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Question
Posted by: Mel | 2010/05/26

Parkinsons

Good morning Doc,

The problem I have is family orientated  my father in law has been diagnosed with Parkinson’ s about 2 years ago, but before that he had his prostate removed and that caused him to lose his bladder control, so he has to wear the condom catheter permanently. But now with the Parkinson’ s he is confused most of the time, and hallucinates and he end up pulling it all out making a mess of himself and the house. Now my mother in law and father in law have not had the best of relationships prior to him getting sick, and this has definitely not improved that situation. She has decided she had enough and wants to put him in a home for the elderly since she has some health issues too and cannot cope with him. The children do not like the idea but what else can she do, he sometimes has no control over his bowel either. My question is, is there any alternative medicine that can be used to help to be less confused and more alert?

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Our expert says:
Expert ImageCyberShrink

I know, from personal experience, that directly caring for someone who has lost bowel and bladder function is enormously exhausting, and can only work if based on really major love for the individual. Dealing with adult nappies is really hard work, especially if the person doesn't fully understand what's going on ; and often along with incontinence, they lose the sense of when they need to empty bowels or bladder, and of whether they have done so. It gets very complex.
Maybe it'd be wise to consult with a good local Geriatrician, who can review the whole picture and consider whether anything can be done to improve that situation, and whether there is a good local home which could provide quality care.
YOu need a good diagnosis of his mental state, too, and his prognosis - outlook in terms of likely duration of life. The Parkinsons may be opnly a part of a more general dementia.
Treatment is difficult and controversial. Some of the drugs most helpful in reducing the confusion and agitation which can make their lives, and the lives of their carers, so awful, have been shown to increase the risk of heart attacks and strokes. Personally, I feel this is often acceptable, as the relief these drugs provide all round can be dramatic, and the risk of both those complications is already high in such people. I have preferred using Risperidone ( now available in a generic form, also, but I think the original Risperdal is the only one ( last time I heard ) which is available in a liquid form. That can be most valuable, both because it can be added to coffee or juice ( not to tea, which damages the drug ) which is espeially helpful in someone who doesn't swallow pills easily ( and the pills are rather small and awkward ) ; and it is easy to titrate, to very delicately vary the dose according to the effect needed. It is usually noticeably effective in around 10 minutes.

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2
Our users say:
Posted by: Mel | 2010/05/27

Would we need a prescribtion from a Doc to be able to buy these medication?

Reply to Mel
Posted by: cybershrink | 2010/05/26

I know, from personal experience, that directly caring for someone who has lost bowel and bladder function is enormously exhausting, and can only work if based on really major love for the individual. Dealing with adult nappies is really hard work, especially if the person doesn't fully understand what's going on ; and often along with incontinence, they lose the sense of when they need to empty bowels or bladder, and of whether they have done so. It gets very complex.
Maybe it'd be wise to consult with a good local Geriatrician, who can review the whole picture and consider whether anything can be done to improve that situation, and whether there is a good local home which could provide quality care.
YOu need a good diagnosis of his mental state, too, and his prognosis - outlook in terms of likely duration of life. The Parkinsons may be opnly a part of a more general dementia.
Treatment is difficult and controversial. Some of the drugs most helpful in reducing the confusion and agitation which can make their lives, and the lives of their carers, so awful, have been shown to increase the risk of heart attacks and strokes. Personally, I feel this is often acceptable, as the relief these drugs provide all round can be dramatic, and the risk of both those complications is already high in such people. I have preferred using Risperidone ( now available in a generic form, also, but I think the original Risperdal is the only one ( last time I heard ) which is available in a liquid form. That can be most valuable, both because it can be added to coffee or juice ( not to tea, which damages the drug ) which is espeially helpful in someone who doesn't swallow pills easily ( and the pills are rather small and awkward ) ; and it is easy to titrate, to very delicately vary the dose according to the effect needed. It is usually noticeably effective in around 10 minutes.

Reply to cybershrink

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