My mother is reluctant to hire a caregiver or to place my father in assisted living with memory care because of the expense associated with these alternatives. After a productive career and careful financial planning my father has amassed significant assets to pay for such care, but my mother hopes to avoid the cost of appropriate care by medicating him with Zyprexa and keeping him at home. She is unable to manage his occasional outbursts (she has refused to join a support group, learn about the disease or accept expert advice about how to handle outbursts and agression even though other family members who have accepted such help are extremely successful in managing episodes), and she is of the view that covertly giving him Zyprexa will be more economical than either placing him in assisted living with memory care or hiring an experienced person to care for him and help structure his day. Her longstanding bitterness towards him is overflowing now that he is in a diminished stated. How can I persuade her not to give him an anti-psychotic with a black box warning when his treating physician, a VA doctor who knows nothing about my father except what my mother, his unwilling caregiver, tells him, encourages her to "manage" him with Zyprexa. Please note that my mother has already received advice from the ALZ Association, a nationally-recongized ALZ doctor and a highly qualified geriatric care manager who visited the home and NONE of their advice has reached her.
I'm sorry to hear that your father isn't receiving the quality of care that you feel is appropriate for him. As for the medications that your father is taking, I can only speak rather generally but agree overall with what you seem to be suggesting - that behavioral (non-drug) interventions are preferrable and should be tried before any prescription medications. Admittedly, many medications can be effective in the management of some behavioral and personality-related symptoms, but they undoubtedly must be used carefully and are most effective when combined with behavioral or environmental changes. And like you've stated, many of these drugs, including Zyprexa as well as other antipsychotics, are indeed associated with serious side effects in individuals with dementia, and their use therefore must be considered with extreme caution. Now with respect to your mother and the fact that she's already been inundated with information and advice from various sources, I can only suggest that you look into the possibility of obtaining power of attorney over your father's financial, legal, and health-related affairs. In the alternative, perhaps an informal mediation, i.e., a family meeting with an outside person involved, might help persuade her in the direction that you're seeking. Additionally, I've attached here a brochure on "Behavioral and Psychiatric Alzheimer's Symptoms" that perhaps you could pass on to your mother in the hopes that she'll read the packet at some point:
All in all, it seems to me that the more you push, the more likely she is to be stubborn in her decisionmaking so perhaps the best that you can do is to make all relevant information available to her so that she can make the most informed decisions possible. If you'd like to speak further about this, please don't hesitate to call us at 800-272-3900. Thanks for posting on our online forum.
