Client, who is 83, is very difficult and daily she states that she wants to commit suicide. Any advice for me?
In our state we have, like most of you, the APS and our local obundsman.
My 83 year old client unfortunately has Lewy body dementia and Parkinson’s.
18 months ago she became non ambulatory and feels very helpless, afraid, full of fear and panic.
I have taken quite a verbal beating from her because I know it is the disease talking yet, when do I draw the line? She said very plainly she wanted to commit suicide the other day and purposely fell out of bed. I was not there at that time but she ended up at the ER with a broken wrist. They wrapped it and discharged her that night, even when telling the social worker she was trying to harm herself.
The next day, I was there and she threatened the same thing so I called 911 for an aid car, as she was on my watch and anyone who is of harm to themselves needs to be mentally evaluated. Her daughter went with her. They casted her arm, and discharged her, not addressing the self harm.
It is very taxing caring for her because Lewy body is really playing a huge roll and the daughter will not Medicate her for the hallucinations.
Any advice for me?
I watch her 20 hours per week!
thank you all for your love and support.
She is with Dementia but at times very lucid?
19 Answers
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At the very least, the daughter should be pressed to medicate her mother to help with the hallucinations. Imagine having the worst nightmares of your life all the time because your brain can't turn them off. The daughter needs to understand that the medications won't prolong her life (which I suspect is her motivation for denying her the meds), but they could provide her comfort and some degree of peace.
While a neurologist might undertake a lot of trial and error with various medications and regimes to find something that helps, the attempts often increase the hallucinations and anxiety, and speed physical decline. In some cases the side effects are severe and long-lasting. Generally, any improvement is fleeting.
This is is by no means as simple as slipping a Benadryl to an anxious dog before a car trip. And BTW, Benadryl is another drug often exacerbates Lewy Body Dementia.
My mother did, for years and years. Drove me batty---nobody else took her seriously and I shouldn't have, but what 10 yo has the ability to hear "I will kill myself and then you'll all be sorry" and not internalize it??
On my 30th birthday, she asked me to come by. I did, and she gave me a card (a 20 mile drive for a birthday card!) I was pregnant with baby #5 and had my 4 small kids with me. What does she say? How unhappy she was and how no one cared..on and on and something snapped inside me. I said "Mother, feel free to kill yourself. Just don't leave a mess for me to contend with. I can't even see my feet for my huge belly".
If she were doing that manipulation NOW, I would call 911 or APS or someone and have her Baker Acted.
If mom is making statements to that degree, she needs to be hospitilized and helped or called out on the manipulation that it often is. (BTW, mother never did one single act of self harm. But, wow, her constant talk of killing herself did a number on me).
My mother does the same thing, and I tell her the same thing as you. 'Go ahead. Just don't leave a mess'.
Even though the mom has dementia, she might just be putting on performances to get attention too. That's always a possibility.
Washington is a 'Death With Dignity' state so your client may be able to request and then self-administer a lethal overdose of medicine to end her life. There is a link to the article above. She has to be mentally competent, however, and administer the meds herself, which could be an obstacle.
I would resign my position with this woman, if it were me, because it's too stressful to be in such a role. Her daughter needs to pull her head out of her butt and HELP her mother here, for crying out loud. What sort of a person refuses to medicate her own mother who's suffering like this??
Maybe some medication to keep her calm and to treat her anxiety would at least help her feel a little better.
Someone that will not do what is best for the patient is likely to blame others when a tragedy occurs. You need to protect yourself.
I would send letters to all of her doctors stating that her daughter is practicing medicine without a license on her mom and her mom is suffering as a result.
I totally believe in doing it naturally when able, heck maybe some CBD would help, but, it gets to a point when nothing being done is dangerous and malicious, IMO.
Best of luck!
There are periods of clarity in Lewy body, in the early stages.
She does need to be under the care of a neurologist, but I imagine that getting her to a doctor's office is a nearly impossible task.
I think this elder would actually benefit from placement in a 24 hour care setting - probably a nursing home - or assisted living with private paid support. If she has the funds.
She won't necessarily be any happier, but she will be safer and there will be people to check on her very often and help her with her needs.
And it is not fair to you to be trying to meet her needs all by yourself 20 hours/week.
Good luck, and take care of yourself.
Please be certain of your obligations now legally and morally and under the law in your own state. I hope you will be able to use your search engine for your own area. These rules are easy to find for my own state.
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