Bursack: Quitting Alzheimer's drugs in late stages can benefit some
Dear Carol: I read your column about older people and medicines so I wanted to write. My husband has had multiple health problems during his life so he's been on a lot of medicine. Six years ago, he developed symptoms from Alzheimer’s and has also been on drugs that were supposed to help slow down the progress of the disease. These medicines seemed to help in the beginning, but after a while, they seemed to stop working.
Recently, the heart doctor eliminated my husband’s cholesterol drug and his general physician took him off several others. What did the most good, though, was when the Alzheimer’s specialist took him off of his dementia medicine. The doctor explained that these drugs can help some people early on, but when people get to my husband’s stage they often don’t help and can even make some people worse. My husband is doing better physically and seems clearer now. I want to encourage you to keep telling people that sometimes taking people off of medicine, even Alzheimer’s medicine, in the late stages can be good. — KR.
Dear KR: Thank you for sharing your experience. That column resulted in a lot of positive mail as well as many stories supporting the idea that fewer drugs can mean better health for older adults.
Virtually all medications can have side effects that can negatively affect an individual’s quality of life. Since people living with dementia of any type, including Alzheimer’s, are often particularly sensitive to drugs, medications need to be prescribed judiciously and follow-through is necessary.
Donna Brooks, a reader whose husband lives with Alzheimer’s, wrote about their family’s experience: “The doctor was ready to put my husband on hospice because of repeated emergency room visits for heart problems,” Donna said. “His dementia was so advanced that he didn’t recognize anyone. We’d been unhappy with the doctor anyway, so we found a new one. Right off the bat, the new doctor took my husband off of five medications and my husband did a complete turnaround and came back to knowing us. It’s been six months now, and we still have bad days but nothing like what we were going through.”
Note: I’ve previously addressed in this column a reader’s concerns about how both prescribed and over-the-counter medications can affect older adults (see Minding Our Elders’ archive on Inforum). For general information, The National Institute on Aging has a good roundup on this topic at www.nia.nih.gov.
Medications, particularly drugs that can help some people’s cognitive function, are frequently prescribed early on after a dementia diagnosis, but often the effectiveness of these drugs is not monitored past the first months. As both KR and Donna said in their letters, in some cases these medications may cease to be effective, which leaves them without benefit but still possibly contributing to ill health through side effects. For this reason, in later stages of dementia, all medications should be reevaluated regularly for effectiveness as well as side-effect potential.
Carol Bradley Bursack is a veteran caregiver and an established columnist. She is also a blogger, and the author of “Minding Our Elders: Caregivers Share Their Personal Stories.” Bradley Bursack hosts a website supporting caregivers and elders at www.mindingourelders.com. She can be reached at email@example.com.