Trying to Make Sense of It

I just got off the phone with my dad's geriatric doctor. I figured if I write down all my thoughts right now, chances are that I would remember more of the conversation. She said it is her feeling, and that of the consulting doctor, that my dad's lack of motivation is being caused by his dementia and not his depression. I can understand that, but it doesn't change my opinion about the need to increase his depression medication.

I told her that I understood her reasoning. However, given that my dad cannot take Aricept because of his past bleeding ulcer issues, and they won't give him Numenda because that's only prescribed in cases of severe dementia (that's correct - that's what she said), I think that a slight increase in his depression medicine might give him some added motivation and wouldn't it be worth a try?

Ruling out Aricept and Numenda rules out the popular Alzheimer's/dementia medication that I'm aware exist. In fact, Tracy's mom is on both of those and I don't consider her dementia to be severe. Maybe I just don't know enough yet about the illness or even the differences between Alzheimer's and dementia.

If I compare Blanche's behavior to my dad's, it's hard for me to see the similarities. Blanche has bouts of paranoia, she makes things up, and she forgets everything a minute after it happens. My dad has not exhibited any paranoia, but he does seem to forget everything a minute after it happens. He does make things up, but not in the same way Blanche does. She tells us of visits she's had recently with her husband, who has been dead for six years. My dad just seems to think he's doing things like he used to do. It's very confusing, but I guess if I re-examine what I just wrote, my dad and Blanche do exhibit similar behavior...

Well, as I was writing, the doctor called back. Hard to believe! She actually gave me a referral to an experimental study that is ongoing at Yale University's Department of Psychiatry. It's an Alzheimer's/dementia study. I think it might be the same study that Tracy and her grandmother participated in when her grandmother was about 95 years old in 2004 or 2005. If I remember correctly, they went to Yale periodically and participated in testing. There were some instances where Tracy's grandmother actually tested better than Tracy did! I better check with her on that to make sure I'm not making that up!

And she then said that if we choose not to participate in the study, or if we do participate and it doesn't seem to help, then they'll bump up the depression medication! After all that. She also said if they do bump it up and it doesn't seem to make a difference, they can always reduce it. That seems to make sense to me, but I still don't get what harm there is in bumping it up now. I think I want to believe the increased medication will help, when I'm hearing these doctors say it won't because my dad is like he is because of the dementia, not the depression. I think we still have to try.

So, we're going to see my dad's primary care doctor tomorrow. I'll do some research on this study at Yale before then and see if I think we can do it. Then I may just tell the doctor tomorrow to tell the geriatric doctor that we want to go ahead and increase the depression medication.