Monday, November 24, 2014

Epilepsy Awareness Month Day 24: Mood and Medications

Robert is generally very polite, sweet and overall in an excellent mood.  It might be physically difficult to care for him but it is not emotionally difficult when he is cooperative, joking around and full of laughter. 

Robert playing ball with the dogs
When Robert (or any caree for that matter) is cranky, caregiving becomes one hundred times more difficult.  It takes so much extra energy to convince Robert to cooperate when helping him dress when he doesn’t want the help (but needs it) or for him to be sensitive to the bath water and complain about it being too hot or too cold (or both) no matter what I do and to even be yelled at when I am trying to help him walk safely.

Robert gets cranky when he has a reaction to medications (which can happen with many anti-epilepsy medications as well as other medications such as pain meds).  He also got very irritable earlier this year when not only was his medication being changed but he was losing his ability to walk.

I can only imagine how scary and frustrating this is for anyone but for someone with a slight cognitive impairment, it must be especially frightening. 

Anti-epilepsy medications can have many side-effects but, of course, not everyone is affected in the same way or for the same length of time.  When Robert was younger, he was on Tegretol and Phenobarbital (and lots of other medications – he may have tried them all). He has been on Depakote and Klonopin for as long as I can remember.  Robert definitely had depression, anger and impulse control issues as a teen and young adult.  The new medication he was put on earlier this year is at a very low dose because he just couldn’t tolerate any more of it.

The Epilepsy Foundation has a terrific list of anti-epileptic medications with the side-effects associated with it. Unfortunately, many times trying a new medication can be a difficult and time-consuming process that in itself can be frustrating.    

When these nasty side-effects show up, it makes caregiving that much more difficult. The caregiver not only has to deal with a cranky caree but has to figure out if the mood change is due to the medication or something else happening to the caree or a change in the environment. For instance, even a dramatic change such as a new Day Program or a simple change in schedule can affect a sensitive caree – especially those driven by routine.

It is important to bring any attitude and mood changes to the attention of the caree’s physician in case there is something new going on or in case medication can be adjusted. 

We were very fortunate that with a few medication changes and intensive physical therapy, Robert got his “excellent” back.  He still has his irritable moments but I am grateful he is generally in a good mood again.  I realize the solution isn’t always that easy or even, possible.

Although, now that I think about it, the solution for Robert wasn’t that easy – it was a long and difficult summer getting him well.

I am definitely grateful for his return to excellent but know that there will be difficult, cranky times as well.  The most important thing I learned this summer is that we can – and will – get through any difficult period.   

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