Doper doctors and others, I hope you can give me your thoughts on this hypothetical issue. Sorry it’s kinda long.
Gertrude is 90 years old and has dementia. In order for her to stay at home rather than go to a nursing home, she needs someone to live with her. Currently, her daughter the Dragon Lady and her granddaughter-in-law Jane split the week between them.
Gertrude has always been very strong and independent and it is very difficult for her to accept that she can’t take care of herself anymore. Additionally, three years ago she lost her home to a flood and her (favorite) daughter to cancer. After the flood she spent a year living with relatives or in a cramped one-room apartment while her house was rebuilt. Since relatives provided part of the money for rebuilding, they did a lot of things the way they wanted instead of how Gertrude wanted, and Gertrude feels that they are mostly interested in what they can do with the house after Gertrude is dead. (She may well be right about that.)
So, Gertrude has been very depressed ever since. She is under a doctor’s care for her diabetes, hypertension, COPD, and other medical stuff, but no one has addressed her depression. The Dragon Lady is the one who coordinates all of that but isn’t concerned with Gertrude’s emotional state. When she is taking care of her mom she yells at her and sort of…not exactly mocks her dementia, but she doesn’t really treat her mom respectfully. Also, the D.L. has religious beliefs that depression is a sin against hope so doesn’t believe it needs to be treated, just “risen above.”
Granddaughter-in-law Jane has no contact with the doctor. Jane is just an in-law and is married to the family black sheep, so it’s not really her place to make demands about Gertrude’s treatment. However she loves Gertrude and hates to see her miserable. She googled depression treatment in the elderly and found that old people can’t take Prozac and that type of thing. So she and her husband talked about medical cannabis and whether it could help Gertrude.
They think it might, but are unwilling to do anything that might hurt her. She isn’t supposed to smoke, but Jane found out that cannabis can be used with a vaporizer or baked into cookies. Jane and her husband are concerned with whether this might interfere with Gertrude’s medication, whether she might have withdrawal symptoms during the part of the week that the Dragon Lady is there, whether it might scare Gertrude or make her sick or anything, and anything else you can think of.
While I can understand their wish to help, do NOT slip marijuana to an old lady who is on various medications, not to mention suffering from dementia. Yes, it may help her depression, but on the other hand, will it make her dementia worse? (It’s not like she’s going to know what happened, and it’ll probably confuse her)
And never, EVER slip a substance – any kind – to someone on medication, if you don’t know if there will be any kind of interactions.
I’m not anti-pot, but this seems like a seriously, seriously bad idea. Jane and her husband are better off talking to Gertrude’s doctor about how they can help her.
I second that. You need to talk to her doctor before giving her anything. I’m assuming you live in a state that has legalized medical marijuana… if not, I’m afraid her doctor may not be able to support the idea, even if it may have benefits.
TCB, I am not a medical person but I do have recent (parental and other) experience with similar situations. Do you know what Gertrude’s “end-of-life” wishes are?
We took my father (dementia, aphasia, heart disease) off all his medications and dietary guidelines so he could enjoy some of his favorite things before he died. Turned out that removing the medications may have helped him live a bit longer (months), not to mention enjoy his favorite ham salad sandwich.
This is a comment made by his doctor, though it could have been made to comfort my mother. But it was also what Dad wanted.
Marijuana is not an effective anti-depressant, anyhow.
It’s possible that someday a safe and effective drug might be made from marijuana, or marijuana production may give us a consistent product standardized enough to use, but right now, there is far too much variation in marijuana for safe use as an antidepressant. A little bit of some strains might be effective, but too much, or a little bit of other strains, can worsen depression.
I’m not anti-pot, either, but I am pro-medicine that works. Pot is fine for recreation (legal issues aside), but “medical marijuana” is largely a (forgive me) pipe dream.
And, frankly, I doubt anyone in this hypothetical is qualified to diagnose Gertrude’s depression. Dementia and depression are very difficult even for psych nurses and doctors to untangle sometimes. The symptoms are very similar to look at, and marijuana very definitely will NOT help dementia, especially when the person doesn’t know they’re taking it. You’re much more likely to end up with a very scared, anxious demented person than curing anything, and that’s just not fair to do to someone without their consent.
ETA: Oh, and marijuana alsoincreases blood pressure, so there’s a straightforward contraindication right there.
