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Medications Dramatically Transform Dementia Patient

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At lunch with my best friend, Marsha, one day, I poured out my soul about the problems I was having with Ed, my beloved Romanian soul mate of 30 years. He had Alzheimer's and was living in a top-notch long-term care facility, the Alois Alzheimer Center in Cincinnati, which specialized in the care of people with dementia.

"Marsha," I said, "I just wish there was something I could do for Ed. He's miserable with his depression and sleep disruptions and I'm miserable with his periodic temper tantrums and just watching his misery in general."

"You know, Marie," she answered. "I realize he has dementia and there's nothing you can do about that, but I remember one of my friends, Joyce, an internist, mentioning to another friend that some Alzheimer's patients can actually be helped by psychotropic medications."

"Joyce said the drugs don't make the patients any less demented but can help with symptoms such as depression and irritability. They might help with other symptoms, too. I don't know."

"Huh. I never thought about that," I said.

"You know, his symptoms could actually all be resulting from depression," Marsha continued. "If you could get rid of his depression, perhaps his behavior problems would disappear, too."

"That would be wonderful," I said. "So he'd still be demented, but might be less depressed and angry? And might start sleeping better?"

"That's what Joyce said."

"You never think about getting a psychiatrist for an Alzheimer's patient," I said. "But what you said makes sense."

"Maybe his heavy drinking was also an attempt to self-medicate undiagnosed depression," she said

She continued. "Many families are aghast at the very idea of putting their demented loved ones on psychiatric medications. They fear they'll be 'drugged into submission.'

"That's how those drugs were typically used in the past. Nursing home doctors used to administer such high doses of the older drugs that patients often turned into zombies. But today's newer medicines can reduce troublesome behaviors and improve patients' overall mood and functioning without sedating them very much."

And so it was with great anticipation that I arranged an appointment with a highly respected geropsychiatrist who also treated several other patients at the Alois Center.

He diagnosed Ed with depression. He initially prescribed Desyrel for Ed's depression and Aricept for his dementia.

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Ed Transformed

After about three weeks it paid off. He began sleeping more at night and napping less during the day. His angry outbursts decreased dramatically, although he'd still have an occasional fit.

His appetite improved as well. He was 5-foot-8 and had weighed only 102 pounds when he entered the Alois Center. But after he'd started the medications a nurse asked me to buy him some larger pants. He was up to 113. A few months later the request was repeated. He was up to 124. I was delighted.

The most dramatic change, however, was his overall mood and behavior. In a word, Ed was transformed, and fantastically so. Yes, he was still demented, but the majority of the time he was the most contented, loving and loveable person you'd ever want to meet -- not your typical Alzheimer's patient.

He said repeatedly how lucky he was to be at the Alois Center and how joyful he was to have all the people there who took care of him. He thanked every person every time they did anything for him, no matter how small.

For example, Mary, the housekeeper, went in one day and emptied his waste paper basket.

"Oh," he said. "Thank you! Thank you so much!"

Then he kissed her hand.

"You are so beautiful and I am so lucky to have your help. I really mean it," he added. "It's from my heart - not just words from my lips. I am so lucky.

You can imagine what he said to his aides when they showered, shaved and dressed him.

A week later, I was signing out one afternoon when Maria, the receptionist on duty, turned from her computer screen and said, "I bet that Edward was a real lady's man in his day! Every time he comes up here he tells me I'm the most beautiful woman in the world, and that he really means it from his heart."

The most charming comment I heard about my newly transformed Ed, however, came from Debbie, an extroverted young woman who worked in the kitchen. She stood by the table, put her hands on her ample hips, cocked her head and asked Ed in her usual loud tone of voice, "Where were you when I was looking for a husband?" I burst out laughing. Ed laughed, too, then reached out for her plump hand and planted several big kisses on it. He finished by telling her how beautiful she was.

Clearly Ed was far more at peace than before. Right or wrong, I attributed those remarkable changes to the medications that doctor had prescribed. I never met the man, but in my mind he significantly changed Ed's life and our relationship. To me he was the most important health care professional ever involved in Ed's care both before and after he entered the Alois Center.

Ed was indeed a man transformed.

(To read more about Ed see my book, Come Back Early Today: A Memoir of Love, Alzheimer's and Joy, and visit my website, which has a wealth of information about Alzheimer's caregiving.)