[NPInfo] Another Alzheimer's question

[David or Diane Dito]

Joy,

Thank you for your suggestions. We are trying to get her back to her
neurologist, and if appropriate to a neuropsychologist to re-evaluate her
and her meds again. That was my feeling, that she might need a mood
stabilizer, but since I don't work in this area wasn't sure if it would be
beneficial in dementia.

What is an FL-2? Is that a document declaring her incompetent?

She is completely ambulatory and--besides the Alzheimer's and psych issues--
otherwise healthy. I think the question is whether to try to place her in an
Alzheimer's or dementia specialty unit/facility or assisted living at this
point. She's in sort of a "twilight" zone of sometimes acting appropriately,
but increasingly is showing lack of judgment, reasoning and the paranoia.
Most of the residents in the Alzheimer's unit we toured seemed further
"gone" than she....

Diane Dito, NP
St. Louis 

-----Original Message-----
From: npinfo-bounces at nurse.net [mailto:npinfo-bounces at nurse.net] On Behalf
Of Joy C
Sent: Wednesday, January 03, 2007 9:46 PM
To: NP Info
Subject: Re: [NPInfo] Another Alzheimer's question

Sorry Diane,  I hit the send button prematurely.  Anyways, if she needs to 
be placed somewhere in the near future, get her family doctor to sign an 
FL-2 sooner, rather than later, and have the sons go and visit facilities. 
You probably won't get on a waiting list for a bed in a dementia unit 
without the FL-2. This is assuming your state requires a document of this 
type.  They may be a Medicare regulation, I'm not sure.

If she's completely ambulatory and early Alzheimer's, she might do well in 
an assisted living for a while.
It sounds like, from her behaviors, she could use either one of the 
anti-convulsants like Depakote or an atypical antipsychotic to stabilize her

mood.  Paranoia is very typical for dementia.

Joy
North Carolina
----- Original Message ----- 
From: "David or Diane Dito" <dddito at charter.net>
To: "'NP Info'" <npinfo at nurse.net>
Sent: Wednesday, January 03, 2007 8:56 PM
Subject: RE: [NPInfo] Another Alzheimer's question


> Speaking of Alzheimer's, we're currently trying to figure out how best to
> care for my mother-in-law who lost her husband earlier this year and is in
> the early- to mid-stages of Alzheimer's. I bought a book, Alzheimer's
> Disease: Everything You Need to Know (revised edition), by Dr. William
> Molloy and Dr. Paul Caldwell, that is helpful (especially for her sons),
> but....
>
> She has some underlying psych issues (personality d/o and depression) on 
> top
> of the Alzheimer's, and is getting into a more paranoid and
> argumentative/verbally aggressive state lately. She has a caregiver in her
> own home 24/7, but will not allow them to monitor her meds...and has
> admitted essentially that she is not taking them as directed (Lexapro,
> Namenda and Aricept). In fact, she wants to send the caregivers away, but
> has been told by her sons that this is not option.
>
> She will need placement in the near future. For those of you with 
> experience
> in dealing with this disease, what type of environment seems to work best?
> We're trying to give her some input into the process, but she seems
> incapable of making a decision, although she agrees she doesn't want to 
> stay
> in her own home much longer. How is the medication issue best handled to
> ensure she takes her meds while maintaining her dignity and giving her a
> sense of some control over her care and environment?
>
> Any suggestions or input anyone can offer will be much-appreciated.
>
> TIA,
> Diane Dito, NP
> St. Louis
>
> -----Original Message-----
> From: npinfo-bounces at nurse.net [mailto:npinfo-bounces at nurse.net] On Behalf
> Of Priscilla Merrill
> Sent: Wednesday, January 03, 2007 7:39 PM
> To: 'NP Info'
> Subject: [NPInfo] Question
>
> Anyone heard of a Dr. Blaylock?  My dad was asking.  His site looks like a
> scam but told him I'd poll the group.  He supposedly helps Alzheimer's
> patients.
> Thanks for any info,
>
> Priscilla Merrill FNP
>
> -- 
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