NURSING IN THE CASE OF ALZHEIMER’S DISEASE: THE SIDE-EFFECTS OF MEDICATION
If a change occurs in the behaviour of people with dementia or they seem otherwise to be behaving abnormally, it is important to consider whether or not the change is the result of a side-effect of any medication that is being prescribed. Older people are much more sensitive to unwanted effects of prescribed medicines and also those that you can buy over the counter without a prescription. Medication ought not to be repeated indefinitely, every month say, without a formal review taking place from time to time. The frequency of the review will depend to a certain extent on the problems being treated and the nature of the drugs being prescribed. Many older people, even those not suffering from a dementing illness, can be prescribed a medicine for a particular problem and then three years later it is discovered that they are still taking the same drugs even though the problem may long ago have receded.
Every so often, people with dementia may refuse to take their pills. If a medicine is being taken two or three times a day, it probably doesn’t matter very much if an occasional dose is omitted. This is best checked with the doctor who prescribed the pills as there are some exceptions. If refusal to take medication is a consistent and protracted problem, it may be necessary to ask the doctor to prescribe an alternative form of the drug, for example a liquid that can be mixed with a cold drink or a capsule containing a powder such that the capsule can be opened and the powder mixed with jam, honey, or something else that is palatable.
It is better always to assume that a person who is confused and forgetful will need to have his or her drug-taking supervised. In the early stages, if this is impossible, there are various tricks that may help to ensure that medication is taken properly. Some drugs come in calendar packs and if not, it is possible to buy a similar gadget, such as a plastic box divided up into compartments, each labelled with the day of the week. In some such boxes the compartments are further divided into three or four subsections so that the medicines for morning, noon, and night can be placed in their own compartment. This is helpful to those supervising the medicines as it may give an indication of how frequently the pills are being forgotten.
Finally, there are three types of side-effect that commonly occur when a medicine is given to try to control abnormal or difficult behaviour in a person with dementia, and which you should look out for. These are: difficulty in walking — a tendency to fall or stumble, especially after rising from a chair or getting out of bed; increased sedation, i.e. sleepiness in the daytime; and restlessness.
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