosed.

If the PCP did not ask for the test I would also consider whether they are really equipped to be the QB for her care team. A gerontologist or internist who works with lots of seniors might be better.

I know this is very overwhelming. I would prioritize getting the UTI test, and scheduling with a neurologist ASAP. I would not start dementia related medications until you’ve had the opportunity to get advice from someone more qualified.

[Anonymous]

My mom started showing signs of dementia. She also lived at home, but needed a walker to get around. Mostly homebound. They tested her for a UTI and sure enough, tested positive. Soon after starting the UTI Rx she was back to her baseline.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP, what doctor recommended this. Is it just her PCP? First off, she needs to be tested for a silent UTI which can cause all of those dementia like symptoms (and exacerbate actual dementia). Next, if she isn't seeing a neurologist, get her to one. There are many kinds of dementia and how to care for your mom if she has dementia will vary based on the type and other factors.

Yes, her pcp. I was wondering about a UTI but can you have one for months on end without the UTI getting worse? Her regular bloodwork has been fine though I know that doesn't test for a UTI.

Yes, these silent UTIs can go on for a long time because they are either symptomless, or the symptoms are so vague and so different from the UTIs that we’ve all had they go unnoticed and undiagnosed.

If the PCP did not ask for the test I would also consider whether they are really equipped to be the QB for her care team. A gerontologist or internist who works with lots of seniors might be better.

I know this is very overwhelming. I would prioritize getting the UTI test, and scheduling with a neurologist ASAP. I would not start dementia related medications until you’ve had the opportunity to get advice from someone more qualified.

Thank you, I appreciate this advice.