Around 70% of patients with dementia cannot manage their medications independently: some forget to take them, while others accidentally overdose. Zhibek Zholdasova, head of the Center for the Treatment of Neuroses and Alzheimer's Disease, explained how to organize treatment, reports infohub.kz.
"There are two extremes if you let the patient take medications on their own. The first extreme is that medications will be forgotten and skipped, so there will be no effect. The second extreme is overdose. Due to forgetfulness, the patient takes the medication several times. Therefore, it is important that one of the relatives or caregivers controls the medication intake," the doctor explains.
According to her, as long as the patient understands the situation, a pill organizer can be used. This is a weekly box with compartments for three or four times a day: morning, lunch, evening, and bedtime. Once a week, the caregiver, together with the patient, sorts all medications for the entire week into this pill organizer. For several more years, the whole family, including the patient, will see what has been taken and what has been missed. No other medications should be given directly to the patient.
However, if the person gets confused even with the pill organizer, then a specific caregiver should dispense the medications. Again, no medications should be left with the patient.
"There are cases when the patient constantly begs for medications. For such people, you need to find empty vials from various medications and fill them with placebo, that is, dummy pills. For example, Tic Tac mints are perfect for this. They come in different colors, can be placed in several vials and labeled, conditionally 'for blood pressure,' 'for joints,' 'for pain,' and so on," the doctor explains, noting that the main intake of real medications continues to be controlled by the caregiver.
In other cases, according to Zholdasova, patients start to be cunning and spit out pills under the mattress, under furniture, into pockets, into the trash, and into the toilet. She advises checking all places and always being present on time when the patient takes medications to make sure they swallow them.
"If there is also a problem with swallowing, you can crush the pills and give them with food. Or for such patients, other forms of medications are available – liquid and patches," the doctor says.
According to Zholdasova, starting dementia treatment at a mild stage reduces the chances of placement in a nursing home, disability home, or hiring a caregiver by 57%.
"This means that a patient with dementia continues to fit into the family's general routine, takes care of themselves, and mental complications are minimized. With supportive treatment, the patient will be able to care for themselves for several more years compared to those who do not receive medications," she explains.
The doctor explained that in Kazakhstan there are two medications for treating dementias – donepezil and memantine. Both can be obtained free of charge at a polyclinic by prescription.
Earlier, Zholdasova listed the most common misconceptions about antidepressants.