Husband with early Alzheimers: Question about medications

Posted by clayton48 @clayton48, May 25, 2016

My husband is 68 and was diagnosised with alzheimers two years ago, he has done very well and is currently on both donepezil and Namenda. He has complained recently of more anxiety and frustration. He is very alert in the morning but struggles as the day goes. If I ask his doctor to increase his medications would that help with his anxiety and frustration? He says he feels "on the edge" a lot. He is a very low key, quiet man. Any suggestions?

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@mojo1965

My dad is completely non verbal now and spends much of his day sleeping. He was diagnosed with PD and dementia at the same time six years ago at 75 (very few symptoms ). His rapid decline was helped along by a broken hip which required surgery and we all know the various issues broght on by the anesthesia. ..uggg. Along with being non verbal at this point we are also making a minced diet for him because swallowing is a challenge. I used to think that this was all PD related but in the meantime have learned that it's prevalent in later stage Alzheimer/dementia as well.
Like some of your loved ones here, he was extremely vibrant and a big personality. His withdrawal from friends and conversations were signs of embarrassment for not being able to keep up. We went through a few years where he refused all company. The speech therapist didn't help either and his light began to fade.
During these times I used two things to perk him up and take him somewhere happy.
Old photos. ..I mean very early...pics with my mom from their 20s, me as a baby etc. He loves that. (Unfortunately it makes my mom cry)
Old music from those days is my second weapon to make him smile. (I had to dig deep...music from Germany in the 50s is hard to find...lol)
I found newer pics upset him and reminded him about his decline...old ones seemed to just bring joy. I'm sure most of you have already experimented with some of this...so this long post is really to say "you're not alone" . If you find something that brings them a smile...share it. We all need strategies.
It's a tough road and you're all rockstars!

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I'm glad your dad stills remembers things, people and music from the past. I have tried music but although he enjoys it he can't recall any songs we used to sing and dance together. I pray the Lord he grants you and your family, specially your mom, with strength on the days to come.

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@suzie2017

My husband also indicated he felt on the edge and at times he would slightly shake. We told his Neurologist and they put him on 5 MG of Lexipro for anxiety. A few months ago my husband asked if it could be increased to 10 MG. That is what he is taking now in addition to Namenda.

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Suzie2017 as you know my husband is only 60 years. His internal medicine doctor reviewed all of his medications and took him off several of them. He still takes his ALZ meds and I don't think those meds cause the lack of words or understanding. It's part of the disease. In my husband's case he uses words from commercials or signs to fill in the blanks. He is past the not talking because he can't communicate, he just says whatever comes to his head and most times none make too much sense. He is healthy though and so far eats well. The last time I took him to the neurologist he just told me to enjoy his health while it lasts. Agree with Scott and others this disease is so different in every person so it's hard to pinpoint what is caused by ALZ or other conditions or medications. Prayers are my best ally..

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Yes, music seems to help my husband, 87 years. He was a good roller skater until he was about 75 years old, so the old style music, and polka music are the best. He remembers many of them, although no longer whistles along with them as he used to. He, too, spends much of his days dozing off although not in a deep sleep. This is a very difficult disease and as difficult for family as the patient. We try to remain positive when visiting him, but it is so hard.

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I just joined and would like to share experiences. My father, mother, mother's two brothers, and her father all died with Alzheimer's. My husband was diagnosed with mixed dementia; alzheimer's, lewy bodies, and parkenson's. Each of them showed different symptoms related to their dementias. My husband has been, and is, a real trooper in living with this disiease. Not that it has been easy,. He resisted testing before and during getting the diagnosis.
This was about 4 years ago, my husband is 84 now. He hasn't driven for over a year. We just adjust our activities as necessary. So far I think he is mosty in the moderate stage, and can mostly care for himself. We can still travel and enjoy day trips with the local museum as long as I'm with him. I do get frustrated at times, and will probably vent here now and again, but overall I feel lucky to still have my husband.

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@bonni3

I just joined and would like to share experiences. My father, mother, mother's two brothers, and her father all died with Alzheimer's. My husband was diagnosed with mixed dementia; alzheimer's, lewy bodies, and parkenson's. Each of them showed different symptoms related to their dementias. My husband has been, and is, a real trooper in living with this disiease. Not that it has been easy,. He resisted testing before and during getting the diagnosis.
This was about 4 years ago, my husband is 84 now. He hasn't driven for over a year. We just adjust our activities as necessary. So far I think he is mosty in the moderate stage, and can mostly care for himself. We can still travel and enjoy day trips with the local museum as long as I'm with him. I do get frustrated at times, and will probably vent here now and again, but overall I feel lucky to still have my husband.

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Hi @bonni3 Nice to e-meet you here and welcome to Connect! I am Scott and came here initially to vent as well --- so I say welcome to a kindred spirit!

I am sorry to hear of your husband's, and your, journey. It is a challenging path and certainly not one anyone chooses.

I wish you strength, courage, and peace along this path!

Glad you are here and we all look forward to hearing more from you -- vent as needed! We have big shoulders, thick skin, and good ears!

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Hi , my husband was diagnosed with terminal lymphoma 1.5 years ago. His anxiety and depression was treated with anti depressants, verging in dosage and family types until he found one that suited him at the time, he's also on pain meds so I spoke with his pallative care doctor and GP . Sometimes it was mental and or physical fatigue that made it worse. He also has a counsler and use to have visits from our pastor when we lived in the city. We've lived in the country now for about a year, a very small town of 5,900. I would say it's been a real combination of anti depressants and talk therapy. He also belongs to a Men's Shed, the group contact and talk, even about regular mundane life things helps his mental health and he's started to laugh again. Anxiety is a very rough road, I think support from a variety of ways helps. I hope this was useful to you. My husband and I both had to find our Joy again, illness, sudden changes , it can be so overwhelming. Finding some joy and some laughter can be hard. But a little goes a long way. I've not been good at having fun in general, so I really have to work at it myself. Now it seems to be a part of coping skills in life. Wishing you the best under these challenges , one day at a time. M.Nina

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It sounds like he's bothered with Sundowners. I don't know what can be done for that, possibly nothing.

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@colleenyoung

@clayton48 we brought your questions to a pharmacist here at Mayo Clinic. She writes:

"Treating Alzheimer’s Disease can be difficult as some of the side effects of medications may be difficult to distinguish from signs and symptoms of the disease. Both donepezil and Namenda may cause anxiety, nervousness, aggression, confusion and fatigue. Depending on what his current dose is, and if the provider thinks these symptoms are from the disease rather than the medication, there may or may not be room to increase it. There may also be other medications to treat the new symptoms he is noticing. It is a good idea to keep an open line of communication with his provider regarding these changes and never hurts to talk about adjusting medication doses. Often times we see dose adjustments and medication changes in patients with Alzheimer’s disease as their symptoms change. You are asking great questions, and I’m glad to hear he is still doing well. It can also be exhausting to be the caregiver, so remember to take care of yourself, too! Best wishes."

@shellsk24 this is definitely in line with the experience you had with your father too, isn't it?

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Hi, I am new to this site I see the post are older but Alzheimer’s remains the same. I have been a personal caregiver for my mom in law since Dec 13th 2015. She has progressed to havin both Alzheimer’s medications. Her MMSE giving last November 2017 was 16/30
The lowest it has been, as of Jan30th 2018 her dr has put her on 2.5 mg of Zyprexa. While she has on been given her 1st dose at bedtime last night.i will be watching for signs if her not engaging at all. Which is something I don’t want. She has become combative which is way out of character for her. And I do not engage her at that time.
She turned 80 last July and I am very close to her as is she with me, I have been her daughter she never had for 31 yrs. and she only wants me and her son caring for her. And now that is about to change, she isn’t takin care of her hygiene and we will be bring in a caregiver to help her with that. She will turn the shower on and may or may not get in but never wash her hair. I hate to see her havin to go through this because she has always been very independent help 2 full jobs for 25 plus yrs.
she has silent strokes and she is almost totally blind. She has 10 % of her eye sight. So seein her dirty clothes is a challenge for her and she refuses to change. So it has become a issue that we have to address.
The 36hours (book) it all looks great on paper. But each person it different. Sometimes she is here. Most times not so much but sits and worries about losing her independent life she has always known.
Tryin now to stay a couple steps ahead of her ugly friend.
Thank you

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@colleenyoung

@clayton48 we brought your questions to a pharmacist here at Mayo Clinic. She writes:

"Treating Alzheimer’s Disease can be difficult as some of the side effects of medications may be difficult to distinguish from signs and symptoms of the disease. Both donepezil and Namenda may cause anxiety, nervousness, aggression, confusion and fatigue. Depending on what his current dose is, and if the provider thinks these symptoms are from the disease rather than the medication, there may or may not be room to increase it. There may also be other medications to treat the new symptoms he is noticing. It is a good idea to keep an open line of communication with his provider regarding these changes and never hurts to talk about adjusting medication doses. Often times we see dose adjustments and medication changes in patients with Alzheimer’s disease as their symptoms change. You are asking great questions, and I’m glad to hear he is still doing well. It can also be exhausting to be the caregiver, so remember to take care of yourself, too! Best wishes."

@shellsk24 this is definitely in line with the experience you had with your father too, isn't it?

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Hi @randee, you would find this site very helpful and people very supportive.  So do keep in touch.  I do not have any suggestion for you right now.  Only appreciation for your concern for keeping in mind your mother in law wishes and dignity.  I am at early stages with my mom and as tough as it can be to see the gradual changes in her cognitive capacities and her memory, I can't imagine to reach the point you are right now.  It sounds overwhelming from my stand point of view.  I hope I get to live later stages with the same compassion and courage you show.

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@colleenyoung

@clayton48 we brought your questions to a pharmacist here at Mayo Clinic. She writes:

"Treating Alzheimer’s Disease can be difficult as some of the side effects of medications may be difficult to distinguish from signs and symptoms of the disease. Both donepezil and Namenda may cause anxiety, nervousness, aggression, confusion and fatigue. Depending on what his current dose is, and if the provider thinks these symptoms are from the disease rather than the medication, there may or may not be room to increase it. There may also be other medications to treat the new symptoms he is noticing. It is a good idea to keep an open line of communication with his provider regarding these changes and never hurts to talk about adjusting medication doses. Often times we see dose adjustments and medication changes in patients with Alzheimer’s disease as their symptoms change. You are asking great questions, and I’m glad to hear he is still doing well. It can also be exhausting to be the caregiver, so remember to take care of yourself, too! Best wishes."

@shellsk24 this is definitely in line with the experience you had with your father too, isn't it?

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Hi, thank you. I took care of my own mama in her last 4 months of her life. Which I never dreamed of doing or wantin to do. But I did want too. When it was plain to see that my mama in law was in trouble livin alone, there was no question as to what we needed to do. We have been livin in her home 2 yrs now and the last couple of months have taken her judgement and reasoning which is very hard to watch because I know who she is without her ugly friend. And that’s who I try and make sure everyone else sees. I can honestly say this is the closest I have ever been to Alzheimer’s and I certainly know more than I care too. Learnin more daily and not likin what it is doing to her mentally and emotionally. But as long as I keep 2 steps ahead of the ugliness. We will get through to the end. I keep her Dr informed of her behaviors and any issues that has come up to the point beyond what I have tried. We took her on her first cruise this last Dec. And it was sad to see just how far Alzheimer’s has gotten.
Overwhelming isn’t what I feel, I feel sad for her havin to go through all the ugly stages while she try’s to fight to stay here.
So with her newest medication I am prayin it just takes the sharpness off the edge she is feelin. Nothing more. We bought a 25 ft travel trailer to take her campin over the summer which is something she wanted to do in 2016, without being with her 2nd caregiver. Today she took a nap to rest her brain and I did up her laundry. She normally will put them away, they are sitting on the couch and she is sitting next to them. Last week she put a pair of pants we bought her away. So I have to wonder what is wrong today and I will continue to watch her. The clothes aren’t in the way and I’m sure if I do say something she’ll tell me she was working on it. I will give her independence as I can.

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