Just the Facts and More: Medication

As a caregiver you need to understand the use of medications, and be alert to possible over-medication and to adverse reactions to drug combinations. No medications prevent or cure Alzheimer's disease, but physicians rely on several drugs to manage delusions and hallucinations, depression, agitation, or sleeplessness.

Although these medications may affect specific disease symptoms and assist in managing them, they can also produce side effects such as agitation, dry mouth, drowsiness, problems in walking, tremors, falling, or constipation.

Even though a physician might prescribe a drug for a limited period of time, it can sometimes take up to four weeks for a drug to leave the patient's system after use is discontinued.

Some medications can contribute to the Alzheimer patient's problems and make some symptoms even worse. For example, a person who begins taking drugs for high blood pressure or a heart problem might appear to be more confused than before he began taking the drugs.

So called anti-cholinergic drugs can also block the production of a chemical within the brain called acetylcholine and further alter the patient's memory.

To understand the effects of medications and how to manage their use, consider the following tips:

Action Steps

Get medical advice.

Be cautious about giving any medication - whether it's an over-the-counter or prescription variety.

Begin by asking your physician to review all medications, in order to check for any possible interactions between drugs.
Make sure that every physician involved in the person's care knows about all prescribed medications.
Find out as much as possible about every medication, including its name, purpose, dosage, frequency, and possible side effects. If serious side effects occur, report them immediately to your physician.

Be prudent.

Under no circumstances should you change dosages without first consulting your physician. In addition, avoid the temptation to exaggerate or over-report symptoms in order to persuade your physician to prescribe a new drug or to increase the patient's dosage. Do not share medications with other caregivers or keep medication bottles from old prescriptions.

Rely on your pharmacist for information.

Pharmacists can be another information source. Your local pharmacist can also check for interactions between drugs. Keep in mind that pharmacists can neither prescribe drugs nor alter drug dosages.

Maintain accurate and ongoing records.

Keep a written record of all current medications, including the name of the medication, dosage, and starting date. Carry a copy of this list with you in your wallet or purse at all times. This record will be invaluable in the event of a serious drug interaction or overdose.

Be candid and direct.

In clear, simple language help the individual understand the kinds of medications he is taking and why. In addition, offer clear instructions such as these: "Here's the pill for your high blood pressure. Put it in your mouth and drink some water."

Develop a routine for giving the medication.

Giving medications in a specific way at specific times of the day or evening will help to reduce conflicts. However, if the person refuses to take the medication, stop and try again at a later time.

NEVER assume the individual will take medications on his own. It may be necessary to check to see whether the medicine has been swallowed. At some point in the progression of the disease, you will need to assume responsibility for giving medications.

Stay organized.

Separating pills into a plastic container with small compartments labeled "day" and "evening" or "Monday," "Tuesday," "Wednesday," etc. will help in tracking medications.

Other caregivers find it useful to give medications in individual cups or envelopes, or to keep a calendar and check off each dose as it's taken.

Adapt to the person.

If the person has problems swallowing pills or spits out the pills, you might try crushing the pills and mixing them with applesauce or cottage cheese. Some medications might also be available in liquid form.

Take safety precautions.

Put a lock on the medicine cabinet or place the medications in a locked drawer. If the person spits out pills, make sure these pills aren't picked up and eaten by children or pets.

Avoid leaving the person alone with medication bottles in the room. Be sure to throw out all old medicines.

Be prepared for emergencies.

Research the names and telephone numbers of pharmacies or taxi services that deliver medications. Also find out the names of pharmacies that are open on Sundays and weekends.

Keep the number of your local poison control center or emergency room handy.
If you suspect a medication overdose, call the number before inducing vomiting or taking any other action.

Resources

One of the best places to turn for additional help is the Alzheimer's Association. The Alzheimer's Association has more than 83 Chapters and 1,600 support groups nationwide, where family members of people with Alzheimer's disease or a related disorder share their experiences, provide each other with emotional support, hear practical suggestions and learn to rebuild their lives.

The primary resource for this fact sheet was Peter Whitehouse, MD, Ph.D., University Hospitals of Cleveland, Alzheimer Center, Cleveland, Ohio.

Special thanks to the following Chapters of the Alzheimer's Association: Eastern Massachusetts and South Central Michigan.

Compiled by the Lincoln/Greater Nebraska Chapter of the Alzheimer's Association, 1999.

Other Resources include:

David L. Carroll. "When Your Loved One Has Alzheimer's Disease: A Caregiver's Guide." New York: Harper and Row, 1989.
Howard Gruetzner. "Alzheimer's: A Caregiver's Guide and Sourcebook." New York: John Wiley and Sons, 1988.
Nancy L. Mace and Peter V. Rabins, MD. "The 36-Hour Day." Baltimore: The Johns Hopkins University Press.