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As my mom continues to decline with her dementia, she is becoming more unhappy. Already on 2 anti-depressants. I think her depression is probably more situational - being in AL and not being able to take care of your own needs or ask for help and being confused and in varying degrees of pain are just a crappy way to live so of course she is not happy. I think the happy ship has sailed.



She's been telling me that she is not happy but doesn't know what to do to make it better. That really does sum it up pretty well. She also told me she just wants to walk out of that building - not that she would because she probably can't really figure out how to do it, etc. But she's just feeling confused and doesn't know how to improve it.



She was bawling on the phone tonight because she can't use her phone most of the time. The nurse had to come in to help her. This is my 3rd attempt to get her a phone that is easy to use. This is my last try. If she can't use it, I'll just have to start calling the nurses station and asking them to help her call me or make sure she answers, etc.



So, do you think that an anti-anxiety would help her feel better? Happier? Less confused? I just hate to think that this is as good as it gets for her. I hate dementia. It's just so freakin cruel.



I am not comfortable with memory care at this time. In her building, it is a very small unit and most of the people seem really bad. I think that would be horrible for her. When she's more at the level of the people I observed there when we went trick or treating, then I think it would be an appropriate match. But having her be the most "with it" person there seems like a really bad idea for her well being.



I am also thinking of hiring a private aid to spend some time with her. That may limp us along until her condition deteriorates more, which I know it will, when she will be more ready for MC or SNF.

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I think it's important to speak with the mental health professional who is prescribing her meds. S/he needs to know how your mother "presents" to you, deeply unhappy and wanting to escape the situation. He current meds may need adjusting, or something added

What worked for my mom was a combo of two ADs AND a low dose of antianxiety med, given on a regular basis. There was also an additional dose of anxiety med that could be given if my mom was upset, but it was keeping her on a regular low dose that seemed to enable her to remain calm and content most of the time.
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againx100 Jan 28, 2024
Thanks so much for sharing your experience. I was thinking of a low dose of anti-anxiety med but hadn't thought about an as needed as well in case of a rough patch.
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Ah--Barb hit it on the head.

We treat MIL proactively so she doesn't get in a rage that requires a larger dose of her benzos. Keeping a level amt in the bloodstream is far better than reacting to a new surge of anxiety.

Without the meds, she just screams at people and is impossible to deal with. For some reason, when my DH has his CG time with her, he will not give her the meds. He won't/can't explain why and I can't figure out why he won't. She is far less angry and troublesome and I know she 'feels' better on them.

When he's having a bad night with her, and I talk to him, he acts like there's nothing to do--yet there sit 3 different kinds of benzodiazepines and he won't give her anything. So they BOTH have a rotten night.

We're moving her to an ALF soon and my only suggestion was that they made good and sure she was sufficiently 'loaded up' on whatever benzo will keep her the calmest. YS will take care of that.

I also suffer from chronic anxiety and I take an AD and a benzo as needed. Sometimes I pre-dose, knowing that the situation I'm going into is going to trigger panic.

Don't let the 'stigma' of these life altering drugs make you choose to let a LO suffer.
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Yes, Ativan helped mom quite a bit with her generalized misery. She was already taking the max dose of Wellbutrin but even IT wasn't helping enough with her angry frustration when the dementia advanced.

I agree with Barb. Speak to moms doctor about the possibility of adding in scheduled Ativan to see if it helps overall. There's only one way to know.

As far as memory care is concerned, I agree with you. Wait till the last possible moment to segue her in there. Unless of course she's wandering in AL or having too much trouble functioning. Sometimes an elder can take a big step down with dementia....suddenly....and get much worse overnight. That may have happened with mom so keep an eye out. I saw my mother take several steps down herself. One came after small strokes, another after a hospital stay and rehab for pneumonia, and one for no apparent reason.

Feel HER out about a private aid before you hire one at great expense. That's my advice. Try the Ativan first, too. It may just take the edge off enough to get her mingling with the others w/o the need for a PA. One step at a time.

But above all, remember this: with dementia at play, not everything can be fixed. Sad but true. You've been a great daughter all along and mom is very lucky to have you.
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Againx,

This situation is very hard. I hate dementia too. Hopefully, continuing research will help to find solutions in the future for this devastating disease.

I would speak to the doctor about her behavior and see if he/she thinks that she needs an adjustment with her meds.

I agree with you that it has to be hard for her in this situation. She is aware of her limitations and it’s frustrating to her.

I wonder though, if her lack of ability to do day to day tasks such as using the phone is causing her anxiety levels to increase more and it’s leading to a deeper depression.

I saw my mom’s outlook change when she had to depend upon others more and more. Ativan and Seroquel seemed to take the edge off and she was able to accept her situation more easily.

Wishing you and your mother peace during this difficult time. Sending extra hugs your way today.
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againx100 Jan 28, 2024
Thanks for your kind response. Your extra hugs are just what I need. I think you're right - that her inability to do things like use her phone are increasing her anxiety and depression. I don't think I should take her phone away but soon I might have to have her brothers call the nurses station to get help with connecting with her.
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I believe, given the anti-depressants already on board, that you are correct. The happy ship has sailed. Things become habitual for those with dementia. And in all truth, with loss upon loss coming at them, there is VERY LITTLE to be happy about. Those like my brother, who had early Lewy's and told me "The ALF is kind of like the Army when I was young: I didn't much like it but I made the best of it". He was honestly just trying to make himself and others "feel better about it". That was his way.
You mom is too disinhibited now, in her expression of her honest feelings, to hold them back. It is very hard on families to "go there" as they feel responsible to "make things better". That isn't always possible. Some things are just hard, and just remain tough.

Certain, if you are POA, feel free to discuss with MD. There is not much harm in trying to play around with the med cocktail. But there's honestly no miracle in it.
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My step-mother is in MC, we had to remove her room phone as she kept looking at it thinking we were calling her, which we were not, it was her reading her own calls.

We now call the nurses station, works fine for us.

She also has had her doses of meds increased as she was really sun-downing, and angry, she is much better.

I am personally not in favor of a private aide it is to me just another crutch to pretend she is not as bad as she really is. Having a PA will do nothing to better prepare her for MC.

I think it is you who is not wanting to accept memory care, she can go further downhill overnight and then it will become an emergency. Why not look into other MC's if you do not think this one is right for her.

Good Luck
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