Geriactic Doctor - Any Recommendations?

[lovetotravel]

My mother is 90 and has dementia/alzheimers. So far, she has been pretty easy to deal with. But she has turned aggressive. She has recently bit my MIL, thew water on my wife, tried to kick and hit her caregiver, threw the dog and put it in the hospital, etc. She is just mean and nasty now. The maid wants to quit. So does my wife!

My neighbor is an MD, works for the government and kinda specializes in geriactics. His wife runs a nursing home near Sattahip. I met them last year and he said he knew of no MD in Thailand who specialized in geriactics. I went to visit a doc who use to work at BKK Pattaya hospital who now has a private clinic, and he recommended some bs chinese herbs as well as meds which are on the BEERS list. Pretty bad.

I would like to know if anybody has any experiences in this area. I am in desperate need. Would love to find an MD who has at least a bit of experience in this field.

A sincere thanks in advance

[Sheryl]

The following doctor specializes in Alzheimers and dementia and is quite good. he is at Bumrungrad in Bkk:

http://www.bumrungrad.com/doctors/Ketchai-Suavansri

I should warn that there is a limit to what can be done for this. but there are medications that can at least control the violent symptoms and make her easier to care for.

[lovetotravel]

Thanks! I would rather not resort to meds, but she is starting to get out of control. And for a 90 year old lady, she is incredibly strong. The MIL is a bit afraid right now for her own safety. Something needs to be done. I will setup an appt and report back how it went.

Thanks!!

[Sheryl]

From what you describe, no choice but meds. It may take some time to find the best ones and best dosages, so be prepared for that and don't get discouraged if the first attempts either don't work or knock her out to much. The doctor will adjust until the right one is found.

[lovetotravel]

Quick update. Visited this doc yesterday. What a nice man. Perfect English also. And a musician! 55555

His knowledge of Alzheimers is very good. I've been dealing with dementia issues for years, so have visited a bunch of docs in the US. This guy is as good, or better, than any I've met. Thanks so much for the recommendation. He does remember talking to you a few times.

The drugs he recommended are:

Risperdal Quicklet, .5mg, to be used only as needed.

Ebixa (Namenda), 1/2 10mg tab 2 times after breakfast and dinner

Seroquel, .5 up to 1.5 tablets 1 time at bedtime

I'm pretty happy with the first, but a bit concerned for the others. Mom is in the 7th stage of Alzheimers. Even he admits not much help may be achieved from Namenda. The last one is to help with hallucinations at night and to help her sleep. As you know, meds like this can be dangerous for older people. perhaps making them more susceptible to falls. We'll give the last 2 a try, but not sure how it will go.

We have a meeting with him in one month for a followup.

Again, thanks so much for the recommendation.

[Sheryl]

Glad you liked him, I was also very impressed.

As mentioned with meds it is somewhat trial and error. It normally takes several adjustments to get it right and even then needs may change over time. But now you have a good specialist in your corner to help with it.

Be patient and don't despair if the first few attempts don't work. Individuals really differ in how they respond to drugs and cannot totally predict in advance especially with these types of meds.

One other thing you can try, if you can get her to take it, is coconut oil. It contains medium chain triglycerides (MCTs) or ketones which for reasons not well understood appear to have some beneficial effect in people with Alzheimers. In the West there is now a drug (a "nutriceutical" actually) called Axona consisting of MCTs approved for use in Alzheimers, but it is not available in Thailand. Because it is marketed as a "medicinal food" rather than a drug it never went through Phase III clinical trials, only Phase I and II but results of those were encouraging. There is another study now underway at the Univ of So. Florida but results will not be in for a few years. Meanwhile nothing to lose by trying - only side effect (other than weight gain, not usuall yan issue with AD pts!) is possible GI upset. Suggested dosage is 4-5 tablespoons daily i.e. about 60-75 cc (can divide into 2 doses if you like). Like most things it has mainly been used for people with mild to moderate AD, but no harm in trying with your Mom. Give it say a week or two, if it is going to do any good it would do so by then, if nothing then stop.

To avoid confusing matters you might want to wait until the other meds have been sorted out, otherwise you won't know what is responsible for what.