Questions to Ask when Considering Psychotropic Medication for Someone with Dementia
Personality and behavioral changes caused by dementia can be challenging for the people who provide care. Medications may be able to help alleviate the symptoms. It’s important to ask questions and understand how the medications work before deciding to try them.
- What problems are you having with the person with dementia that you are trying to relieve?
- Is this patient posing a danger to themselves, staff or other residents/patients?
- What are the possible treatment options for these problems?
- Have all other causes been ruled out that may be causing these problems like infections or side effects from current medications?
- Who can help me understand non-medication ways to relieve these problems?
- What is this medicine for? How will it help? How does it work?
- If the medication is an anti-psychotic, why there is a “black box” warning about giving this medication to someone who is elderly?
- If a doctor refuses to give a medicine due to a “black box” warning, ask about other choices. What alternative treatments are there for this behavior/problem?
- Is this medication recommended for a person with this kind of dementia? (Different medications work best with different types of dementia.)
- Is this medication covered by insurance? How much is the monthly cost for it? Are there programs to help with the cost? Does the patient’s health insurance have this medication on their drug formulary? Is there a difference in the generic and name brand forms of this medication?
- What are the side effects I should be watching out for? What are the risks?
- Does this medicine have any interaction problems with any of the other medications the patient is taking?
- Are there any dietary restrictions I should know about for someone taking this medication? Are there other restrictions to be aware of, such as limiting sunlight? Are there any complications if combined with alcohol? Does it cause weight gain?
- Does it need to be given on an empty stomach or with food?
Monitoring the Medication
- How long does it take for it to take effect? How will I know if it is working? I understand that the medication’s effectiveness varies depending on the person. How do you decide which one to prescribe?
- Will you start with a small dose and increase it gradually or start with a full dose? Why or why not?
- If the medication works for a while and then stops working, what are the next steps? Should we increase the dose or change the medication? What are the alternatives?
- If the medicine does not work, does the patient have to be weaned off it or can I just stop giving it?
Administering the Medication
- What if the person with dementia won’t take it every day? Does it work if not taken consistently? What if they are reluctant to take any medication and think that pills are being given to poison them? What if they consistently hide the pill under their tongue?
- What should I tell the patient the medicine is for? If they hear it is for depression or anxiety, they may not understand the reason they are taking it.
- The person with dementia has trouble swallowing pills. Does this medication come in any other form, such as liquid, suppositories or patches? Are there long acting varieties? Or is it better to dose several times during the day?
- Does it matter what time of day the medicine is given? If it is for sundowning, should it be given in the afternoon? If it is for sleep, should it be given only at night? I want to keep the person as alert as possible during the day. If the medicine makes them sleepy, even if it is not for sleep, what time should I give it to them?