Expert: Paula Damgaard - 4/9/2009

Question
QUESTION: My grandad has altzimers he is very violent and doesn't know who anyone is, the doctor is now changing his medication yet again, he was on diazepam but the doc has taken him off this and giving him something else, not sure what its called, but he has warned that the side effects can lead to a stroke, can you tell me why a doc would prescribe this?





ANSWER: Tracey,

The reason is that there are really NO medications that are approved for this type of behavior with Alzheimer's patients.  The hope is that when they use these medicines (and we use them as well) is that he will "outgrow" his behaviors shortly and the need for this medicine will no longer exist so that the threat of stroke passes.  

The side effect of stroke was found in long term usuage for these elderly people.  Unfortunately no one knows if the medicine really did cause the strokes or if these patients would have had a stroke anyway,  this is the age when people usually have strokes.  

It is far better to get his behavior under control, so that he is not a danger to himself or anyone else with a drug that might give him a stroke then to let his behavior continue and he hurt someone.

Hope this helps and I hope he "outgrows" his behavior shortly.  Paula

---------- FOLLOW-UP ----------

QUESTION: Thank you i understand what you are saying, but it feels he will never grow out of this behavior as he has been violent now for approx 4 yrs, and right now it seemed to be getting worse, he is 83 and before this illness he was the most loving man on this earth and would be heart broken if he knew how he was behaving. my gran looked after him until 2 yrs ago when she could no longer cope and it was far to dangerous for him to be living at home as he regularly beat my gran up then would go missing for hrs, she is also now 83. i know each case is different but how long do you think the violence may go on for?

Answer
I wish I could tell you!  I am sorry you are all having to go through this.  There is no method to the madness.  

Hopefully the new medication will take effect and he will be nicer.  They may make him drowsy, but better drowsy then violent.  Sometimes we have to medicate them until they reach that point of non violence and then back off some. So don't be surprised.  

Just remember one thing: stop making him healthy!  If the doctors want to do some kind of test or give him some medicines to keep him healthy say no thanks.  Better he die of an infection or heart attack then to keep going the way he is and go to the end of dementia!  Ask the doctors what medications you can stop now.  Tell them you only want comfort care.  That you do not want anything done that would prolong his life.  This is no way for anyone to live.  

I hope he goes quickly for your sakes and his.  Take care Paula