Did medication help in Vascular Dementia

Posted by riz1 @riz1, Jul 4 5:25pm

Hi, my mother in law who is 77 years old was recently diagnosed with vascular dementia. The doctor started her on Memantine (Namenda) about 3 weeks ago. He says Aricept would cause more side effects. Since she has been on Memantine, I feel that her symptoms have gotten worse. Before starting this medication, she was able to do her day-to-day things, but since she started this medication, we have noticed confusion, sedation, and a general feeling of being miserable. She does not seem like her normal self. We are reevaluating whether this medication is worth it to continue as we don’t want to compromise on her quality of life. She doesn’t want get out of the bed at all and wants to sleep all day. She feels helpless and even more depressed. Before starting this medication, she use to move around more and do her routine things.

I spoke to the doctor and he suggests that we finish the titration pack and then we will reassess. She is currently at 15mg per day and by next week will be on the 20mg max per day. I’m contemplating if I should contact the doctor again about discontinuing this medication as increasing it more might make her symptoms worse than they already are.

Please advise of anyone has gone through a similar experience. Do the symptoms get better? Should we continue? Or if this is how it will continue to be then shall we discontinue now?

Interested in more discussions like this? Go to the Caregivers: Dementia Support Group.

@trishcnwma

Every piece of info is invaluable in building a better solution! I so appreciate all shared info.

I received a call this morning to tell me that the doctor will see her mid-day next Saturday (July 26)! So great since the appointment is soon, and since I now don't have to worry about my sister being up all night because she's afraid we won't leave in time for the 9AM appointment that was scheduled in September.

Can't believe this doctor schedules appointments on Saturday ("he does it sometimes", his office said). I so hope that this doctor is as good as I envision. Fingers crossed!

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Prayer works.

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In reply to @jimandkaren "Prayer works." + (show)
@jimandkaren

Prayer works.

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I'm pretty angry with God right now and there are days I question if one even exists. How would God enable me to save her life last year (from massive pulmonary embolism) and then give her this? I'm sure this is not a popular sentiment, but it is what it is.

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@cxcordon

I am intrigued by the comments about a nutritional approach to treating MCI and an earlier reference to bradycardia. My husband was diagnosed with MCI eight years ago and his memory issues were mostly just an annoyance. Last year, he was diagnosed with a 90% blockage in his carotid artery, resulting in surgery. His recovery was delayed by an episode of bradycardia that later resolved. Our doctor opined that my husband's MCI might improve by 30% after the surgery but that has not been the case. In fact, there are times when he seems to have more difficulties. Because of that, I questioned whether the statin he started taking is contributing to this occasional confusion as that can be a side effect of taking a statin. The doctor agreed to suspend the statin for 6 weeks to see if there was an improvement. One immediate improvement was he no longer has the hives that appeared after he started taking the statin. It's too early to tell if there is any improvement in his MCI. I see glimmers of hope but I know that may not prove true. Anyway, what do nutritionists suggest as a natural supplement for cholesterol? I wonder if anyone else has had concerns about statins and mental confusion as a side effect. Thanks to everyone on this website. It is a vaulable resource.

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My sister did not take a statin until after her bradycardia event. Looking at past lipid tests, her numbers were good and had reduced over the last year since I started managing all meals (LDL from 117 to 85; HDL 42 to 46; triglycerides 54 to 47). Those improvements were all before she began taking a statin. There's still a long way to go to improving her HDL level (should be 60>). Your message reminded me that she is overdue for a lipid test to recheck those numbers.

I don't know what "bradycardia resolved" means. Hopefully, it indicates that his doctor understand the reason he experienced bradycardia and that there is little chance he will experience it again. We only learned that my sister has SVTs (supraventricular tachycardia) because I brought her to the ER again for a very low pulse. The ER put a ZIO heart monitor on her for 2 weeks and she experienced 31 instances of SVT. When that happens, she's freezing and her pulse is very low (high 30s-high 40s). The ZIO monitor sticks on the skin; you remove it and mail it in a pre-stamped mailing box after the recommended duration. If your healthcare provider offers a patient portal, you'll be able to read the results of the ZIO testing when it is made available to your doctor. A cardiologist electrophysiologist is needed to determine the underlying issue.

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@trishcnwma

I'm pretty angry with God right now and there are days I question if one even exists. How would God enable me to save her life last year (from massive pulmonary embolism) and then give her this? I'm sure this is not a popular sentiment, but it is what it is.

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Well, I can understand that sentiment. What I meant about prayer works was I prayed for you to get an earlier appointment, and YOU DID!
Humans have been discussing how God works since the beginning. For me, it's simple. God created us for a relationship with him. The original fall/sin separated us from him and brought down the perfect world he had created for humans.
Then he gave us a way back to that relationship with him. He doesn't make us sick, evil/our fallen condition does, but He can heal us.
Why doesn't He heal all of us, I don't know. Why he hasn't healed my wife, I don't know, but I do know I have prayed fervently daily since day one and believe He has given me insight and wisdom to help her condition slow. In the relationship with him, our life is not about the condition of our life, but about the condition of our death.
I'll keep praying for you and your sister.

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My wife has vascular dementia. she had a big stroke about 2 yrs ago and her mental abilities went down after that. We are on a steady plane now waiting for next stroke to happen. I have her on menmantine 20 mg and galantamine 24 mg daily. Also plavix and asa for blood thinning.The meds did not change my wife's personallity at all. There are some studies that show men and gal together work better than men or gal by itself. I do not know if it makes my wife better or not. If I take her off of meds and she gets worse, she will not get back to her plane of living even if I put her vback on them. thus the problem. You will have to read the studies and decide for yourself. Just skip to the decussion part of the results. Make sure the dates are the latest ones. Earlier studies show no effect.

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@trishcnwma

I'm pretty angry with God right now and there are days I question if one even exists. How would God enable me to save her life last year (from massive pulmonary embolism) and then give her this? I'm sure this is not a popular sentiment, but it is what it is.

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I too am very angry with god or whateven created the universe. I have never been very relegious and am less now. This is hell watching your loved one get worse and worse.

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@trishcnwma

My sister did not take a statin until after her bradycardia event. Looking at past lipid tests, her numbers were good and had reduced over the last year since I started managing all meals (LDL from 117 to 85; HDL 42 to 46; triglycerides 54 to 47). Those improvements were all before she began taking a statin. There's still a long way to go to improving her HDL level (should be 60>). Your message reminded me that she is overdue for a lipid test to recheck those numbers.

I don't know what "bradycardia resolved" means. Hopefully, it indicates that his doctor understand the reason he experienced bradycardia and that there is little chance he will experience it again. We only learned that my sister has SVTs (supraventricular tachycardia) because I brought her to the ER again for a very low pulse. The ER put a ZIO heart monitor on her for 2 weeks and she experienced 31 instances of SVT. When that happens, she's freezing and her pulse is very low (high 30s-high 40s). The ZIO monitor sticks on the skin; you remove it and mail it in a pre-stamped mailing box after the recommended duration. If your healthcare provider offers a patient portal, you'll be able to read the results of the ZIO testing when it is made available to your doctor. A cardiologist electrophysiologist is needed to determine the underlying issue.

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I am confused. svt is a high heart rate usually >130. Sounds like she is in bradycardia as well. Sounds like they both need a pacemaker. Good luck with all that.

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@jimandkaren

That law applies to mental conditions because of the distress saying you won't get better can cause. Not to all conditions. It also doesn't say you have to tell them they will get better like you said. Notice this thread is about brain diseases. I think you added that which is understandable with the stress we are all under. You just can't say you won't get better.
The Tennessee Supreme Court in three cases in 2024 said. "From expert testimony from the Neurologists involved in these cases... The court is of the opinion every Vulnerable Person (Brain Capacity) has two underlying emotions and thoughts"....." 1. The hope they will get better and 2. Fear". These were cases of Abuse of Vulnerable Adults, under the Tennessee Vulnerable Adult Protection Act and the Court said. "Any person can tell if they have committed Abuse of a Vulnerable Adult if what they do or say reduces that Vulnerable adults Hope or if what they do or say increases that Vulnerable adults fear". So in my case before I remarried my wife so I could care for her, she lost her Drivers License and she wanted to talk to her son about taking the test again. After about 5 minutes he yelled Mom I'm tired of talking about this. You're not going to get better!!! That destroyed her hope and caused tremendous fear. It was a Class D Felony. He didn't care about her feelings. He just didn't want to fool with her. Actually her Neurologist notes a month earlier said "She seems to be getting better" but her son wouldn't dare tell her that! He always would say... "If you don't stop "Acting Up", I'm going to put you in that place you don't want to go" ( Assisted Living). He is an Orthopedic Physicians Assistant, not uneducated. When she fell, and had 2 fractured ribs and 2 displaced ribs and a Rotator Cuff tear he wouldn't even take her for Medical treatment. By the way "Acting up" was seeing and talking to me. After we remarried we discovered he emptied her bank account and used part of her monthly income to pay his Chase Credit Card. She asked for an accounting 3 times and he said "don't worry mom you've got plenty of money". Her daughter who works in a nursing home "Borrowed" my wife's nice Volvo xc60 SUV and wouldn't return it after a year and my wife asking for it 8 times. So me showing back up was going to blow their schemes of taking all their mother's assets. People, even family write OUR loved ones off and even do things like this. They've punished my wife for remarrying me now by cutting off all contact with the grandchildren she adores.
So I've taken 2 years becoming as much of an expert for my wife's care as I can as a lawyer and absolutely an expert on Vulnerable Adult Persons Protection Act. On the Drivers License; she may never get it back but I got her Volvo back and I take her after church or on Saturdays to vacant school or industrial parking lots and she drives around as long as she likes. It tickles her to death. There are countless things we can do at any stage to lift them up, make them feel as normal as possible, give them joy, though it may be small to us. I cherish every normal and abnormal minute with her. Even the ones that drive me crazy because when I didn't have her I felt crazier. Every time she walks by me I say I love you. She gets so tired of that; LOL.
I didn't mean to come across harsh in the beginning here but I just wanted you to be clear that you are correct about what you said and what the supreme Court said wasn't that we should instill false hope. We just shouldn't dash the hopes the person may have, or increase the fears they have , even secretly from us. This is hard yes, but it's harder on her. God bless every minute you have left!!!

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You are an amazing human being.
Unlike you, my dad chose to display his selfishness during my mother's illness. My mother, who had vascular dementia for years, would use her walker to approach my dad in his recliner to pat his arm and tell him she loved him. He would continue his crossword or reading or whatever he was doing, ignoring her while I seethed. After she died, my dad sobbed, "I just wish I had told her more often that I loved her." I had no words for him.
You provide the model I wish to follow. Bless you, and thank you for all the knowledge you have gained from your experience and so willingly shared with the rest of us.

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@trav77

I too am very angry with god or whateven created the universe. I have never been very relegious and am less now. This is hell watching your loved one get worse and worse.

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Yes, this is hard.
Unbelievably hard.
No one can even start to imagine what this is like without going through it.
I don't know what unspoken horror my wife goes through. locked in her own mind, but I know it is hard on her too. Probably harder. She finally can't recall her children's names or much about them or gets them confused when she can recall a little. It's hard and gets harder, but God didn't cause it.
The time she can most remember her children's names is when she prays at night and asks God to forgive them for not calling or coming to see her for months. So I know God helps her remember then.
I feel blessed that God chose me to be the one to care for her and has helped me all along the way.
We each have our relationship or lack thereof, with God. For me, God is who gets me through.

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@njoys

You are an amazing human being.
Unlike you, my dad chose to display his selfishness during my mother's illness. My mother, who had vascular dementia for years, would use her walker to approach my dad in his recliner to pat his arm and tell him she loved him. He would continue his crossword or reading or whatever he was doing, ignoring her while I seethed. After she died, my dad sobbed, "I just wish I had told her more often that I loved her." I had no words for him.
You provide the model I wish to follow. Bless you, and thank you for all the knowledge you have gained from your experience and so willingly shared with the rest of us.

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Thank you. We are one flesh. If she is sick....I am sick. If she is happy....I try to bask in and enhance her happiness. If she is sad.....I hurt and try to soothe her pain. I actually don't relate to doing anything else.
I respect her as a person.
Plus, I love and adore her, who she was and who she is now.

Even if it was your mom, whom I never met, I don't know a reason not to pass God's love along with human hands, human feet.
Thank you for the compliment.

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