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 Hospice Doctor Started Dad on Trazodone, And Other Stuff 
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Joined: Mon Sep 09, 2013 9:16 pm
Posts: 29
Location: Texas, USA
Post Hospice Doctor Started Dad on Trazodone, And Other Stuff
Dad's hospice doctor has prescribed 100mg of Trazodone as a sleep aid. The folks at the nursing home have told us that he's been pretty good in the late evenings and at night (possibly because he's more active during the day and is tired?). But when his late afternoons/early evenings are too disruptive he becomes agitated -- ie. Mom and I were there at suppertime with my Aunt (Dad's sister) the day we brought her up to visit and he became somewhat agitated before we left and later that evening got up and had a slight fall, and yesterday we had to get him out to take him to a final appointment with his family doctor who has turned him over to hospice (and who wasn't even at the office and we didn't receive a call telling us she wouldn't be there, though we did get some things taken care of with her PA, a very nice man who was the go-through to get Dad admitted to hospice) and he apparently became agitated during the late evening. He was asking me about the car being in the shop again (?), hoping I knew where we were going because he didn't, saying we'd been gone hours when it was only one hour, etc., so I know he was having problems yesterday. His eyes were also very red-rimmed yesterday, so I think he's been having sleeping problems.

Anyway, has anyone had any recent experience with Trazodone? I've read that its one of the meds given to LBD patients as a sleep aid and is used for depression, etc., and that it may take a week or so to show good effectiveness.

I'm just really worried that Daddy isn't going to last a long time. Mom has been upset because she says he's not eating (so she wants to be there for a couple of hours at lunch time). She says he's sleeping too much. My take on it is that she's right, he's not eating, but he does seem to be eating just as much as he was before his move to the nursing home. We're told that he's up in the morning, walks to the dining room, talks with the aide, has coffee and eats most of his breakfast, which is what he did at home (the eating part anyway!). He eats anywhere from half to 3/4 of his lunch, sometimes more, depending on what it is. But I think he becomes irritated with my Mom because she cuts his food and hands him the fork and continually urges him to eat and fiddles with his food, etc. He told us yesterday that he'd eat if we'd just leave him alone! And I know the aides help him with eating at the other meals when he needs it, but they can't force him to eat (he was beginning to refuse some meals at home). The great majority of the patients leave most of their food on their plates, not because it's bad food (its actually really wonderful food!) but because they just don't want to eat so much anymore. And Mom is also right about Dad sleeping a lot. But she told me several times, and told the hospice nurse when Dad was being admitted, that he seemed to be sleeping about 20 hours a day, whether laying on the bed or sitting in his chair. The majority of the time that she's at the nursing home is at lunch and right after, when he gets his noon meds, so yes, he does sleep a lot while she's there!

I really don't think she noticed these things going on at home so much because she was there with Dad all day and all night. She was focused on how difficult it was to get him to the toilet, bathe him, dress him, get him up on the occasions when he fell, etc. She became overwhelmed with his nighttime agitation, hallucinations, delusions. She was there at the table to "force" him to eat. Now that she sees him for two or three hours a day, at times when he really is at a low point due to his med routine, I think she's being forced to see just how far his health has deteriorated.

Today we have a short "care plan" meeting with the nursing home and hospice folks, including the doctor. I'm hoping that Mom will be told that she needs to take some time away from the facility to allow Daddy to get more settled in. Our friend who works there will be in the meeting, and I know she feels the same way. I "put a flea in her ear" and asked that they not tell her to stay away completely, but to take at least one day a week off and to not stay so long on the other days. I really think it will be helpful to Dad if she/we aren't there so much because he won't become so agitated from the visits, Mom crying, etc. We also will be taking my Aunt back to her home on Sunday. Its a 300 mile trip, and Mom has said she'll probably go also, so she'll have that time away. We'll stay the night and return home the next day. Maybe that will be a first step. I hope so. She mentioned that she's out of her routine with my Aunt here and hasn't been able to form a "new" routine without my Dad yet. She keeps saying she's a burden and that she wants to sell her house and get an apartment. I've asked her how she thinks that will help?! She'll still need someone to take her to visit Dad, shop, etc.!

I apologize for the long, burdensome post! Thanks for the opportunity to just get a little venting out!

Thu Nov 14, 2013 11:40 am

Joined: Fri Jan 15, 2010 9:33 pm
Posts: 3441
Location: Vermont
Post Re: Hospice Doctor Started Dad on Trazodone, And Other Stuff
Venting is important! And this is a good place to do it so it doesn't get directed at family members, the dog, whatever.

I've noticed that as people age and become less active, their eating requirements greatly diminish. If he is just sitting around all day, or lying down a lot and sleeping, he needs very few calories. In the hospice brochure they outline the stages of the final year of life, and looking back on what my dad went through, they were right on target. People reduce their caloric intake, don't eat foods that they've always eaten and liked, sleep a lot more, start closing themselves off from the people around them. They become more and more inward focused. Forcing people to eat is actually not good for people whose bodies are going through these natural cycles.

Then again, if his health care team doesn't feel that he is at this point yet, perhaps he is just acting out and frustrated, and directing it at your mom when she's around and wants him to eat.

It isn't easy for anyone, that's for sure. I hope things calm down some and your mom gets a bit of time away from your dad to focus on something else and take care of herself. Peace, Lynn

Lynn, daughter of 89 year old dad dx with possiblity of LBD, CBD, PSP, FTD, ALS, Vascular Dementia, AD, etc., died Nov. 30, 2010 after living in ALF for 18 months.

Thu Nov 14, 2013 5:40 pm

Joined: Mon Sep 09, 2013 9:16 pm
Posts: 29
Location: Texas, USA
Post Re: Hospice Doctor Started Dad on Trazodone, And Other Stuff
Thanks for your response, Lynn. Yes, venting is important. I don't know what I'd do without it! Dad seems to be doing okay at the nursing home, or at least as okay as he was doing at home. His eating has remained about the same. Mom does take him sweets to make sure he's eating something! He has become more grumpy and irritated, though. Or perhaps he was that way at home and it wasn't as noticeable. He has been telling us to quit bugging him and to leave him alone! He had his quarterly appointment with the neurologist, who emphasized to my Mom that she had done the right thing in moving him; that there was no way she could have continued to care for him at home; that he doesn't have the capacity anymore to understand a lot of things that are going on. Mom still feels guilty but I think she'll move past that eventually. She said that she has noticed, finally, how bad Dad has really gotten; that she wasn't as aware of it at home because she was around him all the time; she knows she couldn't have kept caring for him because she, herself, was falling apart, even if she didn't want to admit it.

As far as the Trazodone goes, the staff are either cutting back on it or beginning to wean him off of it. He took 100 mg for four nights, but one of the nurses told us two days ago that he was having horrible side effects -- seeing mice running around on the floor, etc. plus some other things -- and it wasn't helping him sleep at all! The night before last the nurse called at 9:30 to let me know that they had reduced the dose to 50 mg. I'm not sure how that's working out yet, or if they'll continue to reduce the dosage. I do know that he was up doing who knows what during the night because he lost a slipper and sock somewhere and they haven't been found yet!

We took Dad's sister home on Sunday and came back on Monday, so Mom had one day away from the nursing home. I don't think Daddy even cared that his sister left. The first day she visited him he was happy and hugged her. The rest of the time he really didn't seem to care if she was there to visit or not.

Thu Nov 21, 2013 4:28 pm

Joined: Sat May 25, 2013 3:53 pm
Posts: 330
Post Re: Hospice Doctor Started Dad on Trazodone, And Other Stuff
I think as people get older and sicker they start to look inside a lot more than we do in everyday life. I think it's just part of the process of aging - with or without disease. So even though they don't look like they care a visitor is there I think they know and appreciate the visit - visits are just on a different level than we're used to. That's my experience three times over now...

Gail, Forum Moderator & daughter of Doris who passed away Dec. 2010 after living with LBD for 7 years.

Mon Nov 25, 2013 12:58 pm

Joined: Fri Apr 05, 2013 6:34 pm
Posts: 17
Post Re: Hospice Doctor Started Dad on Trazodone, And Other Stuff
My husband tried several sleep aids and the Trazodone seems to be the most effective one and one of the better ones for LBD patients, or so I have read. It seems to take my husband a couple of weeks to make adjustments from one med to another.

Thu Dec 19, 2013 7:22 pm
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