Dementia with Agitation... Now What?

Listen to a radio interview with Elizabeth Landsverk, MD as she speaks with Frank Samson on his show “The Aging Boomer” from January 5, 2018.  They discuss many issues of interest to elder care professionals and families caring for loved ones living with dementia:

  • What is a geriatrician?
  • What is dementia?
  • What are the different types of dementia?
  • How is dementia diagnosed?
  • How do decrease risks of developing this brain disease?
  • How to deal with pain?
  • What are strategies for dealing with potential or actual financial elder abuse?

The interview is 30 minutes.

How do you manage family gatherings when someone has dementia?

The holidays are coming. We all look forward to the feasts and family time. But what if you have a parent, elder or loved one who is struggling with the beginnings of dementia? What if you return to your family home and realize that Mom or Dad can no longer manage their affairs? How do you manage family gatherings when someone has dementia? Here are some things to keep in mind to make holiday gatherings the best that they can be.

  • If you live far from your loved ones, don't be surprised if your regular phone calls home haven't given you an accurate picture of your elder's situation. With the passage of time, elders can become more frail. Day-to-day changes may be gradual. Keep an eye out for warning signs. Things may have changed with family since you last saw them.
  • Early signs of cognitive decline include: more forgetfulness, often with appointments, or taking medications, or paying bills; also changes in personality, such as getting more angry about small things, becoming more apathetic, not wanting to go to activities previously enjoyed, may be more suspicious, making up explanations of why they are losing items.
  • If an elder is slipping, that doesn't mean that life has to stop. Elders with dementia can still enjoy life. Focus on activities that are stimulating, but not overwhelming. What does your loved one like to do? We say “What makes life worth living?” Whatever your elder's answer is, do more of that as possible. You can still go out to the ball game, but if finances permit, get a box seat away from the crowds and or go early, have snacks and avoid alcohol. Think of simpler alternatives, if the hubbub of the restaurant causes agitation; how about a picnic in a quiet park? Or in the back yard?
  • Exercise can play a huge role in decreasing the risk of progression or decline. Some studies show that exercise can decrease the risk of dementia or progression by about 40%. Physical activity can also decrease restlessness and sleeplessness. Walking in the park is almost always a winner.
  • If your elder is agitated, avoid “anti-anxiety” pills, except for emergencies. No elder with dementia should take a tranquilizer such as Xanax/Alprazolam; it is short-acting and very addictive. These medications may be very calming at first, but may actually lead to more agitation in the long run. This is also true of alcohol. Minimize alcohol at family gatherings, or water it down for elders with agitation. Try non-alcoholic beer. If you're concerned about tranquilizers or alcohol, remember that they can't be stopped abruptly. If you think there's a problem, keep in mind that it needs to be solved gradually.
  • Remember that large gatherings can be challenging for those with dementia. Don’t expect a loved one who cannot sit for long at a restaurant to be able to manage with everyone. Perhaps your elder can join for part of the festivities, and then rest in an adjoining room on the side, where guests can visit for twenty minutes. If your elder gets upset, it may be time for them to go home.

Rituals, families, feasts; these are what make life more meaningful. Dementia doesn't put an end to enjoying these things. Small changes can make the holidays happier for all.
Please send any questions or comments to the Community Chat page on our web site- just click on the button on the top right that says “Ask A Question” And Happy Holidays!

Elizabeth Landsverk, MD
Geriatric Specialist

Better Health Pharmacy now open 40 hours weekly

The Santa Clara County Better Health Pharmacy is providing a very innovative service receiving donated medications to distribute to low income patients. There is a crisis with the cost of needed medications. The view of the patient primarily as a revenue source is of great concern. Medications such as Flonase for treatment of allergic symptoms is available over the counter for $16, and the same medication, an old steroid preparation, but life saving for asthma treatment, is no longer available in the low cost generic preparation, but is $60-80. The epinephrine pen (EpiPen) lifesaving for severe allergic reactions was $10 then $100 then $600. There is a black market for diabetic testing strips. We might look to other countries that see the health of citizens not as profit opportunities, but as a service for the good of the country. This pharmacy is making a big difference for all of their patients providing no cost medications to those who need them. Information below:

Better Health Pharmacy is proud to announce that we are now open 40 hours weekly! Our pharmacists are also available during those hours to take your prescription orders and to answer any questions you may have at our MD line: 408-794-0565 (this telephone number not to be given to patients).

Our pharmacy is the first and only dedicated surplus drug redistribution program in California. We receive unused, unopened, and unexpired medications from licensed healthcare facilities, and dispense the medications at no cost to patients who have a valid prescription. Our pharmacy aims to improve health by increasing medication access for all and serves patients who cannot afford their medications.

Some important points to know about Better Health Pharmacy:

Address/Public Phone:

725 E. Santa Clara Street #202.
San Jose, CA 95112

New hours of operations:

Tuesday – Friday: 10.30am – 7pm
Saturday: 8.30am – 5pm
Sunday & Monday: Closed

Better Health Pharmacy is also closed on all county-observed holidays.

See list here:

Caring for Elders: Tips for Managing Pain

Caring for Elders: Tips for Managing Pain

By Elizabeth Landsverk, MD

Older adults are more likely to experience pain than the general population but they may be less likely to be treated for it. The most common reason that pain in elders is under treated is that it is under reported. Many elders consider pain a natural consequence of aging – something they just have to live with – and don't report it to their doctors. Untreated chronic pain puts a great deal of stress on the body and on the individual's emotional health as well. It can lead to depression, anxiety, reduced mobility and strength, and loss of appetite and sleep.