Seniors Living with Epilepsy



The following article first appeared on the Epilepsy Foundation website, and is reprinted here with permission from the Epilepsy Foundation.

Living Independently

Although there are always exceptions, senior citizens with epilepsy who are otherwise in good health and whose mental abilities are unaffected can usually continue to live independently. Families may find this idea difficult to accept. With the best of intentions, they often become overprotective, making an older relative more dependent than is necessary.

Of course, there are risks associated with seizures when people live alone. However, making certain changes in the home can reduce them. For example, living in a house or apartment which does not have stairs reduces the risk of injury from falls; carpeted floors provide a softer surface; and so does using padded furniture and putting protective padding around the corners of tables.

Technology is also available to help older people with disabilities to keep in touch with family members. From time to time new devices are developed to help people with disabilities handle day to day living. If seizures are fairly frequent, portable phones or beepers provide a way to call for help from any part of the house. Some seniors living alone prefer to work out a simple code, like a flower pot in a window, or a shade that is lowered and raised according to a schedule, to reassure friends and neighbors that all is well or to alert them if there are problems.

Fire, heat, and water are hazards for people of any age who have seizures. That's because people do not feel pain or perceive danger during seizures, and are therefore unable to protect themselves.

For more information, call the Epilepsy Foundation's toll free service at (800) 332-1000.

Effects on Mental Alertness, Mood, Memory

There are a number of health problems associated with aging that affect a person's mental alertness, mood, or memory.

But when an older person who is being treated for epilepsy becomes unusually depressed, confused, and unable to remember things, there may be some other explanations. For example:

Toxicity

If the level of medication in the blood gets too high, it can produce these kinds of changes. It often takes longer for older people to process medicines and to eliminate them from the body. When this happens, the level of drugs in their blood then slowly rises to levels which cause problems even though there's been no increase in the dose. On the other hand, some older persons may have toxic symptoms at levels that don't cause problems in younger people.

Drug Interactions

People over the age of 65 may be taking a lot of other medicines besides anti-seizure drugs. They may be on blood pressure medicine, blood thinners, drugs to reduce cholesterol, drugs to prevent stomach irritation, insulin for diabetes, as well as medicines for kidney disease, bronchitis, indigestion or the flu.

Some of these medicines may interact with epilepsy drugs, or be affected by them. Drug interaction means one drug changes the effect of another drug. It may lead to negative side effects or reduce the usefulness of the medicine. Epilepsy drugs of different types may also interact with each other.

It's important for the doctor treating a senior's epilepsy, and the pharmacist who fills the prescription, to be told about all the other medicines (including over the counter products) that the older person is taking so the chances of interaction are reduced. Also, whenever medicines are changed, started or stopped, make sure to ask the doctor about the effects of the change on seizure medicine.

Sensitivity

Older people may be more sensitive to the depressive aspects of a drug, or combinations of drugs, and these may lead to altered mood and changed behavior. The important thing to remember about all this is that when an older person who is being treated for epilepsy suddenly becomes depressed, forgetful, agitated, confused, loses appetite, gets a rash, wants to sleep all the time, or in any way seems different from his or her usual self, the doctor should be told so the medication can be checked and, if necessary, adjusted.

People often assume that these feelings are just things that have to be accepted as part of treatment -- but that's not necessarily true. It's always worth speaking up and telling the doctor when things are not going right.

The one thing you should not do, however, is to stop your epilepsy medication or someone else's on your own. Always check with the doctor first. And always alert the doctor treating your epilepsy whenever you're about to start or stop other medications.

Driving

People who are having active seizures with loss of consciousness should not drive, no matter what their age.

However, senior citizens with epilepsy whose seizures are fully controlled with medication (and who meet other licensing requirements) can qualify to drive in all parts of the United States.

In most states they will have to show that they have met their state's seizure-free requirements (usually between three months and one year, depending on the state). They will also have to provide whatever statements from their doctors their Departments of Motor Vehicles require.

If driving is not an option, then using public transportation, signing up with local services for the elderly or disabled, or even moving to an apartment complex or community that has its own transportation may be among the alternatives.

SIDEBAR

Safety Tips

Although you can't protect against them completely, some simple precautions can reduce these risks for seniors with seizures as well. For example:
  • Don't smoke. Having a seizure while smoking could cause a fire.
  • Use a microwave oven for cooking.
  • Serve food from where it's cooked directly onto plates so you don't have to carry saucepans or casseroles of hot food.
  • Use an automatic coffee pot or heat water by the cup in the microwave instead of boiling a kettle.
  • Use a regular knife for carving, not an electric one.
  • Set the temperature on the water heater low enough to prevent scalding.
  • Keep electric appliances far away from the sink or source of water.
  • Avoid the need to iron by buying permanent press clothes and linens, or sending things that have to be ironed to the cleaners.
  • Keep bathtub levels low.
  • Wear rubber gloves when washing glassware and china or loading it into the dishwasher.
  • Don't use space heaters that have hot surfaces, open heating elements, or can be tipped over.
  • Keep a screen in front of an open fire; don't carry hot ashes out to the trash can.
 
IMPORTANT SAFETY INFORMATION

DIASTAT® AcuDial™ (diazepam rectal gel) is a gel formulation of diazepam intended for rectal administration in the management of selected, refractory patients with epilepsy, on stable regimens of AEDs, who require intermittent use of diazepam to control bouts of increased seizure activity for patients 2 years and older.

In clinical trials with DIASTAT®, the most frequent side effect was somnolence (23%). Less frequent adverse events reported were dizziness, headache, pain, vasodilation, diarrhea, ataxia, euphoria, incoordination, asthma, rash, abdominal pain, nervousness and rhinitis (1%-5%). Please see full DIASTAT AcuDial Prescribing Information.