GLP-1's in Demetia Patients

SyndelFuego

Hello Everyone,

Itws been quite a while since I"ve posted and been around. I have some things I'd like some advice on from our community.

My Dad started this journey about 2 years ago and it has only become more complex and complicated. He has a myriad of health issues so I wont get into all of them, but with his Demetia its a bit of a "crap-shot" pardon my phrasing. He was initally diagoned with solely Alzheimer's but with each new physical or emotional symptom it grew. He was then told he has symptoms of every form of Demetia - ALzheimers, Lewy Body and Frontotemporal Demetia (FTD). Over time he became agressive and agry towards my Mom and I. He got upset of we mentioned his contstant eating (A result of FTD) aand he'd slam the cupboad doors or the frigerator and sometimes toss silverware across the coutertops. He is on about 4 different medications for the Alzheimers/Dementia which all have a few not very pleasant side effects. One of which was the agression, He was put on an antipsychotic (Toperamate -sp?)which has the side effect of possible weight loss. Well, it worked for a long while, but he had maxed out his dose.
He had lost roughly 20 lbs while on the med, but the agresiveness was getting worse.

The Neurologist decided to ween him off the toperamamte and told us to go see his PCP and have him put my dad on a weight loss drug. We finally did get him into his PCP and he did put him on Rybelsus, but at the same time we also were finally told that he's become diabetic. We should have been told back in april when it was first seen that his A1C was around 7. He was on the 3mg dose of Rybelsus until two days ago, now he is on a 7mg. This is Midlevel dose and we shoudl start seeing the med do its job now.

Here's my concern, which my Mom has brushed aside and keeps telling me to let the Neurologist do his job. For those unaware with the FTD part of Demetia many people dont remember the what, when, were and how much they've eaten at any point in the day. This especially holds true for my Dad. Even barely an hour after having any meal of the day he is "ghosting" the kitchen, searching throught cupboards, the pantry and even the fridge. When we try to casually mention that he just ate a really decent meal, he obviously doesnt remember, and gets upset wheh we remind him of the meal he recently ate, ask him to leave the ktichen or when he is caught eating. This happens around the clock and he is more agressive toward us and has even spoke back to my aunt to the point she wont even get involved when we try to help him amymore.

Has anyone else gone through something like this and what more can be done to mitigate this and help get the peace back in the house? It gotten the tension and stress keeping me on edge. 😔

SDianeL

if your Dad has anxiety he needs to be on anti anti psychotic medication. I found that a Geriatric Psychiatrist was the best doctor to prescribe anti psychotic meds. I would ask for a referral to one. Regarding the eating, it’s very common, many crave sweets. I doubt the weight loss drug will do anything for someone with dementia. I would not mention his eating to your Dad. His memory is gone and you can’t reason with someone whose reasoner is broken. My DH was diabetic and also wanted to eat all the time. I put locks on the cabinets and fridge and bought healthy snacks and put them in the pantry where he always went. I put small amounts of healthy snacks out in small bowls. I bought high protein Splenda shakes and would offer him one if he started walking in to the kitchen. Gave it to him with a straw to slow down the drinking. There are triggers for behaviors in dementia. Can you close off the kitchen? Also try redirection or distractions. This is a tough behavior to control.

Quilting brings calm

Given all his various health conditions, along with mixed dementia, it might be time to stop extreme focus on his weight. You might have heard people say ‘ dad is on his 80s, let him eat whatever he wants. I realize you didn’t mention his age though.

I suggest not mentioning his weight or the amount of food he is eating to him. He no longer understands or remembers logical discussion. Instead: keep healthier options in plain sight -such as a bowl of uncut fruit, protein bars, trail mix, etc. He might gravitate toward that rather than looking through cabinets. Keep healthy options at the front of the refrigerator, treats at the back. Limit the amount of treats that are bought for home consumption. Substitute a trip through a drive through for occasional treat meals. Reduce the amount of food at each meal since he ‘ will be eating again in an hour’.

He has a terminal disease ( dementia). Discuss with his doctor just exactly how much damage diabetes is likely to do in the amount of time he actually has left. FYI; A1C of 7 is actually decent for someone that has diabetes.

tboard

My mother had FLD and she ate often and would forget that she ate. All we could do it limit her access to food. Not easy but easier once she went to memory care. My DH had dementia and when he forgets that he ate I take it as a signal that he is till hungry. I give him a snack and he is fine after that.

harshedbuzz

@SyndelFuego

This sounds hard. Are you still living with your parents? As an adult child, you are absolutely a stakeholder in the well-being of your parents individually. This is doubly so if you're still living there or are being called in to manage behaviors.

In your shoes, I would get dad in to see a geriatric psychiatrist will have the most training and experiencing in prescribing powerful psychoactive medications safely while managing factors like age, diabetes, stage of the disease, and safety in the home. There will likely be trade-offs.

Is his neurologist a dementia specialist because the idea of turfing an agitated PWD to a PCP for weight management seems odd. Do you attend all his appointments or is this being filtered through mom?

As an adult child, I found that often my mom— the non-dementia parent— was a part of the problem. She was from a generation who did not question doctors and often got marginal car as a result. I also found that she was resentful/in denial/reluctant around taking control of certain situations related to dad to avoid upsetting him even when it compromised safety issues.

If dad is progressing into the later stages of the disease, strict A1C control might not be as valuable as it would be in a younger and otherwise healthy person.

HB