Hope is the thing with feathers

That perches in the soul.

And sings the tune

Without the words,

and never stops at all.

 

-Emily Dickinson-

(1830 - 1886)

 

http://brijoy2006.blogstream.com/

 

Recently, I visited Pretty Rubble's blog and she shared with us her mother-in-law had had an accident, broken a hip. This is the story of Mae, I'm hoping she will read it and find a little hope.

 

"Mae"

Mae is in her early 90's. I would describe her as an "old broad," and in doing so she would only chuckle and say..."you're damn right."

The only medication I provide for Mae is 4 oz. of Kessler's Bourbon at night. That is no lie. She lives totally independent in her one bedroom apartment. Although she is legally blind, she maneuvers around the facility with no guidance at all. She has no signs of dementia.

~~~~~~~~~~~~~~~~~~~~~~~~~

About 2 months ago a police officer arrived at the door of the facility around 1 a.m. He asked if we had any residents there by the name of "Mae." I escorted him to her room only to find her on the floor near the bed, angry as a hornet.

I did my assessment, she was in a moderate amount of pain, and with movement she would grab her groin area and cuss. I knew, or I suspected a broken hip. I sent her out via ambulance.

~~~~~~~~~~~~~~~~~~~~~~~~~

 Two weeks later, Mae was readmitted to the facility. She had orders to go to a nearby facility for rehab but lasted one day there. She didn't like anyone at the facility, and she didn't want anyone taking care of her. They still insisted it was not a broken hip.

 

She started physical therapy in our facility, and with a follow-up appointment with her primary physician, found out 3 weeks later that there was indeed a fracture in her left hip.

(I knew it! )

They, doctor and physical therapist, ordered her to be in a wheel chair. They prescribed narcotic medication for the pain.

Mae was not having any of the B.S. She had been walking for the last 3 weeks.  She never once asked for pain medication.

 

"Who the hell do these people think they are??"

 

They were exploring the possibility of surgery, not happening for Mae.

 

"Why is everyone making such a big deal?"

 

Mae is one of the most colorful people I know. I spend a lot of time just chatting with her in the evening. She reminisces, stories that are always funny and interesting.  She continues to walk to all meals and live independently.

 

My prayers are with PR and her family. I hope the outcome is as amazing as Mae's has been.

 

Nursey

There is no cure for Alzheimer's disease.

It is managed with medications that have shown, in some studies, to slow the disease process.

 

Cholinesterase Inhibitors

Cholinesterase inhibitors are a group of drugs commonly prescribed to individuals with Alzheimer's disease and other forms of dementia in order to slow the disease.

For individuals with dementia, brain function decreases in part because their brain cells are no longer able to communicate with one another as well as they used to. Cholinesterase inhibitors act to increase levels of the neurotransmitter acetylcholine, a chemical which helps brain cells communicate and work better.

In practical terms, you may find that your loved one may be better able to remember names and details or perform activities with fewer problems.

Aricept

(generic name: donepezil)

 

Razadyne

(generic name: galatamine)

 

Exelon

(generic name: rivastigmine)

 

Cognex

(generic name: tacrine) 

 Less commonly prescribed, Cognex was the first drug in the treatment of Alzheimer's disease. It was approved by the FDA in 1993 but today it is seldom prescribed due to side effects it may have on the liver.

 

Namenda

(generic name: memantine)

Approved for use in U.S in 2004. Memantine is a new type of drug that works differently from currently available anti-cholinesterase inhibitors, which are generally only effective in milder forms of the disease.

 

Memantine has been found to slow deterioration in individuals with moderately severe Alzheimer’s Disease.

 

There are conflicting reports and views whether any of these drugs are helpful.

 

Some studies say early use of these medications can delay nursing home placement by 6 months to a year, while other reports say they have no real benefit at all.

 

My thoughts.

In taking care of the people who use these drugs regularly, when taken off the medication there is an increase in behaviors and a decline in mental function. Not in everyone, it seems to be very individual.

The newest drug, Namenda, is usually taken with the cholinesterase inhibitors (usually Aricept.) Again, in some people I did see an improvement in function, while others had side effects such as agitation and increase in behaviors.

It is all we have for now.

I think, for the most part, family members feel obligated to take any action available to slow the disease process. The medications are very costly.

I would opt for the only available treatment for my loved one in hopes it would slow the process and make their days a little more tolerable.

 

Nursey

 

 

 

The Begininng

 

A woman in her early 50's was admitted to a hospital because of increasingly odd behavior. Her family reported that she had been showing memory problems and strong feelings of jealousy. She also had become disoriented at home and was hiding objects.

During a doctor's examination, the woman was unable to remember her husband's name, the year, or how long she had been at the hospital. She could read but did not seem to understand what she read, and she stressed the words in an unusual way. She sometimes became agitated and seemed to have hallucinations and irrational fears.

 

This woman, known as Auguste D.

 

was the first person reported to have the disease now known as Alzheimer's disease * (AD) after Alois Alzheimer, the German doctor who first described it. After Auguste D. died in 1906, doctors examined her brain and found that it appeared shrunken and contained several unusual features, including strange clumps of protein called plaques and tangled fibers inside the nerve cells.

 

Memory impairments and other symptoms of dementia, which means "deprived of mind," had been described in older adults since ancient times. However, because Auguste D. began to show symptoms at a relatively early age, doctors did not think her disease could be related to what was then called "senile dementia. "The word senile is derived from a Latin term that means, roughly, "old age."

http://www.nlm.nih.gov/medlineplus/dementia.html

 

 

Dementia is not a specific disease.

It is a descriptive term for a collection of symptoms that can be caused by a number of disorders that affect the brain. People with dementia have significantly impaired intellectual functioning that interferes with normal activities and relationships. They also lose their ability to solve problems and maintain emotional control, and they may experience personality changes and behavioral problems such as agitation, delusions, and hallucinations.

While memory loss is a common symptom of dementia, memory loss by itself does not mean that a person has dementia. Doctors diagnose dementia only if two or more brain functions - such as memory, language skills, perception, or cognitive skills including reasoning and judgment - are significantly impaired without loss of consciousness.

~~~~~~~~~~~~~~~~~~~~~~~~~~

The U. S. Congress Office of Technology Assessment estimates that as many as 6.8 million people in the United States have dementia, and at least 1.8 million of those are severely affected.

Studies in some communities have found that almost half of all people age 85 and older have some form of dementia.

 

Hopefully,  in 2007, they will find a cure.

 

Nursey

Thank you to Sarah for making my blog look pretty.

http://sarahbobeara.blogstream.com/

 

We had been fortunate in Nebraska to dodge the recent snow storms coming from the Denver area. This morning, not so lucky. We are expecting 1-3 inches of blowing accumulation.

 Please, everyone stay safe tonight as you celebrate the New Year.

 

 

Nursey