Dementia test

What if an Elder Resists Treatment?

One of the most common complaints I encounter doing elder care house calls is this: “My—father/mother/aunt/uncle/grandmother—will not cooperate with care. We’re just trying to help, and our loved one fights us every step of the way!” There are so many reasons that the elderly may resist treatment: anxiety, delusions, frustration, old resentments, a desire for control. I could easily write a book on this topic alone.

elder stress

But one of my key findings is that, for us as family members and elder care practitioners, it’s easy for us to overlook two simple causes for an elder's resistance to treatment: low-level pain and a lack of pleasure in life.

Often, I try two simple solutions before looking for deeper causes:

• I prescribe 500 mg of Tylenol, three times a day. It’s amazing how much more cooperative people become when they’re not constantly burdened by arthritis, headaches, or other ignored pains they may be suffering.

• I prescribe ice cream. One of the difficult realities of growing older and of suffering from dementia is that it’s easy to go days and days without feeling pleasure or joy in life. Elders may lack the mobility or cognitive ability to participate in activities they once enjoyed, whether that’s bridge, golf, reading or needlework. But everyone, even the most frail and ill among us, can enjoy a dish of ice cream. There are even delicious ice creams for diabetics.

Of course, if these simple measures don’t work, more investigation is in order. But as a geriatric specialist, I’ve found that the power of simple over-the-counter painkillers and ice cream is undeniable. Let's allow our care practices to reflect our compassion.

Elizabeth Landsverk, M.D. Specialist in Geriatrics, ElderConsult Geriatric Medicine

Join us this Thursday Oct. 17th 3:00-5:00 in Daly City

Please join us as Dr. Landsverk speaks at Peninsula del Rey on the topic of: Ask The Expert: How to Achieve Peak Performance by Maintaining a Healthy Lifestyle Thursday October 17th

Peninsula del Rey 156 Pierce Street Daly City

3:00-5:00 PM

Please RSVP to reserve your seat at 650-741-1564

Flyer: SR-PD_807x11-SFexam-Expert-Oct13

"Alzheimer's Awareness" Seminar Thursday October 10th in Palo Alto 5:00-7:00 PM

Care Indeed, in collaboration with the Alzheimer's Association and Avenidas Village is hosting a free seminar on Alzheimer's Awareness this Thursday. Please join us for Dr. Elizabeth Landsverk's keynote speech on "What Is Alzheimer's?". Also speaking will be Memory Specialist Beth Corwin on the topic of How Activities Help To Preserve Memory, and Mercedes Roces on the Role of Geriatric Care Managers. Admission is free. Please RSVP to Aprylr@careindeed.com or (650) 328-1001. We look forward to seeing you on Thursday.photo3

Are New Meds Necessarily Better Meds?

Woman with pillsDoctors are people too. And like all people, doctors find themselves attracted to the newest and shiniest things. This goes for medicines, too. We doctors like to use the latest drugs. However, in my geriatric house calls practice, I’ve found that the newest meds don’t always work the best in older dementia patients. For instance, I frequently have to take patients off new antidepressants like Effexor or Cymbalta. Whenever possible, I like to rely on older medications that have been studied and used for at least a decade or more. Of course, I can’t diagnose anyone from afar. But I’ve had great luck in treating patients with Celexa/Citalopram, one of the oldest antidepressants on the market.

Look for a medical center or a medical school with a robust geriatrics department. The doctors there will know about how psychiatric drugs may effect the elderly.

Despite reports that some psychoactive meds only work 20 percent of the time, I have found that, when used properly, these medications can improve patients’ lives more than 90 percent of the time.

Check our Medications section on the ElderConsult website. And, of course, consult your own doctor.

Elizabeth Landsverk, MD

Board Certified in Internal Medicine, Geriatrics and Palliative Care Medicine

ElderConsult Geriatric Medicine, a House calls practice