Wednesday, March 30, 2011

Redirection or Meds… or No Meds?

I asked a question on a forum this week about redirection.  Redirection is a commonly used tactic for misbehaving toddlers – and also those with Alzheimer’s.
After our return from a wonderful respite weekend, Mom was experiencing her typical post respite confusion.  She kept telling me about the “man on the phone” – we’ve heard that before J  – who was telling her she had to go to the hospital.  She had also decided that the daffodils next door were actually “food” and we needed bring them in and cook them.
As usual in her post respite confusion, she laid things out on the bed so she would be ready to “go” – purse (empty), nightgown, sweater, hat.  She walked around the house telling me about “the man” and “the food”.
As she talked, I did my typical and said, “Hmmm, uh huh”, every so often.  When asked specifically about the hospital I told her I hadn’t heard anything so we would have to wait and see and when asked about the “food”, I told her they weren’t quite ready yet or it was too cold to go out.
After posting my question on the forum, there were some excellent suggestions about music, TV, taking a drive, etc.  Some I had used before, some Mom doesn’t go for or is too far into the disease to do any longer but I read along because you never know when you’ll find something that hadn’t come to mind before.
Quite a bit of what was posted involved drugs.  Drugs to calm her down, drugs to help her sleep…  You see, lots of folks with Alzheimer’s get very agitated to the point of distress, anger, crying, even violence.  The meds can help not only the patient but also make the caregiving a little easier.
But  Mom, soon to be 95, has never taken medications.  Given that her overall health is excellent and in general we have calm, quiet days, I hesitate to give her anything because of some wandering or because she takes a while to settle down after I’ve been away.
After years of watching my daughter go through various epilepsy drugs and dealing with the side effects they caused, I don’t feel the need to control Mom’s current behavior with a medication.  When I compared my daughter’s hyperactivity (prior to meds) to what I call Mom’s agitation (she wanders about the house and talks to me or asks me questions), a few caregivers didn’t understand how I could compare the two. 
I do see the similarity because any problem in the brain comes down to neurons firing – or not.  In the case of epilepsy, they are firing when they are not supposed to fire and setting off a brainstorm.  In Alzheimer’s, sometimes they are firing correctly, sometimes they are firing and causing disjointed thoughts or old memories, and sometimes they are not firing at all.
At this point in time, as long as I am calm and settled, it seems easier for Mom to settle.  She’s happy – she is still able to smile so it’s easy to see – and her quality of life is good.  So do I really want to take the chance of side effects before an intervention is necessary?  I think not.

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