When Dad was first diagnosed with Alzheimer’ s his doctor recommended the usual medications, such as Exelon and Aricept, which I gather are still common, now deliverable via patches, which is probably a great boon for some. But Dad had a severe physical reaction to these meds–immediate cold sweats, trembling, nausea, and vomiting.
We kept trying to persuade him that the side effects would diminish if he could just stay with the meds for a little while, but that did not seem to sink in. Now, Dad has never liked anyone to tell him what to do in the first place, and that he was being “told” to take these meds that made him instantly ill just fomented more opposition.
I recall a particularly painful evening when he just refused to take the medication, got up and stormed off. Mom and I tried to explain.
“Dad, if you don’t start taking these meds we may not to be able to care for you at home, even though that is what we really want to do, “ I said. “We care for you and we are trying to help you. We don’t want you to go to a nursing home, but you need to take these meds.” Mom and I were exasperated as he left the room; we let him go.
He was angry and wanted to be left alone. But he came back to the family room after several minutes, and he seemed pretty emotional, less angry though. It was hard to decipher what he was saying but I did catch the words “care for me.” I think he was saying he appreciated us for that, but he did not want the medicine. But before long he relented, and Mom and I were pleased that the side effects were hardly noticeable.
Then a few days later Mom noticed something odd on the floor. It was hard to identify, but after some head-scratching we figured out that it must have been a partially dissolved pill. How did it get on the floor, nearly under the sofa? We came to the conclusion that Dad had tossed it there when we weren’t looking.
Then we began to notice that shortly after taking the medication Dad would often get up and go to the bathroom. Was he tossing his meds into the toilet? I started inspecting his mouth after he had taken the pills to be sure he wasn’t cheeking them, and I was satisfied that he was finally cooperating. Except, oddly, still there we none of the side effects that had been so violent early on.
One evening Mom gave him the meds, and she left the room to go do the dinner dishes.  I was sitting near Dad, reading and keeping an eye on him. To my amazement he spit a pill across the room onto the carpet. I reacted with shock and anger. A complicating factor, apart from concern about Dad, was that a little 5-pound chihuahua shares our home, our lovely and sweet little pet dog, Missy. And Missy loved to scavenge any stray edible morsel she could locate on any surface in the house. And we worried that a single dose of Aricept might do her in.
The evening conflict over meds was never won. Dad became more brazen about spitting them out and that led to more frantic searches to find the pill before our little bloodhound could leap down from her chair and snag it. I was impressed by Dad’s cleverness in hiding the pill in his mouth in a way that it just could not be found. Despite the Alzheimer’s, a good portion of his cleverness remained.
With Dad being steadfast against taking pills and his marked bad reaction when he did take them, we gave up on that class of medication. Instead we contacted a local geriatric psychiatrist who prescribed Nameda and Zyprexa–and we bought a good pill crusher and lots of apple sauce–a combination that has never failed us.