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Mom has dementia and I have taken guardianship of her. She doesn't think there is anything wrong with her and says I am just "after her money". I have her in a nice assisted living facility but visits with her are just awful. She keeps asking when she can go home but i know she can't. My presence just makes her angry and she yells and I get upset. She has said some truly hurtful and awful things to me and about me. I feel guilty because I don't even want to go see her.To make matters worse, my dad is in decent shape and living at home with daily assistance. This makes her angry with him. I think she sees it as " unfair". After 60+ years of marriage, he misses her and is having a hard time accepting her condition and the fact that she can't be at home any longer. I have no brothers or sisters to help me with them. I live an hour away and own a business that requires a great deal of my time and attention. The guilt and stress of this situation is making me sad and despondent. I even feel guilty for focusing on how this affects me when my parents are going through such an awful time. If I didn't have a wonderful, helpful wife I would really be at the end of my rope. Help!

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Mom's PCP, a nice guy, but not a geriatrics specialist, was able to se mom's anxiety and gave her xanax. Told her to take when she felt scared. Worst possible advice ( and not a good drug for elders).
When she got into Independent Living, the geriatric specialist recommended a geriatric psychiatrist who much more fully appreciated mom's situation. She put my mother on scheduled dosages of klonopin, to " get ahead" of her anxiety (you need much less of the meds that way). And she wisely insisted we get mom a cognitive evaluation, which revealed her Mild Cogitive Impairment ...and yes, if we'd been advised to have mom see a geriatric psychiatrist sooner, this might have all played out differently.
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Yes it is. It was essential for us to get the right treatment. Once behaviour in a senior goes "off the rails" it should be required. We would have been saved a lot of stress if she had been referred to one sooner.
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Golden23 - isn't it amazing what a difference a geriatric psychiatrist can make. Along with BarbBrooklyn, I am a giant advocate of this type of assessment when dementia is involved - especially if the person was "complicated" before dementia came into the situation. A geriatric psychiatrist worked wonders with Barbs mom, your mom, and dramatically in my own mothers case. I wish everyone dealing with these sorts of issues were able to have a geriatric psychiatrist consultation - at minimum! Wouldn't it be wonderful if an annual assessment of this type was required to receive Medicaid or Medicare benefits?
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mitch - you are doing te right things. My mother went through some months after she was hospitalized in a geriatric psychiatric hospital when she hated all of us. She was thoroughly evaluated, with a geriatric psychiatrist in charge of her case,and eventually she agreed to go on an anti psychotic which worked wonders. Later an antidepressant was added. She is now in a facility and more content than I ever have seen her. The right professionals are invaluable. It is obviously better for your parents to be separated. Sometimes there are no great or even good solutions - just better or worse ones. You are choosing the better ones. They are fortunate to have you.
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Cmitch, you are the GOOD guy. So many just walk away, driven off by the constant blame game. As for Dad, he misses the wife he married, not the angry woman you have saved him from. Bless you for caring.
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Rainmom - I will certainly look into your advice. I have spoken to many health professionals and no one has suggested this. Dealing with these issues has certainly opened my eyes to the medical profession. I've learned several things...doctors do make mistakes, often they seem reluctant to give direct advice, seldom will they sign their name to anything. Seems like they are afraid of litigation or censure. Personally, having gone through the guardianship process, the last thing I want to do is be involved in any more legal proceedings for any reason. Sometimes, I would just lkike my decisions to have some kind of validation. I second-guess myself so much!
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I agree that if her mood and anxiety is not improving, she may need a medication adjustment. Not all anti anxiety meds work well for everyone.
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CMitch - I wanted to clarify and add that yes, my mom was on an anti anxiety med as well as an anti psychotic and anti depressant at the time I took her in to see the geriatric psychiatrist. What my mom was on had been prescribed by her pcp. It's been my experience that doctors rarely criticize each other so when I met with the geriatric psychiatrist after he'd seen my mother, I was surprised when he told me - shaking his head the whole time - that what my mothers pcp had prescribed made no sense in terms of combination, quantity or dosage. So, as you've said your mother is already on similar medications, don't blow off the idea of getting her in to be assessed by a geriatric psychiatrist. As a specialist in this field- prescribing the specific correct meds in the right combinations and dosages can make all the difference in the world. It certainly did for my mom and therefore- for me.
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CMitch, it sounds like you have done a great job getting help for your parents. It's a tough thing to place a loved one in a place where they can be protected and cared for, especially when their brain doesn't allow them to realize what's going on. But, it's necessary. As a Guardian, that's your job. She would agree with you, if her brain was working properly.

I'd just keep reminding myself of that. I mean, I would feel guilty, if I hadn't done anything. Sometimes, you have to give yourself permission to be proud of what you have done for your parents, even if they are not able to appreciate it.

I agree with others who suggest that you get your mom evaluated by a geriatric psychiatrist. Sometimes, medications can really help someone who is overly anxious, depressed or worried. They helped my loved one a great deal. These meds don't need to make her groggy or sedated. They work on a daily basis to help someone feel as content as possible.

If the visiting experience is too painful, then, I would hold off for awhile or at least until you can gain some confidence in yourself and the fact you did the right thing. And if mother needs medication, perhaps her mood will change and she will be more receptive to seeing you without being outrageous.
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Lol, Rainmom and Mitch, I often think of myself as " Little Miss Geriatric Psychiatrist-recommender" here, but only because the right combination of antianxiety and antidepressant meds made SUCH a difference in my mom's life. They still need adjusting from time to time, like this summer when mom became convinced she had leprosy.

And yes, there IS a difference in the way a neurologist and a psychiatrist prescribe.
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Oh, Miitch, you poor guy! I'm so glad you have a wonderful wife!!

My remaining suggestion stands; have any psychiatric meds ( anti- anxiety, antidepressants, antipsychotics) been tried? Is there a geriatric psychiatrist who visits patients in the facility? While figuring out these meds is often trial and error, the long term results can be worth it.

Hang in there. Any support you can get for your own wellbeing (a massage, yoga or mediation, a talk therapist) are worth your while right now.
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CMitch - I completely understand, sympathize and know how you are feeling. This time last year I was right where you are now - although my beloved father had passed the summer of 2012 and I didn't even have his support and presence to help balance the equation or my feelings. In October/November of last year things really peaked in terms of crisis and ugliness. My mom said things to me that will be seared into my heart and mind until I lose my memory or die - hoping the later comes first. Now, even though I know a lot more about dementia, the hurt of those words are only lessened in minute increments. Finding this site and following the advice given here turned out to be my salvation. I'm sure it was BarbBrooklyn who suggested getting my mom to a geriatric psychiatrist- and while seeing my own doctor for my own rx for anti anxiety meds, he made the same suggestion. So using a therapeutic fib I was quickly able to get my mom into seeing the psychiatrist. After a lengthy appointment where the psychiatrist assessed my mom, he overhauled her medications. Some rxs were stopped and others added over the next month - done gradually. At the end of that month my mom was more herself than she had been in years - and she was in no way a medicated zombie. My only regret is that I didn't know to do this earlier - way earlier! Today is Christmas- my first without either parent and I find myself missing my mother more than I ever thought possible - I do believe having my mom back - more or less - for her last eight months is what's made that possible. These days I'm trying to focus only on my good memories of my mom instead of the bad - but I share my worst memories with you in hopes it can help you. Please don't spend another month, week or day dealing with the heartbreak your mothers broken brain is causing you - do whatever it takes to get your mother into see a geriatric psychiatrist!
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I would add that mom has seen a neutroligist and is on dementia and anxiety meds. They seem to be helping some but she still is paranoid and mean. Before I took Dad home from assisted living, the nursing director there was already telling me that i was going to have to separate them. They had been hearing the yelling and abuse. It just hurts me to have to make them live apart even when I keep telling myself it is best for both of them. Dad is a little sore about me taking guardianship of him but I think he is secretly relieved that the monkey is off his back and I made the decision he could never have brought himself to make. He would NEVER have placed mom in a facility. They would have just both stayed at home as things spiraled out of control and something really bad happened. Sorry to just keep going on but it feels good to get these things out!
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Thank you both for your responses. I left out part of the story due to length. I actually had both of them in the assisted living facility for three months. I was told by several Dr.s , nurses, OTs and PTs that "your parents will thrive in assisted living". That turned out not to be the case. For over sixty years, Mom has been in charge. My dad has always been a loving and devoted spouse. He went along to get along. That was fine with me. Their relationship is their business and my dad didn't seem bothered by a domineering wife. It worked because my mom was very competent in most everything. She kept the books, paid the bills, managed the home, etc. About twelve years ago, Mom developed neuropathy and Dad became her caregiver. He did a great job but i think mom was resentful of him being her caregiver for some reason. She was still in charge. Things went well for about ten years. But when the person in charge develops dementia, things dont work so well anymore. Anyway, my dad has had chemo this year and was hospitalized twice by A-fib attacks. Both times he became confused and disoriented. The nurses called it "institutional confusion". When he got home, mom was always running off the helpers we had hired. In the last ten days they were home, they had EMTs at the house three times. I had to get control of the situation so i took guardianship of both of them. When i placed them in assisted living, Mom, who was still in charge, would not eat, would not leave the apartment would not ask for assistance and Dad followed her lead. Plus she is verbally and emotinally abusive to him. It was not working. Dad is doing much better at home since he is eating and sleeping. Mom is not there to wake him up at 2 or 3 am to yell at him for some imagined slight. Plus he is in his home of fifty years. Even as badly as she has treated him for the last several years, he misses her. Sorry for the lengthy post but it takes a little explaining.
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I agree with Barb and FreqFlyer. You didn't create this disease in your mom, so you have nothing to feel guilty about. You're looking out for her best interests. You've effectively reversed roles so that you're now the parent. Just like a child, as a parent, you do what's right, whether your child agrees or not.

I agree about getting your parents into the same facility if possible. My parents lived in independent living together and in my dad's last three months, he moved to skilled nursing, after he was diagnosed with lung cancer. My mom and I could go visit him without it being a huge burden on my mom or me. If you go visit with your dad, maybe you can slip out so your mom can focus on your dad and not be so negative towards you. In the meantime, I'd limit visits and just keep in close touch with the nursing staff to make sure mom is OK. Also, check whether some different meds might help mom's mood.

I can say from experience that managing two parents with differing needs is a HUGE stressor in your life. So cut yourself some slack. You're in an emotional and physical war zone and you need to take good physical and mental care of yourself. Mom and dad come after that. Your needs some FIRST. Hard for caregivers to learn, but it's a necessary lesson. So HUGS from a fellow caregiver who gets what you're going through.
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CMitch, Barb above had a great idea about seeing if your Dad can move to the same complex. If the facility has a multi-level service, your Dad could move into Independent Living and be able to walk over to the Memory Care center to visit and even have his meals there. It just depends if there is enough in funds to pay for having two units.

Another thing to remember, when Mom says she wants to go home, chances are it isn't the home that she had shared with your Dad, it is her childhood home back with life was simpler and child like fun. That is very common with patients with memory issues. My Mom [98] was always asking to go home but later we figured out it was back to the farm to see her parents and her siblings [all of whom had passed many years ago].

My Dad was different, he insisted it was time to live the single family house as it was no longer safe for him to be there. He loved Independent Living and wished he would have moved there years earlier, but my Mom had always refused.
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A couple of things....
1. It's not fair, but it's also not YOUR fault that mom has this crummy disease. You've done nothing wrong, so can be regretful that she needs to be in AL and not at home, but no guilt.

2. Has mom been seen by a geriatric psychiatrist? There might be meds that would help her agitation and depression.

3. Can you explore moving Dad to AL? If he needs daily assistance, seems like he might be better off there.
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