Ativan - Alzheimer's

I am worried that this thread may be "dead" as no one has posted recently. My mom has 24/7 caregivers, very good Alzheimer's treatment program. They are saying, as I see is typical, that she is entering a new phase. She is not sleeping at night and is more aggressive and slightly combative. They want her on Ativan or a similar medicine so she, and they, can sleep. She never remembers any of her nighttime activity and denies it. When she had knee surgery and was disoriented and agitated, she was given Ativan. She became psychotic, ripped her clothes off, tore out the IV, etc. I know that it can have a reverse effect on Alzheimer's patients. Can anyone suggest an appropriate medication, based upon your experience (I know reactions are quite individual)?

BUMPING this for newer members..........

HUn
YOu are not alone in this
I have been where you are and no I did NOT imagine it either

Benzo's suck as Xanax and ativan I dont think are the best
way to handle an AD loved one

To have them drugged to the point of a zombie is not right IMHo

I wish you could get some help sweetie
I hear your fatigue in posts

God Bless

LYN

The short acting Benzo's cause nightime aggression and agitation. I am POA for my father, and was his 24/7/365 caregiver util two days ago he became aggressive, combative, wandered at night, and impossible to care for, without an orderly who could overpower him. He was admitted through the emergency Dept. of the local hospital and there he sits until they can find an alzheimers bed. One police officer who was trying to assist me in caring for him by calling for well-being checks, dropping by to chat with us and so on, overheard the 911 call on the scanner and drove in to the Hospital to lend support even though off-duty. he saw this as explosive potentially situation. Dad was on Serax. I blame the benzos, plus the inevitable progression of AD, for his rages. Thank-you and God Bless you all.

A friend of mine told me that her husband, an M.D., had died as a result of Alzheimer's. She said he had been addicted to Ativan (Lorazepam). That caught my attention, since I have a 40 year old son who is terribly addicted to Ativan. Getting off the drug is almost impossible, and without good insurance there is little medical support -- a real tragedy.

Cliff Gieseke, San Antonio, TX

If you are concerned about the medications that are used on a family member or friend in a residential nursing facility, you should be aware that there are laws to protect the residents. And some affect the use of medications.

(1) As a starting point, the nursing staff is probably legally responsible for reporting NEGATIVE CHANGES in a resident's physical condition, mental condition, and social interaction to their family and their doctor. If a medication makes it harder for a resident to walk or feed themselves, if they are more forgetful, or if they are withdrawn; then these changes should be reported to you and the doctor. If the nursing staff refuses to acknowledge it when there is a negative change and/or the doctor hasn't been notified, I'd be concerned about the facility. You probably can't move the resident. But you might want to get more involved. When you are visiting, take pictures or videos and keep a diary of activities. (How does the resident greet you or say goodbye? How much is the resident sleeping. How far are they walking?) If you see any changes, talk to the nursing staff or the resident's doctor. Or you can talk to the state's nursing home investigators.

(2) The residential facility cannot use medications in lieu of "cares." It's my understanding that in the 80's or so, facilities started using the trendy drugs (like Valium?) to sedate residents. The 1987 Nursing Home Reform Act was passed. And most or all states have some version of their own. Nursing facilities are now prohibited from using medications for their own "convenience." It's considered a "chemical restraint." And it's a form of ABUSE against a resident. Unfortunately it's not always clear what it means to use a medication for their convenience. But I think there are a couple of good rules of thumb. There may always be some positive and some negative effects of a medication. But for a drug to be considered effective, the positive should generally outweigh the negative. And the info published on the drugs will usually say that a patient should get the LOWEST dose that works. So if a resident seems to be experiencing a lot of negative side effects (e.g., sleepiness, having a hard time using legs or arms, very withdrawn and non-communicative), it's right to question whether the medication is benefiting the resident. Then start watching the staff. And see if they are taking care of the resident as they should be. First, each resident should have "cares" prescribed for them specific to their condition. Common sense dictates that a resident with memory problems should be reminded of what's going on. The staff shouldn't come in and grab the resident out of bed or pull down their pants without first warning them. Or the resident might get agitated! Especially if a gang of two or three grabs them or strips them. Second, the laws will often require that the facility do certain things to help make the residents stay more pleasant: provide recreational activities (even those bound to their room), pay attention to the resident's likes and dislikes in re to menu selections. Otherwise residents will naturally experience some depression. And third, the residential nursing facility generally has requirements to educate the resident's family about what they can do to help. If the nursing facility isn't using proper "cares" and isn't making even a minimal effort to do things to make the experience tolerable for the resident (that are legally required) and then the nursing staff is specifically requesting the residents doctor for medications (and is always just adding more and never decreasing them) and those medications seem to be making the resident more like a vegetable, then I think there is an argument that the facility is using the medications for their convenience. (Sometimes they are stupid enough to make statements like "We need a regime that works for US" and "We like to use the HIGHEST dose that can be TOLERATED.")

A good starting point for learning how you can help your family member or friend is the National Citizens Coalition for Nursing Home Reform at www.nccnhr.org .

bump important info here imho

Remeron will help you sleep better.......