Potent Pharmaceuticals in Terminal Dementia:
The Benefits of Potent Opiates, Benzodiazepines, and Anti-psychotics in End-Stage Dementia
Claire Bassett
Excelsior College
Abstract
Potent pharmaceuticals like Haldol (haloperidol), Roxanol (morphine sulfate oral suspension), and Ativan (lorazepam) have clear benefits in Advanced Dementia (AD) patients. Though often contraindicated in elderly and demented patients, these and similar medications are frequently used in hospice and palliative care settings for terminally ill patients. Elderly and demented patients can frequently have reactions to these medications that are the opposite of their intended effect, which can discourage providers from utilizing these medications.
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California has a population of approximately 38.8 million (Census Bureau, 2015). Dementia is a degenerative condition of the brain that may damage all parts of a person 's functioning. Memory, personality, social functioning, problem-solving, and eventually even physical abilities can all be affected. Once a person notices symptoms and seeks treatment, there is no cure. There are medications and therapies that can slow the progression of dementia, but nothing can restore what has been lost. Dementia is typically a disease of "old age," and dementia was considered a normal part of aging for many years. In the advanced stages of dementia, patients typically lose the ability to communicate, and either the desire or the ability to take in nourishment. This stage is typically called the Terminal Stage or End-Stage Dementia. The absence of response to external stimuli does not mean that these individuals are not suffering. These patients still possess the ability to feel pain, fear, and to some extent can be comforted. Hospice and Palliative care programs exist to provide care for those approaching the end of life, and to give them the ability to pass in a peaceful way, with as the support of their loved ones and caregivers. Dignity and the absence of pain and stressors are an important part of this specialized care. Too often, however, dementia
Dementia is a cognitive disorder which causes a loss of brain functions which mainly affect memory .
Dementia is a progressive disorder that will affect how you’re brain functions and particularly your ability to remember, think and reason. Dementia usually affects older people and are approximately 820,000 people in the UK with the disorder, and around 15,000 are under the age of 65. If the dementia is recognised early enough that are a lot of things that you can be done to make the quality of life better. In a lot of dementia cases the symptoms and quality of life will progress and get worse over a number of years. The most common symptoms of a dementia patient are:
Dementia often includes symptoms such as memory loss, trouble doing normal everyday activities, and problem solving. Once the symptoms come, they will most likely stay. They will only become worse and worse over time, so it’s necessary to try and come to terms with the disease. Caregivers can try to make the person affected as comfortable as possible as their body is slowly transitioning. Because there is a loss of blood flow to the brain, signals that are necessary in order to keep the body functioning properly eventually stop being sent. The muscles will stop being sent signals to move, and sometimes the signal to breathe can even be stopped.
Dementia is a loss of brain function. If affects memory, thinking, language, judgement and behaviour. Dementia is progressive, so the symptoms will gradually get worse. In a later stage of dementia people will find it hard to carry out daily tasks and will come dependant on other people.
At the end of life: Many people can die from dementia; however they can also die with another disease which doesn’t relate to their dementia even though they suffer it. Usually, the dementia will be that far advanced towards the end of life the individual may not even know what is happening or may even be too ‘ill’ to understand. However, it is important as a care worker or any professional that is trained in end of life care (palliative care) to ensure the best quality of life until the end. Each individual should be treated equally, yet individually. These individuals must not be overlooked and still have rights as well as everybody else.
In dementia care is a key aspect of best practice. It is a way of caring for a person with dementia as an individual with unique qualities. It means looking at the world from the person’s point of view ‘standing in their place’ as it were and appreciating how they may be feeling.
Dementia is a term used to describe a collection of signs and symptoms that happen to the brain when it is affected by the progression of certain diseases such as vascular dementia (when brain cells die due to lack of oxygen) and Alzheimer’s disease (a specific brain disease). Some of the affects these diseases have are on a person’s memory, language and communication abilities, behaviour and ability to make rational judgements.
Dementia is a terminal illness; and patients with advanced dementia suffer from distressing symptoms, just like people with other terminal decease, such as cancer.
Living with dementia can be overwhelming, stressful and emotional. There is a lot to take in, appointments and assessments to attend, sorting out what support you are entitled to, care preparation, wishes and preferences.
Dementia is a weakening in the mental ability (a sign of this may be asking the same question frequently) which affects the memory and many other aspects of the brain which causes difficulty with thinking, problem solving and concentration it is also the result of the death of multiple brain cells.
Illnesses like Alzheimer's disease make it difficult for those who want to provide supportive care at the end of life to know what is needed. Because people with advanced dementia can no longer communicate, they cannot share their concerns. Is Uncle Bert refusing food because he is not hungry or because he's confused? Why does Grandma Ruth seem agitated, is she in pain and needs medication to relieve it, but can't tell you. As these conditions progress, they also obstruct efforts to provide emotional or spiritual comfort. How can you let Grandpa know how much his life has meant to you? How do you make peace with your mother if she no longer knows who you are? Someone who
It is inevitable that eventually each of us will grow old and begin to face more and more health problems as our age rises. Elderly people are challenged by many illnesses and diseases that unfortunately, are incurable. One disease that becomes more common as people age is Alzheimer’s disease. Alzheimer’s a common cause and a form of dementia and can severely damage a patient’s cognitive functions and can ultimately cause death. Living with Alzheimer’s disease can be saddening for both the sufferer and the family. Family and friends will find it very hard to cope when a loved one begins slipping away and losing memory of who they are.
Dementia care offers support and services to an individual affected by the disease itself, which is dementia. It addresses the right and needs of the person with dementia and their families. Improving quality of life and changing attitudes towards dementia is the main goal of dementia care. Dementia care also provides quality of care, maintain dignity and promote health, security and comfort in consideration with the standard of care and ethical guidelines (Adams & Manthorpe, 2003).
Current medications for dementia are limited and there is a need to explore traditional medicinal system to investigate the agents that can prevent progression of memory loss or improve the existing capacity of learning and memory. Thus present study was carried out to evaluate the effects of Ayurveda drug formulations, Tinospora cordifolia (Tc) & Phyllanthus emblica (Pe) with and without Ocimum sanctum (Os) on learning performance and memory of mice. We also tried to investigate the possible mechanisms of these plant drugs for their effects on learning and memory using Scopolamine, Diazepam and Cyclosporine as amnesic agents.
During my first clinical rotation as a nursing student, I was assigned to care for several older adults suffering from dementia. Although all of my patients ranged in severity from mild to severe progression of dementia, they all experienced moments of agitation, anxiety, or disturbed behaviors related to their disease. It occurred to me after careful review of several patient charts that despite often being prescribed pharmaceutical regimes for other comorbidities, these patients were rarely prescribed medications, besides those to control anxiety, specifically targeted at treating their progressing dementia. Through some research I discovered that the significant number of individuals affected with dementia is a growing public health concern in part due to the current limited ability of pharmaceutical treatments to treat the disease (Samson, Clement, Narme, Schiaratura, & Ehrle, 2015). This revelation began my interest in current nonpharmacological treatments being implemented in controlling adverse behaviors and feelings in patients diagnosed with dementia.