Dementia and Drugs: What You Need to Know

If you’re caring for someone with dementia, you already know how hard it is to balance comfort, safety, and quality of life. When a doctor suggests a new medication for agitation, anxiety, or sleep, you may feel both hopeful and uneasy.

Well, a new study published in the Journal of the American Medical Association (JAMA) confirms that your concern is justified, and that families like yours need to be active participants in these decisions.

The study results were alarming. Researchers found that about one in four people with dementia on traditional Medicare are prescribed medications on the Beers List, medications that experts have warned against for years. These include antipsychotics, benzodiazepines, certain antidepressants, and many sleep drugs. While these medications are often used to calm distress or help with sleep, they can also increase confusion, raise the risk of falls, and lead to emergency room visits or hospitalizations.

Even more troubling, people with dementia are more likely to receive these drugs than older adults without cognitive impairment.

You may be told that a medication is needed to manage behavior or help your loved one sleep, but you deserve to understand the risks, not just the promised benefits. That's the only way to make choices that truly protect your loved one.

Why This Happens

When your loved one is anxious, restless, or awake all night, it can feel like a crisis. Medication can seem like the best and quickest way to address that crisis. But medical charts don’t always show what you see every day: the subtle changes in alertness, balance, or personality that can come from these drugs.

That’s why it’s reasonable (and important) for you to ask questions about the medications your loved one has been prescribed, especially after:

• A fall

• A hospital stay

• A sudden change in behavior

• The addition of a new sleep or anxiety medication

You’re not being difficult. You’re being a protector. Let’s face it. You are the expert on how your loved one is really doing. Your observations matter just as much as what shows up in the medical record.

Sleep Apnea: A Complicating Factor

One of the most common and overlooked contributors to nighttime agitation and confusion is sleep apnea. Many people with dementia have undiagnosed sleep apnea, which causes breathing to stop and start during sleep. This leads to poor oxygen levels, broken sleep, and daytime fogginess, symptoms that can look like worsening dementia.

When the real problem is sleep apnea, a sedative or sleep-inducing drug may actually make things worse. These medications can relax the airway, increase breathing problems, and deepen confusion the next day.

If your loved one snores loudly, gasps during sleep, or is extremely sleepy during the day, ask about a sleep study. Treating sleep apnea can sometimes improve alertness, mood, and even memory.

How to Protect Your Loved One

You don’t have to accept every prescription without understanding it. It’s up to you to advocate for the best care for your loved one, and that includes being informed about the drugs your loved one is being prescribed. Here are steps you can take:

Bring a complete medication list.

Always bring an up-to-date list of every prescription, over-the-counter drug, and supplement to each appointment.

Ask clear questions.

For each medication your loved one takes, ask the doctor the following questions:

• What is this for?

• Is it still needed?

• Could it be causing falls, confusion, or sleep problems?

• Is there a safer option?

Get the right specialists involved.

Geriatricians and geriatric pharmacists are trained to recognize which drugs are risky for older adults and when something can be safely reduced or stopped.

Make sure you have legal authority.

With a Georgia Advance Directive for Healthcare and a HIPAA authorization, you can speak directly with doctors, request reviews, and ensure your loved one’s wishes are honored.

When you have the legal tools in place, you don’t have to stand on the sidelines. You can actively advocate for care that keeps your loved one safer, healthier, and more likely to age with dignity.

Dementia and Drugs: You Don't Have to Do This Alone

Navigating dementia, medications, and medical decisions can feel overwhelming. But you don’t have to figure it out by yourself. At Kimbrough Law, our integrated planning approach helps families like yours bring together legal protection, care coordination, and advocacy so you can focus on what matters most: protecting the person you love.

Ready to get started? Call 706.850.6910 to schedule a consultation.