We had a tele-appointment with Jim’s geriatric doctor yesterday and it’s official. After being somewhat stable between his August and January appointments, he’s started to slide again. Nothing I didn’t already know but it’s helpful to have my observations validated.
His answers to the MMSE (mini-mental state evaluation) further confirmed that Jim knows where he is, not when. He couldn’t tell the doctor the year, month or date but he could rattle off our address and phone number without hesitation. He couldn’t remember three words past a 15 second delay but could easily recite the days of the week both forward and backward.
After he was done with Jim, the doctor and I revisited the option of medications.
The meds won’t guarantee to delay the disease or prolong the time he spends in the same stage – at least not noticeably. He said often patients only see a difference when they stop taking the medication. Then they may see a sharp decline as the drugs leave their system. Only then is there proof it was actually working.
This little bit of dementia relief comes at a significant cost to his well-being.
There are side effects. Not could be, or possibly be, he said there are usually side effects and they aren’t minor: diarrhea, vomiting, nightmares and loss of appetite.
Jim’s bowel system is already sensitive, he frequently wakes from bad dreams and has recently started losing his desire to eat (I think he’s slowly losing his ability to taste and smell). It doesn’t seem fair to add these side effects to his already unsteady physical condition.
It comes down to quality of life vs. quantity.
If he was a younger man, the doctor said he’d probably be more vocal about prescribing the drugs.
Jim is 82. He’s healthy, happy and still finds something to joke about each day. I don’t want to take that away from him.
He knows there is something wrong but is also blissfully unaware of how devastating his dementia symptoms are to those around him. He doesn’t want to take more pills.
Considering all of the above, I’ve said no to the medications.