Mary,

I hadn't been following this group closely and I missed this
question that you posted regarding a posting I made back
on July 4 about a Medscape article on psychosis and
anti-psychotic drugs in Alzheimer's patients.

My personal interest in Alzheimer's comes from close family
members who had or have the disease, and of course from
my own fears for the future.

My mother was diagnosed in her early 60's.  She lived to age
80, dying in an Alzheimer's care facility after refusing all food
for three weeks.

My Dad started to show symptoms of dementia around age 84.
He suffered considerable decline in the next 3 years and died
of a heart attack at age 87.

My mother-in-law, now aged 81, is currently living in an Alzheimer's
care facility.

Anti-psychotic drugs were used on my mother and my M-I-L.
In my mother's case, I don't know what else could have been
done.  When she was first put in the first AD facility, it was
against her will.  We took her out after 3 days and she lived
with my Dad for another 6 months, but it became completely
impossible to care for her and Dad committed her again,
again against her will.  She fought furiously, climbing a fence
around the place, refusing food, yelling at the staff, and so
on.  Dad moved her from place to place, trying to find one
that she would like, but she never liked any of the places,
although they were all places with good reputations.

Mom became manageable with Haldol.  We didn't like giving
it to her but didn't know what else to do.  Without it, she
fought everyone and was aggressively miserable.  With it
she was quieter and more passively miserable.  She was
an intelligent woman who had been disappointed with almost
every aspect of her life for many, many years and her
disappointment, depression and anger seem to have
been accentuated by Alzheimer's.

My M-I-L's case was very different.  She is a sweetheart who
never gives anybody a hard time.  But she doesn't really
understand where she's living and always wants to see her
husband and go home.  Her "agitation" consists of
constantly pestering the staff to call her husband and send
her home.

The AD facility doctor recommended what he called a minimal
dose of Zyprexa.  We tried it.  It made her sleep all the time.
She became unresponsive.  She couldn't keep her head up.
All she wanted to do was take naps.  She wasn't much
interested when family came to visit.

We insisted that the Zyprexa be taken away and, within a
couple of weeks she was back to "normal".

In her case, I believe that her "agitation" required more
staff time than when she just went to sleep, but it was
manageable with nothing more than personal attention
and reassurance.  We as a family attempt to provide
as much of that as we can, and we hope that the AD
facility (which charges $4,500 a month!) will do some
too.

I'm not complaining about the facility's treatment of her,
or of the experiment with Zyprexa.  But I am convinced
that the experiment was a failure and that the quality of
her life, such as it is, went down significantly with the
drug.

   Alan

Major agreement here!  Anti-psychotic drugs are what keeps my MIL from
trying to break windows to get out to "her car", from hearing her long dead
parents calling her and many other things much worse than drugs.

When there's no cure ahead, IMO, a civilized society at least should offer
whatever respite is available.

Karen