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Hi Everyone, My mother has post stroke dementia since August 2017. She has been home from rehab since November 2017. I had hopes that her experiences would improve with her homecoming but they haven't yet. She hasn't had her 6 month follow up with the neurologist due to missing the appointment due to weather.


We are trying to reschedule this but she hates going to doctors, and we are involved with her out patient physical therapy these days and we are also getting her to see a urologist for the first time since she has had her third urinary tract infection since the beginning of the year. Her dementia symptoms DEFINITELY WORSEN when she is having an infection too. When we can discuss these symptoms with her primary care physician or with her neurologist, we are considering asking if anything could help these symptoms. She has a conviction that she used to live in another house and points up or down the road as to where she feels it was / is.


She believes she is supposed to be living in one end of the house while my sister and I are supposed to be living in another part of the house. She talks about the house like it is a duplex and not a single family home. She feels there is an addition to the house or a seperation in the house that doesn't exist in these ways and she feels we are lying to her when we try to explain she doesn't have another house to "go back home to" as she calls it, and that she can spend more time in the other part of this house but it won't be the separate duplex part of it that she is convinced somehow exists in this same one house. She says that we go to "our house" ( my sister and my house ) and then come back to her house and they are duplicates of each other. She doesn't know how it happens since she admits we don't travel between the houses. She claims we go back and forth between these houses "by magic" as she calls it. She says "I go to sleep in one house and I wake up in another house."


Also she has various delusions about things that have happened to her since her stroke. And she has some hallucinations of sights and sounds my sister and I don't hear. She accuses my sister and I of lying to her and trying to trick her when my sister and I can't always go along and agree with her about what she believes or what she sees or hears. Her long term memory is affected in ways but what is even more affected is her memory since her stroke. Both the days immediately after her stroke and her daily life nowadays. She can jumble different facts together. Like she'll have certain facts correct regarding two different situations BUT she will sometimes place them together into one single situation when they are really two different situations she is talking about here


She has outbursts of upset. Rages and anxiety and depression. BIG depression about her physical injuries that have kept her from having full use of her mobility since her stroke. She walks with a walker.... And she can't drive because of her stroke. She can't drive due to her physical injuries BUT when the time comes with her therapy I don't see doctors allowing her to drive again due to her cognitive injuries as well. I have heard negative reviews of prescription medication for these symptoms in people with dementia, but I don't feel there is any choice but to at least try to see if anything will have any positive affect on her now. Does anyone know of ANY medications that can aid the experiences I describe above without having harmful side effects? THANKS SO VERY MUCH FOR ANY HELP.

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All psychotropic medications have side effects. Just like all medications have side effects. You weigh the positive and negatives and discuss with the doctor and make your choices. Everything you have written sounds like classic dementia (with maybe some UTI-delirium thrown in there). The medications don't stop or even slow down the disease. They just extend the time prior to needing nursing care, and can make the patient more comfortable in their own skin. Is it worth it? I think so. Others choose to make the journey without medication.
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One could argue that the side effects of pain medication are serious and cancer patients should not take them either.
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Definitely talk to her primary care physician &/or with her neurologist about the worsening symptoms. Don't wait until you can get an Doctor's appointment--Call them NOW!!

It may take lots of trial and error to find the right combination of antidepressants and mood stabilizer meds before your Mom's behavior improves. Because each person is different, I can't really suggest a specific medication for your Mom. Your doctors know her better than I do.

Your Mom's behaviors are so similar to my Mom's that I thought that I was reading about my Mom. It took awhile to find the right medications and dosages to calm her down. :)

Good Luck and keep us updated.
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Medication is hit or miss, mostly miss in this house. ALL calming meds appear to work in reverse for my mil.

And I could have been reading about my mil, as well.

Good luck.
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THANKS For Your Responses.

DeeAnna... or anyone... do you feel that her primary care doctor will call in any prescriptions without seeing her in person?

Her primary care doctor called in a prescription for a hemorrhoid ailment this week but these kinds of medications are obviously a whole lot more serious.

She is scheduled for a primary care appointment at the end of May.

But honestly I am not sure we can wait that long for some sort of prescription regarding at least her emotional states and outbursts ...

She has been diagnosed with dementia due to her stroke by the doctor at the nursing facility she was in for her in patient rehab post stroke.

We haven't addressed her emotional symptoms or her dementia symptoms with her primary care doctor that much .... Just how they increase during her 3 recent UTI's.... But we haven't discussed how challenging these symptoms are during the other part of the time.....

THANKS SO MUCH AGAIN FOR YOUR HELP.
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She should be seen by a geriatric psychiatrist as soon as possible. Vascular Dementia patients often seem to develop terrible anxiety and depression. For my mom, two different antidepressants and an antianxiety med were the right mix to keep her calm and happy.
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Please DO NOT wait for your Mom to see her PCP at the end of May. Call her PCP's office and talk to the Triage Nurse Practitioner or Triage Nurse for the clinic and tell her/him what the problem is and see if she can help you get some medication prescribed or an appointment within the next week. As BarbBrooklyn suggests: ask for referral to a geriatric psychiatrist or a psychiatric nurse practitioner because they are more knowledgeable about vascular dementia and have a better idea of what medications to prescribe than a PCP.

Prior to calling anyone, sit down and write a clear, concise list of behaviors and medical history for your Mom so that when you are talking to any healthcare professional, you have the information in front of you and can calmly and succinctly talk about your Mom's health issues. After any conversation with a healthcare professional, write down a short summary of the conversation.

Start a journal of your Mom's behaviors and write down how your Mom's behavior changes once she starts to the medications. It makes it easier for you and the healthcare professionals to determine whether the medication(s) are working or not working for your Mom.

Please keep us updated on how your Mom's doing.
Good Luck and God Bless!
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Yes please get her in to see her PCP before the end of May. It’s not likely her doctor will call in any of those prescriptions before actually examining her.
A geriatric psychiatrist is a great idea but in the interim a visit to her PCP is a good start.
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