I went to see my dad in Tampa yesterday.  His health has degraded tremendously at his Assisted Care Facility.  I’m saddened to see how much worse he has gotten since he first went into the home only five months ago.  I sat down and talked with one of the care givers and she gave me a list of his medication.  He is on the following drugs:

Mirtazaphine 7.5 mg (antidepressant),

Olanzapine 10 mg (antipsychotic, schizophrenia and bipolar disorder),

Depakote ER 500 mg (seizure disorders, mental/mood conditions such as manic phase of bipolar disorder),

lorazepam 1 mg (anti-anxiety),

memantine 10 mg (Alzheimer’s disease),

donepezil 10 mg (Alzheimer’s disease),

enalapril 10 mg (high blood pressure, diabetic kidney disease, and heart failure),

hydrochlorothiazide12.5 mg (high blood pressure),

vitamin d3(fat-soluble secosteroids responsible for increasing intestinal absorption of calcium, magnesium, and phosphate, and multiple other biological effects)

This seems excessive to me.  I’m not a doctor but I don’t have to be a genius to see this list and say, damn that is a lot of medicine.  It seems like too much.  He was so drugged up when I saw him that he could barely keep his eyes open, barley walk and barely talk.  He lost a lot of weight.  We took him to Panera Bread so we could visit outside of the home.  He was passing in and out in the car.  It was difficult to get him out of the car and in the restaurant.  I had to pick up each foot to put them on the ground and then hold his hands and pull him out of the car.  I brace myself into a deep lunge and put his arm around me to get him to step up onto the curb.  I walk him to a table and he shuffles his feet about 2 inches at a time along the ground.  We ordered him a soup.  His hand couldn’t find the spoon and I had to help make sure he didn’t stick his whole hand in the soup.  I hand him the spoon and he takes about three bites.  Then he passes out again.  I tried to put him down on the bench to nap but he was physically stuck and couldn’t lie down.  I kept him sitting up.  My mom gave him water with a straw and he barely sucks up the water.  He is so weak.  I rub his back and his head and he responds positively to the touch.  He tries to whisper weakly to me but nothing he says makes sense.  He wants to say something but he can’t.  I ask him questions and he responds yes or no.  I’m confused because he understands me.

We stop at Safety Harbor Resort to see if we can visit with him there and try to take him to the bathroom.  I drive up to the valet and he can’t get out of the car.  They run to get him a wheel chair and the valet’s help to get him out of the car.  I park and go in.  My mom is trying to get him to go to the bathroom but he won’t go on his own.  He walks up to the toilet, messes with his pants and then walks out.  We walk into the men’s room tell him like 10 times to go to the bathroom.  We try to help but he won’t.  He plays with the lock or just waits on the other side of the door.  Another man tries to help him to no avail.  We sit him in the lobby and he sits for a few minutes and then he wants to get up.  He won’t stay put.  He asks me if I have any money.  Why does he ask about this I wonder?  We walk down a hotel lobby because he likes to walk.  He looks like he wants to pee in a corner so I hurry to take him outside.  He won’t pee outside either.  The drugs are wearing off and he is more conscious.  We stop at Walgreens and my mom buys my brother some groceries.  While we are parked I do some of my Assisted Thai Yoga on his neck and arms.  I press my thumb up and down his forearms and squeeze his biceps and triceps.  I also bend his fingers back and forth to stretch his hands and wrists.  He likes it but I have to be gentle.  He kisses my head.  He recognizes me.  I ask him, “dad, are you ok?  Are they being nice to you at the home?  Do you want to come home?”.  He tries to answer but he can’t.  We stop by my brothers house to drop off the groceries and I take my dad for a walk.  He wants to walk, all the time.  He actually has non-stop movement.  When he has come to my house he shuffles around the entire time and would walk out of the house and get lost.  I’m sure that is why the home has him on so many drugs.  He is having incontinence.  On our walk he poops in his depends and he doesn’t tell me but I can tell because he reaches to touch the back of his pants and it smells.  We go about three blocks of shuffling and my mom is right there to pick us up.  He is too weak to go far but I take him and try.  We used my moms walker the whole time.  He looks so broken down that everywhere we go people come over and offer to help and ask if everything is ok.  It breaks my heart to see him like this but what can I do.  We take him back to the home for them to help change his diapers.

I talk to the care giver and ask her to reduce his medicine.  We need to give the home a power of attorney because they don’t have one.  My mom said she gave them one so I don’t understand.  I get to talk to a nurse practitioner who agrees to reduce the drugs that she has him on.  The psychiatrist has him on different drugs including the schizophrenia drugs but she is not in because of Memorial Day holiday.  I tell the care giver that I want the psychiatrist to reduced or eliminate the other drugs.  I was surprised that he was even on them.  I didn’t even know that Alzheimer’s and schizophrenia may be related.  The only symptom that I noticed was that he has disorganized speech.  He is so drugged up that how can I possibly tell if he has a mental disorder or if it is the drugs affecting his behavior.  I know my dad was getting violent with diaper changes.  I can only imagine the humility he must feel to have to have someone else change his diapers.  I’m sure the medicine is to help curb some of this behavior.  It’s just sad.  He was so much healthier before.  Were the nurses always gentle with him for diaper changes?  I don’t know.  I have been trying to move my dad to an Assisted Care Facility in Clermont but the first home denied him because he was on too much medication.  He got interviewed at a second home and is on a wait list to get into this home.  My only other option is to bring him home and my hesitation is that I still have to work and I need help.  I could hire someone but that is only for one shift.  If he is at home then it’s 24 hours.  I feel frustrated.  I don’t know what to do.  I don’t know what is the best care for him.  I’m a single mom already taking care of my mother who is sick with Parkinson’s and a 4 and 6 year old.  All I can do for now is wait for him to get into the home closer and keep applying to the other homes in the area.  If he is in the area then he can come home and visit at least.  Alzheimer’s is the worst disease.  I never understood how tough it is until now.  I do have a calmness that I never had before about his illness because I’ve been doing a lot of research on death.  I’m not as scared as I used to be and I feel prepared.  I want him to be in the best situation for him during his time earthside.  My mom was originally going to live with my brother in Tampa but she wants to stay with me because she loves my kids and because I work more part time where my brother is more full time.  Now that I know she wants to stay with me, I think it is best for him to be close to her.  My mom misses him and I’m sure she misses him.  Hopefully I can get him moved soon.  Peace out my friends.  If you know someone with Alzheimer’s then I send you and your loved one lots of love and prayers.  My heart feels so much compassion for victims and their families for this illness.  Much love!