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Old 05-11-2016, 08:47 AM   #41
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Those of you who are so violently opposed to the use of medication for extreme anxiety, depression, psychosis, insomnia that goes on endlessly and violent behavior have obviously spent not one iota of time in the kinds of settings I described. Nor had any medical training.

These patients are truly suffering. I made no one comatose or even sedated, with micro-doses of carefully titrated medication. Nurses would have been relieved if I knocked out the patients - I refused. Everyone's an expert here, right? But this was my specialty. It's so easy to bash doctors, especially psychiatrists as if we are all idiots.

Thanks so much. I am out of here.


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I don't see any comments like that and find your response confusing. Perhaps if you come back to the thread we can clear this up - it is certainly a misunderstanding.
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Old 05-11-2016, 08:51 AM   #42
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Somebody touched an exposed nerve...
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Old 05-11-2016, 08:56 AM   #43
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Aside from war, plague or environmental disaster, the future of healthcare for the aged may be the single greatest challenge facing the world in the neartime.

In the few short years since I was born, the world population has grown from about 2 billion persons, to over 7 billion. The most rapid growth comes from people living longer. While healthcare has been the major factor in this increase, sadly, solutions to the decline in mental facilities has not kept pace.

Short of euthanasia, no easy solutions to the cost and efficacy of maintaining this growing part of our complex world.

.................................................. .................................................
The scope of this change is breathtaking. As a young person growing up in the 1930's and 40's, I have no recollection of nursing homes, per se. Those persons in the declining years usually stayed at home, or in the homes of their children. It was the accepted practice, much as the way in which Japan accepts the responsibility of their aged. For those who could not remain in the family scene, there were "old folks homes"... softer in nature, and bearing little resemblance to todays' antiseptic nursing homes. The "homes" were a place to go to die... places that were forgotten or overlooked by society in general.

At this point, it seems that government has not seriously looked to the future of the cost involved in caring for this part of the population. The current cost of $70K to $120K/year is not sustainable. As far as I can see, there are no serious proposals for alternate low-cost maintenance for those persons with reasonable health, but serious cognitive degeneration.

Where do we go from here? Those who are reading this, may included this in their retirement planning, but it begs the question of cost and viability for the overwhelming majority who will not have this option.

While calming medication is not politically correct, it seems to be the only reasonable means of containing surging expenses at this time.

Just my thinking and opinion on a serious and growing situation.
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Old 05-11-2016, 09:01 AM   #44
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+1

And the trend has been to "outsource" the escalating cost to the government. Uncle Sam is broke and cannot pay for it. And he is not alone. All developed countries have this problem.
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Old 05-11-2016, 09:01 AM   #45
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Originally Posted by iac1003 View Post
Those of you who are so violently opposed to the use of medication for extreme anxiety, depression, psychosis, insomnia that goes on endlessly and violent behavior have obviously spent not one iota of time in the kinds of settings I described. Nor had any medical training.

These patients are truly suffering. I made no one comatose or even sedated, with micro-doses of carefully titrated medication. Nurses would have been relieved if I knocked out the patients - I refused. Everyone's an expert here, right? But this was my specialty. It's so easy to bash doctors, especially psychiatrists as if we are all idiots.
+1000
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Old 05-11-2016, 09:21 AM   #46
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Alzheimer's is not mental illness, it is a physical disease that affects the brain. Really, there are very few truly dangerous patients, it is much more common - but still not the norm - for someone to be disruptive. What they need is a facility with a memory care unit. This is where access is carefully controlled, all patients are monitored 24/7 and the staff is trained to deal with those suffering with AD.
My mom has Alzheimer's and is in a memory unit, but the reality is they aren't equipped for overly aggressive patients when the meds stop working. I do fear this for my mom. Recent adjustments to meds have helped, but there are only so many adjustments that can be made.

One of the people who led a support group actually had their mom evicted, but they were able to find another place that could handle them.

cd :O)
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Old 05-11-2016, 09:51 AM   #47
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I presume if you have dementia then you don't know. Perhaps freezing to death under a bridge beats years in a home.
I think with most, if not all, forms of dementia, you do know what is happening in the present but your memory (either short or long-term, or both) is severely ailing, or completely gone. You'd be aware of your suffering, but very possibly not aware of why you were suffering, so it could be quite terrifying.

Having said that, there's a good possibility that by the time I'm old and ailing, there may well be no loved ones around to care for me, so I could end up in a less than ideal situation. I hope to develop a more thought-out approach but in the meantime, my take on it is that I am not going to worry too much about what would most likely be a relatively short period of suffering at the end of what has been (and still is) a jolly nice life.


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Interesting. I have heard a theory that dementia just accentuates your trait; if you were a mean person, it turns you into an unbearable person. And that seems to be the case that I have observed in some people.
Both my parents had dementia and for both of them, their underlying character traits were brought out by it. My father "forgot" that he had a strong critical and argumentative side, and turned into an easy-going teddy bear. My mother, who had been a very sweet and thoughtful person, exhibited some rather virulent racist behavior. I don't know the details, as I wasn't there, but I heard from one of my siblings that the home help, poor lady, had been reduced to tears. I think my mother had always harbored racial prejudices but for most of her life, had kept them under wraps and filtered them out. Dementia removed that filter.
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Old 05-11-2016, 10:06 AM   #48
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Aside from war, plague or environmental disaster, the future of healthcare for the aged may be the single greatest challenge facing the world in the neartime.

<snip>
At this point, it seems that government has not seriously looked to the future of the cost involved in caring for this part of the population. The current cost of $70K to $120K/year is not sustainable. As far as I can see, there are no serious proposals for alternate low-cost maintenance for those persons with reasonable health, but serious cognitive degeneration.

Where do we go from here? Those who are reading this, may included this in their retirement planning, but it begs the question of cost and viability for the overwhelming majority who will not have this option.

While calming medication is not politically correct, it seems to be the only reasonable means of containing surging expenses at this time.
I agree; it seems that for the vast majority of the population, their long-term care plan is "run out of money and qualify for a Medicaid nursing home". It makes me very worried for my son's (and now my granddaughter's) generation. I also agree with you on calming medication. I'd rather have a loved one (or myself, for that matter) treated with calming medication than face eviction from a familiar facility.
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Old 05-11-2016, 10:12 AM   #49
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+1000

I have see it in my own family. Doctors in the US have a completely different mindset which is let us medicate the problem. I have seen young teenagers on medication for sleep, depression, whatever even in cases where the child can fight through it or use some natural remedies such as exercise and social stimulation.




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Old 05-11-2016, 10:44 AM   #50
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For some reason I popped on today and read this thread again.

I'm so distressed and depressed by this thread that I need to take a break from this board. Nothing anything anyone here said, just that this topic stabbed me in the heart.

See you after my break.
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Old 05-11-2016, 11:11 AM   #51
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Wow, tough topic. So sorry to the posters who were profoundly affected by the discussion. It is something we all have to deal with, one way or another.
My sincerest sympathy to anyone who is deep in the midst of caring for and living with the decline of a loved one.
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Old 05-11-2016, 06:48 PM   #52
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A good friend of mine got early onset Alzheimer's but her hubby cared for her at home. He got cancer and died and all her family was dead. I am her guardian and put her in a home. If she was a ward of the state things would have went bad for her. She was so drugged up that she could not eat and her head was stuck in a down position and her neck was killing her. I got her off old meds and on 1 new one and now she can eat, hold her head up, etc. She always was a gentle, kind soul but now doesn't want to bathe so we give her Xanax so she will cooperate. It takes a lot of time to work on issues and if a person didn't love you they wouldn't bother.
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Old 05-11-2016, 08:30 PM   #53
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Yes, invalid patients, not just those with Alzheimer, demand a lot of care. If the caretaker is not a loving family member, it is very difficult to ask for the care and love that is required. One can just put him/herself in the shoes of the healthcare giver. Not all of us can be Mother Teresa.
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Old 05-11-2016, 11:14 PM   #54
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There's a bit of casual callousness, a slight tendency to arrogance, and a readiness to accept pop psychology and quack medicine as truth among some of our posters. Combine this with trigger sensitivity in those persons who have been directly dealing with these issues for years, and we have a recipe for some pretty hot responses.

Ignoring this thread might be a good idea for some of us. Showing some real restraint and consideration in
posting might also be useful.


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Old 05-12-2016, 06:54 AM   #55
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It is good to hear that there are at least some caring, intelligent, mindful professionals working with the most vulnerable patients.

Many of our posts reflect the very real fear and anger we feel in response to many, many articles and news reports (plus our own experience in many cases) that assure us that few people in the healthcare profession know how to treat people with dementia. Most, we suspect, may fear and even dislike such patients. Few talented medical professionals, it seems, want to work with them, as the challenges are many and the rewards all too few. This is what we are told, and often what we observe.

So to hear from a healthcare professional who not only gives it his/her best shot, but has gone against his own staff's wishes (the nurses who wanted the troublesome patients "knocked out") in the process is quite eye-opening.

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Originally Posted by iac1003 View Post
These patients are truly suffering. I made no one comatose or even sedated, with micro-doses of carefully titrated medication. Nurses would have been relieved if I knocked out the patients - I refused. Everyone's an expert here, right? But this was my specialty. It's so easy to bash doctors, especially psychiatrists as if we are all idiots.

Thanks so much. I am out of here.


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Old 05-15-2016, 11:46 PM   #56
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I have see it in my own family. Doctors in the US have a completely different mindset which is let us medicate the problem. I have seen young teenagers on medication for sleep, depression, whatever even in cases where the child can fight through it or use some natural remedies such as exercise and social stimulation.




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Doctors in the US have the mindset of using all the tools available to improve the lives of the elderly and children, including medications. Not certain where you got your medical degree or what qualifies you to judge whether a teenager's issues can be managed with "natural" remedies, but we have an epidemic of teen and young adult suicide in the US. Uninformed rants are not useful.
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Old 05-17-2016, 09:44 AM   #57
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Dad suffered from dementia for about five years. Toward the end he broke his arm in a fall and his behavior worsened dramatically (possibly from the pain and pain meds). A nursing home psychiatrist eventually put him on Seroquel, which, as I understand, is a controversial application of the drug. This was in late 2008-early 2009.

I always had mixed feelings about Dad being medicated that way. On one hand, warnings at the time stated that use of the drug by Alzheimer's patients increased the risk of death (I'm paraphrasing here). On the other hand, Dad's behavior was hindering his recovery from the fracture. I OK'd the drug. I'm not sure it did any good. He eventually moved to a memory care unit where they did not use Seroquel.

Doctors at the time told me that a broken bone usually spells the end for a dementia patient -- they're usually dead within a year. Dad passed about five months after the fracture.
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Old 05-17-2016, 09:53 AM   #58
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Having seen and been close to my father and father-in-law in their final years, I know how sad the end of life can be. Often, there's not a whole lot one can do.
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