The Professional Geriatric Care Manager’s Blog

Pseudo-dementia

As most of you know I have frequently talked about how adverse medication reactions can cause lots of problem in older adults.  This is particularly true because often times the older adult’s kidneys and liver do not work as well as when they were younger and the drugs are not metabolized as quickly.

I have an interesting experience I’d like to share with you about my favorite Client, my dad.  Many of you are aware of the fact that my mother died in March of this year.  My parents were married for over 60 years and my father has taken her death extremely hard.  Most recently he had been complaining to me that he has been feeling “fuzzy” around the edges.  As someone who suffers from depression, I can tell you with certainty that fuzziness is a symptom of depression.  I hate depression and even though it’s to be expected during the grieving process I was concerned enough about my father to consult with his geriatrician and get him started on an antidepressant.

My father suffers from dual dementia, he has both Alzheimer’s disease and vascular dementia.  He is relatively high functioning and is taking Aricept and Namenda to slow the progression of these diseases.  He takes other medication for his blood pressure and cholesterol as well.

Well, I picked up the new medication and filled his mediminders.  Day one of the new medication was uneventful.  Day two, my father seemed increasingly confused.  He could not subtract 20 dollars from his checking account balance. (I handle most of his finances, but he has always been able to handle small checks for even amounts.)  He did not answer the phone when I called him…after checking on him he indicated that he heard the phone, but didn’t know what to do with the phone.

Oh-oh!  What happened to Dad???  Luckily as a nurse the first thing I suspected was a drug interaction!  I called the doctor and let him know that I was discontinuing the medication.  On top of the two dementias he really has, he was experiencing a pseudo-dementia.  It took two days but he is back to his baseline now…still not perfect, but he can subtract even amounts and knows what to do with the phone again!

One of the things we do at Distinctive Care Geriatric Care Management as part of our initial assessment process is a complete medication review to determine if there are any drug interactions the family should be aware of that could potentially be exhibiting as signs of dementia and should be investigated.  We also do medication management for our Clients, monitoring for adverse side effects, especially when starting on a new medication.

Distinctive Care Geriatric Care Management serves Bergen and surrounding counties.  If you are interested in finding out more about the medications your loved one is taking contact us for a medication review at any of our 3 locations, in Ridgewood, Tenafly and Dumont by calling our main office at 201-587-5283.