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Mismanaged prescription drugs may create dementia-like symptoms

Carol Bursack of Minding Our Elders

Dear Carol: My mom was drugged into dementia. She started out having a thyroid problem, but she kept developing more illnesses and receiving more prescriptions. The prescriptions ranged from her thyroid medication, which was necessary, to anti-depressants, anti-anxiety pills, etc., until she was eventually put in a psych ward.

There, she was prescribed Alzheimer's medications and then moved to the memory unit of an assisted living facility where she was medicated with antipsychotics. To shorten the story, I have Power Of Attorney so I moved from one coast to the other in order to be with my mother and fight to get her well. I read your work religiously and know that you tell people to watch their elders' medications. Please keep doing that. My mom is now living with me and takes just three necessary drugs. She's again going to her art class, seeing friends, and enjoying life. — NM

Dear NM: While your experience with your mom was extreme, dementia-like behavior because of a specific drug, or interactions between multiple drugs, is not unusual. I've written often about the fact that there are reversible types of dementia-like behavior, some of which can stem from prescription drugs.

Other issues such as infections, low vitamin B12, and yes, thyroid issues, can also cause dementia-like behavior. All of these possible causes should be considered before a dementia diagnosis is made, preferably by a specialist.

Before pharmacies and doctors' offices were computerized, many people often went to several pharmacies for their medications. This wasn't necessarily done to deceive, but for reasons of convenience in having a particular prescription filled. The obvious consequence of doing this was that no one pharmacist had a complete list of the medications that their customers were taking. Even after computerization, many older people continued taking medications that were no longer needed, and the doctors, unaware of all of their patients' drugs, kept treating illnesses, some of which may have been caused by drug interactions.

The cure for an elder's confusion and memory issues has often been brought about by one sharp doctor who's taken over the weaning of all medications, sometimes in a hospital, and then started over to determine which medications are actually needed. Unfortunately though, as your story illustrates, over-medication of elders still can happen.

I can't imagine a scenario such as the one that you describe happening in my community. While there may be exceptions, the professionals that I've encountered have been dedicated to their patients as well as careful and honest.

However, no community is immune from the possibility of this type of neglect and outright abuse. There are over-medicated elders everywhere, some of whom haven't been honest with their doctors, and some of whom have doctors who are less than diligent.

I'm sorry that you had such a battle, but you got your mom through it and now you can carry the message to others who need to be on alert. Thank you for using this column as a vehicle.

Carol Bradley Bursack is an established columnist, blogger, and the author of a support book on caregiving. She hosts a website supporting caregivers and elders at www.mindingourelders.com. Carol can be reached at carolbursack@msn.com.

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