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Mom is losing her memory, in bad health and lives alone. I feel she is a danger to herself. She is currently being seen by a pain mgt doctor, spinal issues and long term prescription drug use. Smokes, has poor nutritional habits and is getting more confused daily. She has extreme outbursts and overreacts to most things. She does not trust outside help and makes it difficult to be around. My life has been on hold for several years now and I need help.

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My first thought was, do the pain management doctor and the addiction doctor know about each other? With the health issues your mother has, she does need medication, but how much? Some kind of supervision might help. Other helps like rehab, physical therapy, more scheduled visits from you might help. When someone is that lost, people move away from them, understandably. But what would happen if you stayed overnight, or until she asked you to leave? You don't have to do that, just start to think outside the box instead of what has not worked before. Do BE THERE and encourage her, or take her when she is ready for rehab. So sorry that you are going through this. There are support groups for you, have you ever been?
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Yikes. Addictions are something you do to yourself. Find out what detach with love means, so you can learn to intervene without hurting yourself.
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One neighbor was falling, fearful, and taking too many laxatives. The paramedics said, after APS had failed to help, that she would literally have to fall outside or call for help herself. She fell outside, went to a board and care.
Family can intervene earlier: 1) by getting a second opinion and, 2) consider what would have happened if you saw her in her chair (more passed out than asleep) and you did not help, but a neighbor saw her or 911 was called.
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Sometimes you really do have to let Humpty Dumpty fall off the wall. Our medical and social support systems are setup to be re-active for the most part. It has to get really, really bad for help to come.

There has to be a crisis or an emergency event. An ER visit that can open the door to time in rehab and then a placement in the right kind of care.

KEEP A JOURNAL. These records are your life line to establishing a history of decline and lost ability to live without help. Otherwise, social workers and doctors have to assume all this is "recent and new".

It doesn't have to be a long journal. Just jotted notes from what you see and hear during phone calls and visits. "Mail piling up; mom refused to let me sort it." "Dishes from last week still not washed" "Bathroom smells like urine" "Med bottles in lots of drawers in kitchen and bathroom" "Food in fridge rotten"

The enormity of the situation will creep up on everybody until it's REALLY bad. It's hard to get traction on this stuff with authorities when the parent has a reputation for being difficult, odd, weird, strange, mean, etc. anyway.

Try to track it to the ADLs and IADLs. If you google these, you will get an endless list of different inventories of skills needed to do basic self care and the ones required for independent living. I promise, this will get the attention of the right people.
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this is a continuation...if he does manage to leave on his own, they will call and report him to adult protective services. I have tried myself but as long as I help/look after him, they won't do anything. Its awful to have to do that but if she's ever admitted to a hospital, you might think about. I learned its better not to sign any consent forms because that puts you into the caretaker role.
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I feel for you and understand where you are coming from. I've been "enabling" my elderly father for a couple of years. He is 90, has been diagnosed with dementia and will nor consider any alternative to living at home by himself. He has no friends, no family (except me) and no church. Like you, I have put my life on hold. I say I've been enabling him meaning that I took him shopping, set up bill payments, took him to doctors etc. He always has been a self centered, controlling, you know what. But as a child who grew up in a crazy, abusive home, my role was always to be the caretaker. Anyway, he has definitely become a danger to himself. Five days ago, I had to take him to the hospital for the third time in past six months for a health issue. They got him fixed up and said he could go home. I flatly refused to take him. The very kind administrator at the hospital told me to stick to my guns and sent me to the social worker. She was resistant at first but after she heard my story, she told me that I could "abandon" him. They cannot refuse to let him go. (I have visions of him in a cab in a hospital gown) but if he does manage to leave
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Yes, Mallory, 1 mg. Xanax! I got a prescription for .25 mg a few years back, and I even broke those in half. My doctor, when I told her that, was amused. She said I was probably only getting a placebo effect, but all I wanted was to take the edge off encounters. My mom occasionally tries to push her Xanax on me, for anything from a headache to a backache, and I don't want it. I partied in college, throwing back my share of beers and shots of tequila, but I don't like feeling impaired. I just want, if I have to spend an afternoon towing my mom around, to feel like I can get through it without wanting to bang my head on the wall!
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Sandwich, that is such a good idea. Too bad they don't have someone extra in attendance for certain situations, in an observant third-party role.
A woman gets a pap smear and a nurse is present to make her feel safe and comfortable, but why can't there be an extra person there for a senior's evaluation, or even a person with some kind of mental illness.
It'd be worthwhile to have some extra observations noted. A doctor's already busy enough trying to address a host of medical issues in 15 or 30 minutes and prescribe meds and give referrals.
Some kind of case worker would be good.
In my mom's case, I'd love it. Maybe there'd be more support for getting some mental help or help for dementia then. "Hey, she always mentions she's lived too long. Maybe we can give her a different antidepressant or encourage counseling." Or, "She gets confused and goes on about a feud with a neighbor and it doesn't add up. Let's look into this confusion and obsession a bit more..."
That's such a great idea. Oh, how I wish it were policy!
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Sandwich, your suggestion to add a person -- a "listener" -- into the healthcare process for geriatric patients is a really excellent one. And your list of things to look out for is really good too. It might be a hard sell at first w/insurance companies, but I think a feature like this would greatly improve medical care, and would also save lots of money for both healthcare companies and their members.
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One thing my mom did was equate medical attention with affection.
She would not have hugs or social interaction from anyone else. It had to be medical and procedural to "count". A prescription in hand was as valuable as a love note to the rest of us. It's due to an illness event in her childhood, but this is the way she was. Other interpersonal encounters irritated her to no end.

When doctors started to be evaluated by how many people they could put through in a day, they stopped having time for the "relationship" part of the visit. This did not go over with my mom AT ALL. It's hard to be a hypochondriac when nobody will let you perform.
The anthropology student in me wonders why we couldn't put that "visit time" back into geriatric visits on purpose. It doesn't need to be the doctor who sits through the story time, but a different person. It could really be a behavioral assessment through observation, that feels like visiting time to the patient. It could be a way to pick up on changes before they turn into a crisis event.

I think there are some cues into the person's situation that can be gleaned during that time. Do they tell the same stories each visit? Is the story now changing with different facts? Is the story mixed up compared to the past version? Is the person struggling to find words? Is the story more confabulation than truth? Is the process of relating the information (telling the story) becoming frustrating? Is the patient becoming paranoid or delusional? Is it getting harder to talk?

For some patients, having this time and attention is very calming and reassuring. That's why mom made a career out of going to any doctor she could. I believe it may make them more receptive and cooperative with the next part of the visit that could involve procedures. Just a hunch from an unqualified lay person!
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Yikes and Mallory, I can relate to "life on hold" and also to the difficulty of taking care of my own medical needs. Some days I can't summon the energy to do One More Thing, which is anything for my own life...and for my own future....
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Heidi, I just re-read the previous notes, your mom was given 1 mg? sheesz, when I've had Xanax prescribed it was for 0.25 mg, very very small dose. I cannot imagine 1.0 mg. that's horrible for a senior!
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I hear you, Malloryg8r. Xanax is hard to come by. I once had a doctor who gave me a small prescription for Klonopin, and that's better still. It's actually more drawn out. I'd take it if I had a bad bout of anxiety or horrible PMS before going to drive my mom around and it was great for that. Unfortunately I don't have that doctor anymore, but I'd love to have a few on backup for such situations, since it didn't make me feel tired or anything: Just beautiful calm.
But I don't get why they give out Xanax to old folks. A friend's mom, who is 88, has it, too, and she pitches a fit about it, but not as badly as my mom does. Old people who are on tons of medications already probably don't need a potent dose of Xanax. But I suspect some docs think, oh, they're old, let them enjoy it. I get that, but I don't think they realize that it creates problems for the family. My mom has gone to the hospital once or twice a year for the last four or five years and had to stay there several days each time. I'd say at least half of those stays might very well be tied to Xanax misuse. So, this "oh, they're old" attitude is stupid. It means family is driving around, the parent is racking up medical bills (in my mom's case, at least, since she always cancels her supplemental insurance), and all this other drama. A simple pill to calm a person ends up causing tons of stress for everyone else.
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Heidi, I am starting to believe my mom has a twin out there lol. She too loves to chat about things she did in her twenties act that no doctor has time or cares to listen to. Most doctors when they meet my mom and see all the issues she has want to refer her to another doc simply because they know she is going to be a thorn in their side.
My mom had another major incident the other day. She called 911, ended up in the ER but after a day there she was let go and they called her a cab. ( we had an argument so were not speaking, I believe this was another one of her stunts to manipulate as the nurse called me and said mom told everyone she has nobody and nowhere to go) I explained the situation, mom has taken a cab home from the casino plenty of times so as long as she is stable and couldn't be bothered earlier with letting me know what was going on then she can get home on her own.
Well… later the homeowner security guy called me and said she was confused and disoriented but he got her to go back inside her condo. (She still has not called me and she knows my number because she normally calls it 10 times per day)
I decided to go to bed and follow up with her in the morning. At midnight the police call me to come over as she called them 1st saying she was disoriented but when they did not get their fast enough she called and said someone was breaking in.
I went over there and she told me she just wanted to see me and has no idea why or how she got to the ER. The police wrote up a report and said next time they would hold her on a 5150. She said she couldn't remember my number, the entire time looked very confused. I told her then she needed sleep ( I think she is deprived of sleep as her home was a mess with medical papers everywhere and bills) At this point its usually a drug abuse issue as this has happened before right before she decides its time for rehab. Anyway… that is exactly what she mentioned to me the next day. She wants to get off everything! Today will be day 3 no smoking! Her brain petscan is this am…wish us luck!
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Wow where are all these doc's that give so much Xanax? I can only get 4 tablets and then they want me to start SSRI. (panic attacks, from CG stress plus career stress etc). For me, a long walk outside in fresh air is best. Away from it all! But there are too many times when I am prevented from doing just that, b/c of mom duties. Xanax is wonderful for those who really do need it, and can tolerate it without addiction tendencies. but yes for seniors with dementia, or vertigo, or addictive disorders, not so good.
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My mom had a fall and went to rehab. I kind of thought they'd say, "she needs to get to a home," but a week in the hospital and 21 days in rehab, she had less Xanax and Norco, and no cigarettes, and did great. (That's another thing she gets: something like a monthly 90-pill supply of Norco, so she has that, xanax, smokes and bad diet habits, takes statins, plus some signs of mental illness -- which she had before she started up on the xanax, etc.) But she did great in the rehab and they let her go home.
I've hoped my mom would get a new doctor because she says this one "doesn't know much" -- the woman doesn't specialize in aging issues, so she has tried to send my mom to specialists for heart and neurology but my mom won't go. So she gripes about this doctor but goes back mainly to get more pills.
On one hand I want to get mad at the doctor but I know she has to follow the rules of the hospital she's part of. My mom goes in and the visit takes an hour because my mom rambles on and on about unrelated things (I'm sure the doctor wants to hear all about her trip to the Netherlands in 1961) and it's a confusing mess. Then when she tries to direct my mom to try therapy or see a neurologist my mom pitches a fit about the costs or says "I've lived too long."
The doctor has a limited amount of time and she's probably just trying to get through the day and I assume help people who really will follow through. It's not ideal, but I get that. I don't like it, but I understand that she's limited in what she can do.
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Remember that statin drugs can cause memory issues, as well.
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An odd shuffling gait can be parkinsonism, and yes, Xanax is not a great drug IMHO. It gets given sometimes appropriately in small, PRN doses for severe episodic anxiety, but it is way too euphoric, people like it too much, and may keep taking piles of it and end up kind of floating through life on it. The docs who keep giving it are just trying to make people happy and keep them that way, and out of their hair. That's NOT good practice. These days, docs are more likely to get turned in for overprescribing narcotics while not doing pain management contracts and verifying proper use, but you can certainly try a complaint to the medical board. Better bet is to get them to a new doctor if you possibly can.
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Yikesneedhelp, sometimes the only way we can get help for an elder is if they have a sudden serious illness or a fall where 911 needs to be called. Then while in the hospital and for a couple of week in rehab, then it could be determined that the elder cannot go home if there are no caregivers there to help them 24/7.... that becomes an open door to relocate to a continuing care facility.
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Yikes, I've wondered that myself. My mom gets something like 1mg of Xanax and the prescription says "take up to 3 a day." Well, she takes two or three at night because she can't sleep. (Of course she does nothing all day except smoke ...) One time a few years back, we were visiting and playing a game of Monopoly and she got super loopy and we were wondering if she was sneaking booze behind our backs or if she was having some other medical issue. Turned out she'd taken three Xanax!
Every time I've been at the hospitals, the nurses comment on how strong the dosages are -- "strong enough to knock out an elephant" is how one put it. I've mentioned it to my mom's doc, too, and told her a couple of the falls that sent her to the hospital could be tied to the Xanax. The doctor keeps giving it to her anyways. My husband has wondered if we could report the doctor for being so generous with the Xanax.
You'd think, with it aggravating dementia, it being taken improperly and with it being strong, the doctor would at least address cutting the dose. When my mom was at a facility recovering from her latest fall, they cut her xanax by half to try and ween her. Once my mom got past the mean stage of getting less dope -- and getting hostile with me for not smuggling her pills in to her -- she actually became much more pleasant and clear-headed for the last week or so at the assisted living facility. Then she went home and got right back onto her cigarettes and Xanax and turned mean and loopy again. The pills aren't the whole problem, but I'm convinced the Xanax and the cigarettes are a huge part of it.
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Heidi, as a matter of fact, that is one of the medications she takes for anxiety and alternates with valium too. It makes sense that it would be bad but then why do doctors prescribe it? Very frustrating!!!.
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Your mom isn't on Xanax, is she, Yikes? That can aggravate dementia. My mom has a strong dose and shouldn't be on it, but the doctor keeps giving it to her. Several other doctors and nurses have told me it's terrible for people with dementia, though.
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Sandwich, thats a great idea. I just found my mom asleep outside in her courtyard leaning so far to the side of her chair it looked as if she passed out. I checked on her and asked her to go inside. In spite of our huge blow up yesterday she reacted calm and did just that. I don't know if she is taking too many prescriptions or ?? Her gait was odd as if shuffling. Its so sad to watch and I am not ready to make the call. Next week she is supposed to get a petscan of her brain to check for dementia. Hopefully that will lock in a diagnosis. The guilt my mother tries to put on me and the anger she displays toward me is so painful to deal with. To think I have devoted so much time and energy only to be accused of not caring makes me ill. I need support to take it to the next level… I have no siblings and she has no other relatives or close friends so its a lot. Also, I am fearful if APS believes her ridiculous stories and they have to legally look into things that ultimately it could complicate things?
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Sandwich, you didn't lie. Your mother benefited greatly from that visit -- and from your quick thinking!
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Yikes. Your story sounds SO much like mine. My mom needs a day's notice for anything and everything. Even if you were to just take her up the road to the bakery so she could pick out the donuts she'd want, she'd need hours. My mom sits around and smokes, watches stuff like the People's Court, and looks at old medical bills and says she's swamped with it, and then ponders suing all the area hospitals. Then she wants my support in it, and when I ask to see the bills because I'm not going to get her a lawyer for anything I can't see, she waves me off and says I'm being mean and aggressive with her!
Sandwich: I've pulled that line on my mom before: When a home nurse or social worker comes by: "Well, mom, they're coming to help you. They just want to make sure your needs are met; it's a good idea, and it helps you stay independent in your apartment longer." Then she'll agree and let them visit once or twice, say they're snooping around, and then tell them not to return!
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APS is legally required to complete a visit on every call. My mom refused to let the APS lady in several times, even took to hiding in her closet like a little child. Ultimately, they will have to get the Sheriff to open the door if she won't open it voluntarily. If the Sheriff opens the door, you're going to need to call a handy man.

I was able to get mom to open the door by calling her and telling her that I had gotten a phone call at work about her not cooperating with the county. I said they have to come check on all the elders and she has to let them in or they will break down the door. They have to follow the law and she can't stop them.

Mom's mental illness was in full gear and her dementia was still in early days, but definitely present enough to degrade her quality of life. She had paranoid delusions and beliefs that they were going to hog tie her and carry her away to kill her if she opened the door.

Somehow, I was able to persuade her to open the door by saying they just want to check on you to make sure you're getting all the benefits you're supposed to have. *That* is what I think convinced her - the prospect of getting government help or money. Yes, I know I'm going to hell for these lies, lies, lies to my mother. Sometimes one has to do what one must in the name of the greater good.
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Wow sounds familiar. My mother has no friends (thinks she does) as her behavior is so unpredictable. She needs 24 hour notice to go shopping, come over for dinner ect. otherwise she never gets dressed for the day. I just found out she never completed the intake forms so the appt has to be rescheduled:( My mom also doesn't do anything except smoke, watch Oprah and Dr Phil and sweeps her floor all day long. Thx for sharing!
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Yikes, your situation sounds so much like mine. My mom smokes, lives alone, has poor eating habits (and is diabetic). She makes accusations and gets hostile. Only wants help when it comes to getting more cigarettes or more pills. I hope the visit with the psychiatrist is a good one! I'd love to go to one with my mom, but she'd never go for it because she thinks the psych would find her life so fascinating that she'd gossip about it to the whole world. (Yeah, on top of that my mom thinks she's famous, at least in town, even though she really doesn't do much of anything.)
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Good luck! I would caution you against putting your life on hold for your mom. You can help her, but please don't do it at your own expense. Your needs are equal to mom's needs. {{{{Hugs}}}}
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Thank you! Yes I feel I need to do something soon. We had a terrible argument, she is very suspicious & angry at me. Thinks I want to put her in a "nut house" and take her money! I am so upset as I have only tried to protect her and help but this is turning out to be a 24/7 job and not very rewarding. We take 2 steps forward and 10 back as she will not follow any doctor orders -only if in the form of a pill. We have an appt with a psychiatrist today. Wish me luck!
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