Chapter 42: Medications for DementiaTest BankMULTIPLE CHOICE1.A patient is identified as having stage 2 Alzheimer’s disease and elects to take donepezil (Aricept). The patient asks the primary care nurse practitioner (NP) how long the medication will be needed. The NP should tell the patient that donepezil must be taken:a.until symptoms improve.b.indefinitely because it is not curative.c.for 24 weeks, which is when cognitive function improves in most patients.d.until symptoms worsen, when a switch to memantine (Namenda) will be needed.ANS: BCholinesterase (ChE) inhibitor drugs such as donepezil diminish symptoms; when the drug is stopped, the symptoms return. Cognitive function will show improvement at about 24 weeks, but the drug must be continued indefinitely.DIF:Cognitive Level: Understanding (Comprehension)REF:4592.A patient who has Alzheimer’s disease has been taking donepezil for 1 year. The patient’s spouse reports a worsening of symptoms. The primary care NP should consider:Memantine hydrochloride can be added to therapy when symptoms worsen. Ginkgo biloba may be useful but is not recommended as adjunct therapy. Antidepressants given to patients
Today, I’m happy to share a guest post from author Kathleen H. Wheeler. Wheeler’s new book, Brought To Our Senses, is a fictional work that explores the importance of family and forgiveness when facing dementia.
The novel tackles the impact a messy divorce has on a family, how Alzheimer’s affects already tenuous relationships, and the excruciating journey to obtaining legal guardianship.
Wheeler writes from her own experience as a young sandwich generation caregiver in the mid 1990’s. These days, she characterizes her life in terms of BA (before Alzheimer’s) and AA (after Alzheimer’s), terms I’ve often used myself. Those of us who have traveled this road know that to say it’s a life-changing experience is an understatement.
Please join me in thanking Kathleen for being with us to share her story.
A Guest Post by Kathleen H. Wheeler
Why choose Alzheimer’s as the focus of my new family saga novel Brought To Our Senses?
It’s a fair question. After all, Alzheimer’s is argued to be the disease feared most of all. The mind-robbing illness has a bad reputation and a stigma stifling discussion in mixed company. So why exactly would I tackle such a difficult subject, one so many avoid altogether or shrug off as hopeless?
The answer is simple: Alzheimer’s has transformed my life, an existence now measured in two distinct periods of time: BA and AA. “Before Alzheimer’s” was my life until 1996 when dementia came calling for my mother with a vengeance. She was only 62, and I was 30 with a newborn daughter at home. “After Alzheimer’s” is the last twenty years I’ve spent raising two children and dealing with my mother’s diagnosis, decline, and death from this monster.
My mother passed away in 2009 but dementia lingers like the familiar nightmare waking me in a panic and cold sweat. I’ve never faced anything more difficult or devastating in my life. Like it or not, Alzheimer’s has wormed its way into my present and future thanks to genetics. I am susceptible, as are my siblings and children, and this reality drives my waking hours and efforts.
For raising awareness through my story, I was recently recognized as an Alzheimer’s advocate by the Greater Illinois Chapter of the Alzheimer’s Association during the opening ceremony of the Walk to End Alzheimer’s on September 24, 2016. It was a humbling event. So many people work to raise awareness, to change policies and attitudes, to provide support and hope that my efforts seem small by comparison.
While some see my efforts as selfless, my motives are equally selfish because I advocate on my own behalf and that of my family. With all of our futures at stake, doing nothing is inconceivable. I desperately want a cure for dementia so that my children and their generation will never experience the devastation my siblings and I have witnessed. No one, whether age 85 or 40, should suffer through the tortured course of dementia.
That’s why I wrote Brought To Our Senses, and I had three goals for my book.
1 The Story: First and foremost, I wanted to tell a compelling story, one that just sucks you in from the get go. I’ve been drawn to reading and writing since I was a kid and have always wanted to write a novel. Once I grasped the premise for my book and realized what a great story it was, I just couldn’t let it go. I had to write it.
2 Build Awareness: I wanted to share the reality of the illness, from before a person is afflicted through the bitter end, and I wanted to emphasize the importance of strong family relationships to get through such an ordeal.
3 Give Back: Finally, I wanted to do something positive for the community, something that would help others struggling with the difficulties of dementia. For each copy of my book sold, I’m donating to organizations that support dementia patients, family caregivers, and research to find a cure.
I’m excited to share my book with the world and hope it will provide hope and inspiration to those touched by dementia. I’m never going back to the time “Before Alzheimer’s” and plan to look ahead and work toward a world without Alzheimer’s instead. It’s the ultimate goal for all of us who have lost a loved one to this disease.
About the Author:
Kathleen H. Wheeler, author of the debut novel Brought To Our Senses, writes stories that sing because she cannot. A graduate of the University of Illinois, she has wordsmithed as a marketing communications professional for ad agencies and corporations since Nike first coined the slogan “Just Do It.” Wheeler is a music enthusiast and lifelong fan of a British musician known by a one-syllable nickname. Along with her husband and two children, she calls the Land of Lincoln home.
Look for Kathleen on Twitter and Facebook, and be sure to check out her blog!
Elizabeth Miller discovers that aging parents are a family affair when her divorced mother receives a deadly diagnosis and becomes a volatile patient. Forced to work with siblings at odds through the crisis, she learns when all is lost, family begs to be found.
Brought To Our Senses (Attunement Publishing, released November 1, 2016, paperback $16, ebook $9.99) is available now from all major online retailers. For more information, visit www.BroughtToOurSenses.com.