'Abuse' isn't really so clear cut. it has nothing to do with kickbacks: some atypical anti-psychotics help in treating some of the behavioral problems associated with dementia, which can be very serious. More commonly used BZDs which also have negative side-effects. But simply put some dementia patients can become very violent, dangerous to both themselves, their families, other residents and caregivers, and require extensive monitoring if they're not sedated to some extent.

Drugs might not be the best solution, but there just isn't enough money to provide that kind of care to medicare and medicaid patients.

And if you impose such harsh "malpractice penalties" then the Physician shortage is going to be worse than before, because let's face it, why bother?

Yet another example of erroneous reporting just to slam the pharmaceutical industry because it's the popular sentiment these days. Companies do not prescribe medication nor influence prescription writing, period. See post #3 from a neurologist if you disagree.

While the Food and Drug Administration has warned doctors that using antipsychotic drugs in elderly patients with dementia increases their risks of death, doctors continue the practice because they have few other good choices, said Dr. Daniel J. Carlat, editor in chief of The Carlat Psychiatry Report, a medical education newsletter for psychiatrists.

OR put another way, psychiatrists having spent the effort and laid the ground work TO MAINTAIN AND SUSTAIN THEIR REVENUE STREAM FROM ELDERLY MEDICATION RECIPIENTS AREN'T WILLING TO STOP THEIR PRESCRIBING THEM EVEN THOUGH IT IS AGAINST THE LAW & KILLING PEOPLE.

#UNETHICAL

• 1

• !

#1

*heh heh heh* Keep this in mind, boomers, when he gubmint starts talking about how to reduce the entitlement-deficit in the coming decade.

heh heh heh Andy, you are probably not going to fare any better, heh heh heh. To be quite honest, everyone hopes to avoid the disease, but 1 in 7 will develop it in their lifetime. Not looking forward to it and as the song goes hope to die before I get OLD. Average life expectancy is 77. Huge increase in dementia in mid 80s. With any luck, we'll have enough sense to take care of it on our own before we lose it completely.

Do the “Death Panel” employees think their work will be easier by keeping the Residents doped up, or else die faster?

All PHYSICIANS know that "It's about quality of life - not quantity."

The situation is much more complex than the posters on here seem to realize.

1) The aging population is running into a situation where there are simply not enough nursing home beds. Period. It takes an average of 17 years from the time a nursing home is proposed until it can open its doors. The nursing home industry has invested everything in "assisted living" centers which skirt federal and state regulations and try to care for a primarily demented population. There are no new nursing homes being built. And it is too late to reverse the trend.

2) This has also percolated down to the first rank of caregivers - CNA's. Certified Nurses Aides are extremely poorly paid. Understaffing is rampant. And the demand for beds is overwhelming. Assisted living centers are even more understaffed and the pay is just as bad.

3) Drug company reps are telling physicians and nurses that anti-psychotics are the only way to keep demented elderly "manageable." Phizer actually puts out a training video that claims (falsely) that a 92-year-old demented woman stabbed a nurse to death in Phoenix.

4) One physician will often "represent" as many as 750 nursing home patients, seldom seeing any of them in person. If they complain about the food, the care, etc, they are almost always put on anti-psychotics. There are numerous cases where patients with severe bedsores are put on anti-psychotics to keep them from complaining to state and JCAH inspectors.

There is absolutely nothing in the way of punishment that is too severe for those drug companies, drug sales reps, physicians and nurses that conspire to deprive the elderly of their last years for the sake of convenience and profit. If you are a physician and you allow a person under your care to be made into a zombie so they are more manageable, you do not need to just lose your license. You need to spend some serious time in prison.

Any off-label use of prescription medication should be punishable by prison time. Period. And the prisoners should include not just physicians but drug company executives, sales reps, and nurses who actually administer inappropriate drugs along with the pharmacists who dispense them. These people spend a lot of time covering for one another, so they should be able to watch each others backs in prison.

The elderly deserve better than we give them.

It's very easy to be critical of doctors, nursing homes and drug manufacturers (and I am NO fan of drug manufacturers) when you have some very simple statistics in front of you. It's another thing to live in the shoes of the families, care givers and doctors of the severely demented nursing home resident. When Mom or Dad curse like sailors, won't eat, fight tooth and nail when the nurse's aid tries to render even the most basic care, yells at the top of their lungs until they are hoarse, and so on, families and doctors are at their wits end. If an antipsychotic medication medication calms them, makes them a little more manageable, a little happier and less disturbing to other nursing home residents, is that a bad thing? We are not talking about residents that are a little forgetful, these are patients with end stage dementia. Volunteer in a nursing home, and ask if you can help in the Alzheimers Unit. You will be apalled. It is a horrible disease, with a horrible outcome. It steals its victim's humanity, and the quality of life is nil. I doubt that this is a play for greater income for the doctor or nursing home, but rather a last ditch effort to make life easier for all concerned. It's easy to criticize from reading an article, it's another thing to actually know what you are talking about. And no, I am not a doctor, have no financial interest in a nursing home or drug company or anything else of that nature. I have worked in the rehab department of a nursing home for many years, and have nothing but sympathy for these patients, their families and their care givers.

J100 I totally agree with u. Further there are 11 or 12 atypical antipsychotics and depending on the other disease states, weak heart, poor kidney function, respiratory problems, the atypicals provide a pretty good solution to dementia with this number of choices. I think the article does not bring to light these types of meds are expensive and therein lies the reason for the attack on their use for dementia. The fears the elderly have in many instances are due to the Wars they were in, WWII and Korea, many vets of these wars turn back the clock in there 80s and demonstrate post traumatic stress syndrome. These meds in many instances return them to a mental state where being afraid of everyone stops and allows them to enjoy thetime they have left.

I am a neurologist as well, and I am constantly floored by the accusation that MDs get "kick backs" for prescribing medications. The pharmaceutical industry is so tightly policing itself, that pens are no longer given to physicians. I prescribe Seroquel after discussing the risks with the patient's POA and/or family. It is far superior to the "approved" medications for anxiety (Ativan, Valium, etc.) because it does not cause worsening confusion after the sedation wears off. I'm not trying to "shut up" the patient. I'm trying to treat the effects of the disease that is slowly destroying them. The general paranoia that physicians are willfully harming patients is unbelievable.

Surprise of the week...... drug companies put profit above safety. How naive, drug companies have been killing off over 100,000per year for the last 25 years and now it is news? Their greed has never taken a back seat to anyone. Because there is no profit in being well. Now shut up and take this 3 times a day.

I am a neurologist as well, and I am constantly floored by the accusation that MDs get "kick backs" for prescribing medications.

#REALLY?!? "floored"

Whistleblower Lawsuit Moves Forward Against J&J

California claims drug giant bribed docs to prescribe

Concern over high medication rate among foster kids

Seroquel Marketing Undeterred by Deceptive-Marketing Settlement

J&J fined $70 million over bribery allegations

Drugging America: The drug industry exposed

ALL CLASSES of "mental health" medication harm elderly equally

...and these are just the articles I found in 10 min from the last 12 months. There are SCORES of documented cases of graft, kickbacks, bribery, and sweetheart deals between pharma and prescribing "drs"

"floored"

#REALLY?!?

Thank you. I am a long time nursing home social worker and administrator. These medications are the only thing we have to treat extreme behavior problems. In my opinion it is cruel to withhold a medicine that can increase someone's quality of life. Only those who have worked extensively with patients with dementia can understand how aggitated, angry, scared, and upset these folks can get. Its very sad to see people this way. Also the studies referrenced show a correlation between elderly patients taking the meds and rate of mortality. It does not show proof that the meds are killing people. These are very sick people and in the case of alzheimer's, a terminal illness. People caring for folks at home use these medications just as much, but when the family can no longer deal they bring them to the nursing home and somehow the nursing home is supposed to magically make these symptoms go away. I am so tired of the media acting like the nursing homes just want to drug people. If we could not use these drugs that would be great, but behavioral interventions just dont always work for someone with dementia. I have never heard of any kickbacks and I know that at times we lose money on these drugs because medicaid, (the payer source for most nursing home patients) will not pay for them. If we decide it is in the patients best interest the nursing home eats the cost.

Why are patients with dementia having these behavioral problems? Has anyone researched the cause or causes?

A better understanding of the causes should lead to better treatments, less stress on families and care givers, and a higher quality of life for dementia patients (and, probably, higher profits for the pharmaceutical industry).

Dear lord, Goat Rancher Bob wants to know why dementia patients are having behavioral problems. I have an answer: it's because their minds are (to be somewhat euphemistic) going away. In the case of Alzheimer's patients, irrevocably and irreversibly. When the brain doesn't work right, there starts to be hiccups and then full-blown storms in behavior. It's not something the patient is doing knowingly, it's not something that they or anybody else can control, and it's very, very heart-wrenching to watch. It's because their brain is D-Y-I-N-G. There is nothing that can be done except deal with the symptoms, and ameliorate them as much as possible. Keep them comfortable. I actually have to agree with Neurologist, and Ann, because I've worked in years past as a nursing assistant and been on the front lines, so to speak, of caring for patients with Alzheimer's and other dementia. It is not easy for anyone: the doctors, the nursing facilities, the families, and least of all the patients. I do think pharmaceutical companies have things to answer for in pushing atypical anti-psychotics for off-label use, but realistically speaking, if your 72-year-old mother or grandmother is diagnosed with Alzheimer's disease, how is it even possible to make the claim that the medication used to keep her from being agitated and violent killed her years before her time?I hate to sound callous, but what is going to be gained by her living another 10 years if she spends the last five years of that time strapped to a bed to keep her from walking into the street in front of a car, or because she's broken a caregiver's nose because she's agitated and combative? How do you know she would have lived another ten years anyway? She might get to the point where she's eating her own feces, get an infection, and die of it--something that medication might have prevented. Anybody want to take that on?

Thanks Doctor!! It does get old to hear about "kickbacks" and other unsubstantiated B.S. in the industry. The Md's taking care of my mom have been the greatest, and are doing what they can for her and it shows. As for the pharmaceutical/Doctor relationship, I can only say what I have seen first hand-my Dr. years ago providing me with samples temporarily for a prescription I would soon be purchasing any way once my insurance kicked in. What he did was a kindness, not a profit maker for him. If you think a DR. is unethical, report it!

Maybe someone with the medical background can answer a question for me:

My mother went through a neuropsych exam awhile back and was diagnosed with Mild Cognitive Impairment. So far, so good. As time went on, she was becoming more and more paranoid that one of her neighbors was out to get her. She was living on her own, and the closest of her children (which would be me) lived 50 miles away. None of her children were contacted by either her primary physician, or the psychologist who began treating her with Seroquel. We knew about the paranoia because she talked with us about it.

She had major surgery in 2008, and I moved in with her to help her recover and so she could stay in her apartment. Not until that time did I know what medications she was taking. A physical therapist mentioned to me that there was a diagnosis of Lewey Body Dementia on my mom's chart. After researching online, I discovered that Seroquel is one of the worst drugs that can be given for this type of dementia.

My mother had a stroke three weeks after I moved in, and passed away in a nursing home three months later. And her primary doctor continued to approve the Seroquel.

In my mind something is wrong if these medications are not thoroughly discussed with the patient's family (especially if they are 83 years old). None of the family knew the extent of my mother's medical issues until the end of her life. When it was too late. And since I knew my mother was ready for the end of her life, I did not pursue questioning this aspect of her treatment.

So how much of my mother's experience was due to the pharmaceutical companies giving kickbacks to doctors? You tell me, because I don't know.

My wife is a gerontologist. NO competent neurologist would give anti-psychotics to any dementia patient for any reason except to drug them into complacency. It's not just the risk of death, but the fact that anti-psychotics have NEVER been approved for and do not treat dementia. Dementia has a myriad of causes but are NOT related to psychosis.

This is much like a physician saying "I am a pediatrician and I prescribe off-label anti-psychotics to children to make them more quiet so they don't disturb their parents." It is EXACTLY the same thing --- drugging defenseless people to make it more convenient for the caregivers.

The issue of kickbacks is really iffy with institutionalized elderly. The motive of simply warehousing them and providing the least treatment at the greatest Medicare and Medicaid reimbursement is motive enough. Why would physicians need kickbacks in that case? Kickbacks are starting to become very risky business for physicians and most are abandoning the practice and using other methods to "supplement" their income.

No physician is helping any caring relative of a dementia patient by illegally prescribing these sorts of drugs. It is a quiet form of euthanasia. And there is simply no way to pardon caregivers who violate their professional oaths and maltreat patients. It is just one of the reasons that makes this country the leader in the world in malpractice incidents and just one reason why medical malpractice by the for-profit medical industry is the fifth leading cause of death in this country.

My question is this, Is doping up patients to improve thier quality of life or is to improve the caregiver's quality of life. Nursing homes are many times understaffed of qualified caregiver. Not all of them. And is the dementia due to all the medications they are being given? My mother was given one of these medications, i believe it was Risperdal, and had some bizarre symptoms, hallucinations, talking to people who were not there. . My siblings and I were her caregivers then and had that medication stopped. She has since passed away from Altzheimers in a nursing home.

catmandu, the doctor didn't discuss your mother's meds with you due to laws concerning patient confidentiality- HIPAA. the only way that a doctor can discuss anything about your family members healthcare with you or anyone other than the patient, is if the patient has expressly waived the right to privacy. and unfortunately, often the doctor doesn't ask the patient if there is a family member who needs to be contacted, or more often, the patient doesn't want anyone in the family "knowing their business" until the dementia has become incapacitating.

if you have an 83 year-old relative, you need to actively pursue with them this type of information. not to mention setting up (with their consent) durable powers of attorney before they even get to the stage where they are becoming cognitively impaired. too many people feel weird or uncomfortable asking parents about this stuff, until they are dying and it is too late.

I agree with "neurologist"...especially since that is my field as well. Also..."Ann" makes the point clearly. I know of NO MD who would think of prescribing for monetary gain, nor do I even know how to make money of it! One writes Rx. for what seems to be the best choice...evaluates & modifies...and changes as needed after the "team" (MD, staff, family and patient, if possible) does evaluation conference. If not helping then move on. And just for the readers. "Not approved" ONLY means that the FDA has not reviewed & approved a specific application for a product. THAT IS A TECHNICALITY! Many, if not most drugs work well for many problems...but it is a costly processes of lengthy review to get approval for each indication. Thus, once released, any drug can be used, with discretion, for...whatever. In my field it turns out that seizure meds were the first useful controllers of nerve pain (peripheral neuropathy) that famously doesn't respond to narcotics well. Our under (and UN-) educated politicians seem to try to get press by sabre rattling in aresa they either don't understand or purposely try to mislead their constituents (Ok...THEY LIE) to get press coverage. I've had to testify as an expert in court on many cases defending a doc that DID IT RIGHT. So..... how about rationale medicine and let the families and doctors work it out? Cheaper...better... and maybe I won't run for office! LOL!!!

Thank you Allie.

Once my mother was admitted to the hospital, her POA kicked in, and we were notified about her surgery. Whoopee. Unfortunately, neither my brother nor myself (who were listed on the POA) asked about medications right away. And no one offered the info. Our problem, I'm sure.

catmandu, the awful truth is in this whole scenario, that for most of us, we learn about what to ask and what to do as we go along, and more often when it's too late to help our loved one. I've lain awake many nights kicking myself for all the things I didn't know to do for my mom and dad, but at least (I hope anyway) that with my grandmother I'll be able to get it better. and eventually I pray to god I'll be able to help myself!

I think the worst, most painful part of grieving and loss is wishing you could have a 'do-over'. hopefully people will read all of the thoughts here, and maybe they will be able to ask a question in time, that you or I couldn't ask then and wish we could go back and ask now. it's sure a crappy way to have to 'learn as you go'.

@Nuerologist,

Not for nothing, but don't you think some of the medical issues the elderly experience are due to a shortage of qualified doctors who specialize in elderly care? After all, medicine is not a one size fits all that should be practiced.

And yet people are screaming for an end to the "entitlement programs" which in fact are the very programs that enable these people to have ANY care. Without them, all nursing home patients would be private pay, to the tune of $5000+ a MONTH.

That's excessive, you say? And yet you want around the clock, loving, one-on-one care, including complete housekeeping and laundry, medications, and trained nurses. Good luck with that.

My wife is a gerontologist. NO competent neurologist would give anti-psychotics to any dementia patient for any reason except to drug them into complacency. It's not just the risk of death, but the fact that anti-psychotics have NEVER been approved for and do not treat dementia.

WELL SAID!

The issue of kickbacks is really iffy with institutionalized elderly.

In many cases involving the elderly , the "kickback" occurs by an inappropriate relationship between the facility and pharma companies in trial phases of drug development or approval.

As stated above, "informed consent" is quite often at a stage in the process when caregive-ing relatives are looking to relieve a stressful and painful process (institutionalizing their parent or grand-parent) after long and difficult periods of searching for solutions. "Informed Consent" is designed, in most cases, to inform them of risks associated to medication or treatment but under the practical application by these facilities, it becomes a blanket type of waiver signed by loved ones, giving consent to "treat", WHATEVER MEANS. The idea that "informed consent" supposedly warns family members or loved ones of potential life threatening risks in any kind of appropriate and adequate way IS A FALLACY .

It ( "informed consent" ) has been bastardized and co-opted into an indemnification of the facility by its owners to enter into ANY myriad of types of sweetheart & backroom promotional, and delivery deals by pharma companies and doctors to use ANY TYPE of medications by ANY TYPE of suppliers. The cheaper and more lucretive for the facility the better.

The number and types of civil suits brought against pharma companies for product liability is a direct indicator of just how often this occurs.

With proper, adequate, and appropriate informed consent these suits would be VASTLY REDUCED in FREQUENCY, SIZE, AND AWARD.

My mother is PERMANENTLY damaged from the prescriptions of lithium and seraquel. Even though my sister and I had power of attorney at the nursing home, they did not inform us of the addition of these meds.

see comment #7 from below

Exactly right!

Speaking from experience, such inappropriate and dangerous drugs are given mainly for the convenience of the caregivers. If they had their way, many would just as soon keep their charges sedated...

So obviously you have never known or dealt with someone who has dementia. Please before you continue to spout your uninformed opinions, read about it and the changes as it advances and takes its toll, then maybe you will understand the PROPER use of the drugs involved and the benefit to both patient and others involved in their care.

nobody who has been an actual caregiver of someone with dementia would spout so much nonsense about 'keeping them shut up'... never had a loved one break their nose or blacken their eye because they were convinced you were a 'damn Jap' coming into their foxhole to bayonet them... yeah, we all love seeing Dad in that state for weeks on end, believing that 'someone is coming to murder him' if he falls asleep... uh-huh, sure. you're talking out your a**

So, in other words, you (Stop The Hypocrisy, Scubasteve58001, Take21a, Chris-749391) and some others above, have never had to care for or watch a family member with advanced Alzheimer's and really have no basis for an opinion. You would make a good politician--after all, then all you would have to do is sit on your butt in an office and make uninformed decisions about things you have no expertise or experience with.

As a practitioner, with a family member who had these problems, I, like many others on this post, have an informed opinion for why these meds are sometimes needed. If you notice, those of us who have lived it, tend to have a different view than you. We didn't want to "shut" my grandfather up or keep him from complaining, we just wanted to be able to care for him and him (and us for that matter) have some reasonable life. We chose to give him these meds because they improved the agitation and helped him calm and think clearer so that we could keep him at home longer. Without drugs, he spent most days severely agitated because he thought we were keeping him hostage. In his mind, he had another house and family, and he didn't even recognize us. My father, his son, was "that man in the red truck"...His sister was "that women with the gray hair that brings the food." He roamed the house 22-23 hours a day, sleeping only about 30 minutes at a time. Ambien would let him sleep about 3 hours, but he would wake up more confused and combative if we used it. He found old guns in the house we didn't even know existed and sneak out at night and shoot at street lights. We found him in the yard at 5 one morning, laying in the snow, even with a paid caregiver and a family member in the house. Sometimes, there just aren't any "good" options without some risk. We ended up being unable to care for him and had to place him in a long-term facility where they could keep him locked in. There, caring from him was also almost impossible as well. He became horribly agitated, depressed, more/worsened behavior problems. He assualted other residents, tried to sleep with strangers, and was never where he was supposed to be. Of course, you can lock people in Geri-chairs, or keep them in restraints...is that preferable to you? How those people managed to care for him is still a mystery to me.

I became a practitioner because of the problems I saw with his and other family members care. I wanted to be in a position to help people--make it a better world for them and others. and because I felt that would allow me the most education and ability to effectively care for my family when needed. I have prescribed Seroquel and similar meds for others in long-term care facilities, after discussing and trying alternatives. But, like I said, sometimes there just aren't any good options. When the skilled facility tells you they can no longer care for them because they are roaming the halls, stealing from other residents while they sleep, combative at times, cussing continuously, playing with themselves in public areas, climbing in bed with other residents who can't (and shouldn't have to) defend themselves, what is your suggestion? ...And, yes, I witnessed this myself. I would rather my family have meds, that may, OR MAY NOT, shorten their life, but have a life until whatever time God chooses to take them home.

Good for you! Courageous and intelligent comment

So in other words, these patients are being fed these drugs to help shut them up and reduce their complaints.

Just THAT would be abhorrent and bad enough but when you add the pharma financial incentives toward facilities and prescribing "doctors" its far excedes being CRIMINAL.

That's terrible Cheryl. So sad to read this.

We found the best way to deal with these problems is to choose a good doctor ourselves. If you have a Med POA, then the doc must consult you before prescribing. The nursing facility cannot alter your doc's order without notifying him/her. A good doc will always keep you in the loop.

Find a good doc, preferably a well liked gerontologist. Ask around .. a lot !! There are many dimentia networks, for all areas of the country. Ask people in nursing care networks, especially the ones you cannot afford, they know all the docs. Medicare will pay for the doc. The doc works for you. It took me about two weeks of work to find a really good gerontologist.

Good luck!

That's horrible Cheryl. You should seek legal action against the facility(s) and the psychiatrist of record.

#UNETHICAL

#ILLEGAL

#ACTIONABLE

I've been there. I've seen these medications prescribed for no good reason.

My mother was confused at times, but responded to patience. Her caregivers were just not willing to put in the effort - I fired 6 in-home care companies, before finding one whose people were willing to make the effort required.

I also found a house-call doctor who understood the elderly, and didn't believe in prescribing such drugs.

So you can take your opinion and shove it.

Such strong, angry opinions !

When my Dad was dying, I saw many different manifestations of dementia. It seems to me that each individual is a bit unique.

Shouldn't the choice of medication be made by family members with caregiver input?

Shouldn't the choice be personal and informed?

One size does not fit all. One medication does not work for all.

I watched my mother being subjected to Medical abuse where she changed 'overnight' to the point that she was almost unrecognizable. I don't care if she did have dementia. She was given the drugs so as not to be an inconvenience to the staff; plain & simple. Unfortunately, I lived out of state and couldn't convince local siblings that Drs (and staff) are NOT always right. I dare not think about it, as it breaks my heart to remember my Mother being subjected to such cruelty. I hope all that engaged in abusing my Mother suffers at least the same treatment. And to quote another respondent..."So you can take your opinion and shove it".

sole caregiver,

I am with you on this issue, as I too am a sole care giver for 7 years. I am intricately involved in what my family member takes.

Some of those "meds" are helpful to manage the person. What ever naive person thinks the "PAID" care givers in the Nursing Homes needs to take their "loved one" home with them for a week.

The bottom line is the people with Dementia are NOT capable of making "LIFE KEEPING" decisions for themselves.

Without medication management [ of the Dementia ] they will eventually wind up killing themselves anyway!

For the people "who have not been there, done that"....take care of the person first, then make judgments about the efficacy of taking some of those meds.

But, Recall, did you take care of your "loved one" yourself? Around the clock? If not, you have no basis for compaint. It amazes me how many people will so self-righteously criticize others who are doing the best they can to cope with an intolerable situation that the complainer will not deal with for five consecutive minutes.

I'm not going to claim that all health care workers are great. They aren't. But when you say you went through six inhome care companies before finding one you liked, that speaks volumes to me.

How dare you discount the heart felt comments from people who have lived with and watched their elderly parents suffer at the hands of the Medical profession. Are YOU so ignorant to think that medical staff don't do any harm; that they're not often lazy, ignorant, impatient, and heartless individuals. Try going to an Alzheimer's unit everyday for 2yrs, at varying hours of the day AND night, and you'll get a eye opener as to what really goes on. And don't you DARE tell us to "Shut Up"....how pathetic you are.

Smitty in Irvine:

Arrogance and ignorance is, as arrogance & ignorance does !! With your self-righteous, all-knowing attitude, I sure hope that you are not a care giver to anyone .

Iowan, you are obviously so angry you didn't even read Smitty's entire post. in which he specifically says

"unless you have experience in medicine, Medicare, as a caregiver or as a family member of a dementia patient .. SHUT UP. Leave the comments to people who have a point of reference.

which, according to what you have to say in your post, would obviously exclude you from that group, since you have obviously got experience with a family member as a point of reference. you want to spew, you have the right, but try reading all the way through with a little clarity of mind yourself, before you go nuts on somebody just because you didn't read the post carefully.

somebody who has been there with a dementia patient and says "go drugs" has just as much right to say so as someone who's been there with a dementia patient and says "no drugs". the people who love to get on the 'vine and turn every health-related topic into a rant about "big pharma this" and "big pharma that" don't have any personal reference, other than their obvious fear about what is going to be facing them someday. they are speaking from fear (and paranoia), not from experience.

To: An Independent Thinker

True, I may be arrogant, but lets chat about this ignorance.

I must ask you; have you cared for someone who was decaying from dementia? Have you ever managed the health care for someone you love who could not care for them self? Have you been faced with difficult life & death choices of someone dear to you?. Have you ever dealt with people in the medical community who take little or no action for a patient because he/she are old and obviously dying? Are you a medical practitioner or caretaker? Have you done any research or reading about dementia or nursing care? Before you toss your direct insults at me, please show us how it's not you who is ignorant.

There are dozens of causes of dementia, each with it's own symptoms. Alzheimer's being the most common, the disease is still not the same for everyone. Some dementia victims go quickly, some take a decade from mild cognitive impairment to death. My father took 12 years.

The needs of dementia patients change as they go through the phases of their own personal decline. Sometimes, medication is necessary. At some point it becomes futile. Also, different types of care and facilities become necessary as the patient's disease progresses.

I was fortunate to secure outstanding care for my Father, because he set asides funds for his end days. But good care required constant involvement and oversight. This included questioning all medication and regimens. Sometimes, standard FDA approved medication works well, sometimes one needs to seek more expert advice and try alternatives. The best interest of the patient requires diligence.

There is an obvious trend for some caretakers and even some medical providers to take the easy route with a dementia patient. After all, the patient WILL DIE. He/she will never be able to speak for them self again. Unless someone is there to manage the care, a dementia patient is just made comfortable until death comes. Obviously, that usually means medication, even if it's inappropriate.

While I have seen dementia patients medicated for the convenience of caretakers, and some possibly inappropriately, all of these cases I witnessed were when the family members were absent, uninvolved, or not assertive enough to speak out.

I do not believe the FDA should have omnipotent control over anybody's care, as their track record is pathetic. The list of wrongly approved or disapproved treatments would fill a book. A patient must direct their own individual care, administered by a personally involved physician. In the case of dementia, it's up to proactive family members to ensure the best care.

There are many angry people here (normal for this site). I say again, unless you have been involved you have no room to speak. There are angry people who have experience dementia care. They are angry for a reason. It's extremely painful to watch this happen to a loved one. Even more so when you feel powerless to help. The only thing I know to do is to be as proactive as possible.

Smitty,

And Iowan, and Recall, and a dozen others, yes, I have cared for a relative with dementia. I have also, many, MANY times, cared for the relatives of others, some of whom were involved and cared, and many of whom were not and did not, as long as THEY did not have to provide the care. The truth is, these patients behavior is not tolerated for any longer in an acute care hospital, which has far better staffing, than it takes for intramuscular or intravenous sedation to take effect. Further, if YOU were sharing a room with someone who was confused, agitated, and violent, you would be screaming to be moved, or have THEM moved, in about 30 seconds.

It's not always true, but far more often than not the first thing a nursing home does is go through the medications a patient is admitted on and see what can be eliminated, and this is particularly true in the case of sedatives and antpsychotics.

You are exactly right. I can remember back in the day when restraints were used and that was horrible and dangerous. i have recently retired after 20 years working with elderly. Without some kind of intervention it is impossible to provide basic hygiene and nutrition to these folks. They are dangerous to self and others, with risks of elopement and wandering. You have to do something to protect the patient and the caregiver. If you don't the good people leave the profession.

and you have never been to medical school, are probably too dumb to get in, so you need to shut up

Tea? Really are you kidding? My Mother threw a lead candlestick at my head. I can just imagine hot tea in my face. You don't understand how anxiety, fear, paranoia invades the minds of some people with Alzheimer's and they are in a total living hell. These medications can provide some relief and thus quality of life. Sorry but I doubt you have ever experienced the depth of trauma that some people endure - both the family and the patient.

I totally understand where you are coming from - I had a similar situation with my Mother. It is so annoying to hear people comment on a serious issue who have no idea what they are talking about. You did what you had to do to give your mom a better quality of life. Only one who has seen fear in the eyes of their loved one that nothing can soothe can understand.