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My mother has I believe stage 7 Alzheimers and is taking 100mg of Trazadone and a antidepressant, this allows her to sleep and get rest, where before this she would ask for cars they have been gone for years. My sister seems to think that we are over medicating her and this is the reason she can't speak and doesn't eat. I've read articles on the Alzheimers and her symptoms are that of stage 7 and I am her main caregiver.

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Use the medicines as prescribed. Late stage Alzheimers includes loss of speech. Failure to eat should be reviewed with the MD. This would represent end stage of the disease and the MD may refer you to Hospice. Your sister is looking for a recovery that isn't going to happen.
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Get your sister some information about Alzheimers and its progression. She can read on this site or go to the Alzheimer's Association www.alz.org and read the seven stages on their website. She needs to do her homework about the illness her mom has. Good luck...you sound like a wonderful daughter and caregiver.
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I agree with the others that it sounds like your sister is wanting to get her mother back. It is easier for her to blame you than the disease. I agree that if she understood more about the disease, she would understand better what is going on. Hospice sounds like a wonderful idea, because they would help with your mother and also helping your sister understand what is happening. She would learn that it isn't your fault.
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These are all good suggestions. These situations are exactly the reason that I wrote my book Healthcare Handbook for Senior Citizens and Their Families. The Alzheimer's Association is an excellent resource. Hospice is also a good option. There are also resources for caregivers such as respite care through state agencies such as Area Agencies on Aging and Departments of Economic Security.
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Consult with moms physician on what you dosing. He might have some other suggestions or splitting the dose etc.

You are the primary caregiver and coping with moms needs I presume; sister should mind her own business. If she would like to take care of mom for a few weeks, then tell her you would welcome her help and the respite.

If you know when sis is coming, you could consider delaying moms dose to have mom more alert when sister is visiting if that is the concern. Ask sister to come and have mealtime with mom to help spur moms appetite although I think this has everything to do with the stage of the disease and is normal for the progression -- but maybe sister needs to witness for herself.

Do what you think is best to keep mom calm and comfortable. Talk to your dr about any concerns.
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Does your sister live nearby? If so, does she help out with your mother to give you some relief? If she were more actively involved, she may have a better understanding of your mother's needs. Of course, this will depend upon her relationship with you and your mother.
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There is something very frightening about personality changes in a loved one so it is easiest to pretend there is another cause for the changes sister sees in their mother. The dr prescribed the medications and as long as those orders are being followed there is no cause for anxiety about over medication. Be thankful that the Dr has sufficient understanding of the disease to prescribe calming medications as the disease progresses. As others have said loss of speech and not eating are end stage indications and using hospice services will help lighten the load, You are the caregiver so follow your heart and keep Mom physically and mentally comfortable. Don't do things 'that are good for her" Let her rest in bed. move the bed into the living room if she is calmer around people. Put it by a window if she likes to look out. Do whatever seems to make her happiest. there is no right or wrong way of caring for a loved one at the end of life there is only your way which is always the best way. Hugs You are doing a good job the best there is being a loving daughter.
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As her primary caregiver it must be hard to be questioned. All the above suggestions are good. I don't think I can add anything new. I just want you to know that I am here for you and know you are doing the best you can.
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Keep doing what the doctor tells you to do and use the meds as perscribed. If your sister wants her off of them. Invite her to stay with your mother for a week while you go on vacation. I promise she will change her tune. People always know the answer when they dont have to deal with the consequences. Keep up the good work and God bless!
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you are not doing anything wrong,use the meds as prescribed.You are dealing with stage 7..your sister should help out and get a reality check..I worked in the medical field for 30 years plus..I have dealt with this personally and professionally..keep doing what you are doing..keep her comfortable and if she wants to rest in bed, let her rest in bed.Get her up into an easy chair to change sheets etc, but you are doing everything possible.These are precious times ,difficult but precious, you are an angel and an excellent caregiver..never forget that..we are all here for each other and that means you as well...take care of yourself and God bless..
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Such good advice.. My story is I moved mom close to me soon as her husband died. She was in another zone for months. Because her primary doctor is an hour away, I called and informed him her BP was very low on several attempts and asked if it would be o.k. to drop one of her 3 BP meds. He advised to cut one in half. He sent out nurses more recently to evaluate her when I had taken her to a neurologist about her (undiagnosed) dementia and he did a CT scan and found a "brain bleed" along with the signs he expected of dementia. I asked the neurologist to look at her list of meds and he said he thought they were fine. I'm so thankful I can be near and see when she isn't doing well with meds or other things. I would give my sister a copy of her meds list and tell her if she really wants to know if they are right for her mom to take to a dr, preferably moms who knows the details. It is easy to look in and criticize. I especially liked the suggestion to take a trip and ask sister to "mom sit".
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When someone in the family is critical in what I do, I tell them " when you've walked in my shoes for as long as I have been doing this, then you can have a say in the care". obviously the doctor has set the level of medication so for anyone to question how much you give her, ignorance is in play here. Sorry to be so blunt but you're sacrifice to care is so selfless and you don't deserve the added stress and lack of support from others who don't. Do what you can and don't let anyone bring you down.
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God bless you. If your sister has any compassion include her in your endeavoures. otherwise tell her to take a walk. some never get it. all reasons mentioned are valid -- however -- you are the caretaker with no backup or assistance -- therefore, no one should interfere without proper backgrounding. I'm there with you all the way!
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You are doing your best, that's all anyone can ask for, especially your sister. Hang in there, there is light at the end of the tunnel. You're doing a great job, blessings to you, you will be rewarded one day!
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Part of your sisters problem may be the internet. If you type in a medication, the wide range of dramatic posts would scare anyone. The only way for her to truly understand is to be around long enough to observe your "twilight zone" life without medications.
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Hi.
Not knowing your moms weight, that amount of trazadone is a lot. It has no benefit other than to sleep and there are sedating antidepressants that should work.
Maybe a trip to the prescribing MD is in order for you and your sister. Not knowing the history of your moms meds and recent changes, if any that's what I got for ya.
Side note... Yes siblings can be a PITA but I'd rather have someone there asking questions, even if they piss me off from time to time so I am kept in check :)
Good Luck
Be well
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Are you saying she is taking Trazodone and another antidepressant? Trazodone is an antidepressant on its own. Unless she is a really down, negative person or the MD really feels she needs both meds, she may be overmedicated. It is time to do some research and make sure of the names of both meds involved. Then talk to the MD. She might benefit more from a different antidepressant in AM then just the Trazodone in PM. Or, changing the dose of Trazodone to 150mg at bedtime by itself. I'm on Cymbalta in AM and Trazodone in PM for chronic depression. Not very familiar with ALZ but sure do know about antidepressants.
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Huntscots
You are absolutely right. I had no idea. Always seen it used as a sleep aid.
Sorry sdcaregiver. However, if its being used as a sleep aid, I do know that 100 mg is a lot.
Be well
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It is important to keep siblings in the link. We email each other with the results of the doctor visits, little home disasters, decreases in functioning etc. It's not as good as being there, but it is less shocking to have heard it progressing over time. See if you sister can come to a doctor's appointment. My sister just stayed with Dad and I for a week, and I think she saw the current version of him replacing her more functional version she previously held. It is hard to see someone diminish. It is also hard to be second guessed by someone without current information.
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Hi Sdcaregiver- First of all, tell your sister that she can alternate taking care of your mom, or to leave it alone! Second of all, I do have to say that I reduced my mothers meds down 10 pills a week and she is a different person. She had to go on medication during the wandering agressive stage but I weaned her down a pill a week each 6 weeks until she was off of them. My Mom cant walk but that little change actually allows her to stand when I lift her off the toilet holding onto a bar with one hand. This helps me to dress her incredibly. She also says a few words now, laughs so much, and overall isnt drugged up and feeling great. Get her off anything you can. My Mom is on antidepressants for aniety but has been for about 16 years. I often wonder if those darn things, or lipitor caused this damn dementia. Anyway, its worth a shot to try anything. Her doctor told me he reduces all his patients meds as soon as he can. but Nursing homes cannot deal with them not drugged. Most want them to sit and be still and quiet to make their lives easier. I love hearing my mom laugh about nothing every morning!
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Late stage Alzheimer's is so difficult to watch Mom or Dad go through. They often are not able to be at home towards the end because of wandering and danger to themselves and you, so if the medication is keeping this in check so she can stay at home, then she is very lucky indeed as it's always more comfortable at home. The main thing is keeping her safe. All of the above suggestions are good. Different siblings handle things so differently. Can you have a heart to heart talk with sis to get her to understand what happens without the med? I too hate to see older adults over medicated, but Alzheimer's is one of the big exceptions that usually requires it.
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"Accusing" is a big word. And "I'm the caregiver, and I've read etc" sounds like you're insulted to be questioned. So there's TWO problems: she's worried and you're defensive. How about if you said to yourself (rather than "my sister is accusing me...") "my sister doesn't understand and she's concerned...." Then you'll know what to do. The two of you have enough sorrows to deal with, without fighting.
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That does not seem like a large amount of medication to me and I worked for many years in the geriatric field as a nurse. What it does sound like is end stages of this disease that effects our loved ones brains and your sis does need a reality check. Besides if she is not in the trenches she does not get a vote.
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These are all very good suggestions. In addition, may I add that maybe her Dr could write out some type report explaining mom's condition and medication for you to share with your sister or better yet...Maybe sister would like to go with you and mom to Mom's next Dr appt and talk with him herself.
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Invite your sister to a family discussion with your geriatric care manager, if possible. Be careful not to exclude her, she is grieving the loss of her mother as well as you are. Recognize her grief. Include her in some aspect. if the primary physician does not want to be part of this discussion, then you can most likely find a visiting nurse who will. Discuss with this mediator up front and let them address your sisters concerns in the meeting. It may only be an olive branch, but that may be all that is needed. Imho. It is hard to recognize that this is a steadily declining situation, rather than one that has a solution.
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I am constantly amazed at the gall of individuals who are not the caregivers nor would they even take on the responsibility of being one, standing in judgement of those who are. I deal with this myself as I have a sister who stays at work about 4 hours past her quitting time for the sole purpose of NOT COMING HOME AND HAVING TO DEAL WITH THE CAREGIVING OR JUST HELPING AROUND THE HOUSE. She HIDES basically, but is willing to throw a jab, ridicule me by laughing in my face and telling me that I am no caregiver! Yet leave her alone with Mom for an hour and she is losing her mind!

We were given two meds about 3 months ago to get my mother's behaviors under control and allow her to sleep at night. They were a lifesaver because I had reached the point of thinking I would have to admit her to a care facility or I would have to commit suicide because I could not longer handle it. My sister however felt that Mom's nap during the day was too much and for too long and thought the medication was too strong as well. We have had many an argument over medications lately and I have told my sister I will not go back to the way it was previously, nor do I know why she would. If she has any thoughts that she will regain our mother and the way she use to be she is mistaken as out mothers dementia has grown worse.

If you mothers physician has given you the medication and they feel that this dosage is the correct amount, you could approach they and just relay your sisters thoughts, but if they are adamant that this is correct and you are good with it, then stick with what YOU feel in your heart is the best thing to do. These people who love to criticize but bear no burden of care....bluntly...they make me sick.

You sound like you are a good caregiver. God Bless You!
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My mother went through the wandering/agressive stage 5 years ago. At that time I used morning daycare as I still worked and most of them there were the same, all considered early - mild stage alzheimers. This is only the beginning of it and it goes away after a year or less. I just chained the doors, and got a small dose depakote for her as the neuro prescribed for that time period. IT ended and I weaned her off the medication. In a couple of weeks I start my 7th year with her in my home, she cannot walk now , swallow well, or talk , but no one ever really has to use a nursing home, its their choice, its the easy way out, because they get much better care at Home. Nursing homes do not keep them safe, most go straight downhill, get uti's, infections, fall, cry of depression, and die. IN fact , in order to keep them safer at nursing homes, they highly medicate and put them in a hallway parade so they can watch them all at once. It bothers me when people say " its at time for that nursing home stage to be safe" when thats so untrue. What people want is an excuse to give up the hard work. What would we want when we age, to move? I dont even want to move now, never mind when I am old and confused. Anyone can keep their parent home if they really want to, we didnt give up our children when times were tough, and if you had a parent that was always there for you, they deserve to have a good life. Its sure not easy, but at home help mornings can keep us sane and keep our loved ones loved. My Moms doctor believes in using the least amount of medication possible and wean them down to the lowest they can be on if they are home. On too much depakote my Mom couldnt walk, as I weaned her down, it was like the awakening, fnally I got her off of it, anything is worth a try. She became happier and it made my job easier when she would walk or stand for me at that time, off the medication.
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Sorry to disagree about NH care. My mom gets excellent care; she is on meds for BP, depression and anxiety. She is alert, reads the newspapers, participates in therapies of OT,PT and Speech to keep up the progress she's made since her stroke and later, a broken hip. She has dementia, can't tell you whether someone visited her yesterday or last week, but she still knows us all, thank God. This is in Connecticut.
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Like everything else there are good and bad nursing homes, it is up to you to do your true diligence when choosing one. Make more than one visit at different times of the day. Financially it is not always possible to keep a loved one at home. Someone after all has to have an income to keep a roof over their heads and put food on the table. Physical strength is another problem as is emotional burnout and the relationship you had with the patient before the dementia
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Trazodone comes in two forms, extended release (releasing certain amounts throughout the day), and a non-extended release form. This medication is an antidepressant. If she is taking this one at 100mg and ANOTHER antidepressant, then that seems excessive to me too. You don't say how much she weighs, but with stage 7 and not eating or speaking, I would imagine very little (80 - 120 lbs). Speak to her doctor about decreasing the 100mg dose, and deleting the other. If one sleeps all the time, how can one eat or speak? At this stage, she should be in hospice care and monitored from a professional. Time is running out for her and my best wishes she dies in her sleep.
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