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My elderly father is 91 and waking at night wanting to "go home" or having other worries. His wife is concerned that she may not be able to calm him and keep him safe. Anumy ideas what may help? Considering an anxiety med. but don't want this to interfere with his mobility. He is also somewhat anxious during the day. He has early, mild symptoms of dementia.

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Waking up in the middle of night. Elderly Man. Could be prostate issues. Needing to urinate, but dehydrated anyway. If he is a fall risk and has sleeping issues and has not been diagnosed yet with dementia officially, then can be life-threatening. I am of the opinion still that sleeping issues complicate symptoms of so many things for any age, but when a person is age 80 and above, and cognitive problems get confused with lack of sleep or both are occurring, then all types of specialists come to mind. Urologist for the need to get up every night, to improve rather than just meds, but due to his age, likely firming up the diagnosis for dementia is paramount. Sounds like long-term memory is still good, but short-term memory is not.

Also the type of medication and dosage also has to be considered in relation to other diagnoses that have been evidenced by a physician. There are a lot more types than the ones mentioned, and the dosages of all medications are better to be managed by one doctor, so dosages do not get changed with multiple doctor appointments. Easier to manage one doctor, one patient, one pharmacy.

Mobility was mentioned. Good that he is still mobile, if he is not a fall risk which comes with lack of sleep or dementia. Walking is healthy, but not on 3 hours sleep when caregivers are all asleep even if they live in the same abode. Good luck!
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Don't rule out a UTI or new (or changes to) medication.
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It has taken me a year just to begin to understand ALZ, there is no cure and I have learned that I can't change the memory loss. I no longer try to remind him that he has children and a wife. When he speaks of his Mom and Dad, brother etc. and asks how they are I just say "they are just fine". I had to accept and let go and am finding peace with that.
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Perhaps the spinning of wheels here ... Barb & Heather... could we all agree that in all cases discussed that what it boils down to is it's taken 'some "one" with a license to take time with each elder to find out what works. It may not be so much a difference in liscence /title we are arguing, but simply finding one that takes the d*mn time to treat them with respect and to have knowledge of the meds as well as themselves as individuals that actually work for them. Because I have a negative approach to psychitirists does not mean you do.. because I have taken extreme efforts to find a specialist physician that took genuine interest in my mothers well being does not mean there are many out there ( because there are not)  .... folks let's face it, we as care providers for our family members do not find the help we need easily no matter what that is. I need it understood and I believe I've said it, if you've found someone that works, so be it, because I really don't care if it's the trash guy, if I'm seeking help and I get it, not unlike any others I will stick to that until that help fails.
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My mother's psychiatric evaluations did not involve hours and hours of sessions. In each case, we are talking about a doctor having a 15 or 20 minute conversation with her.

Geriatric psychiatrists specialize in medication management of the elderly. I think that you are the thinking perhaps of neurocognitive evaluations, which involve several hours of paper and pencil testing.

No amount of "paying attention to" my mother did anything to help her anxiety. Meds did.
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While you're waiting for an evaluation from the doctor, Google Lemon Balm. This is used in Europe to treat agitation in the elderly with dementia. I give this (the tincture version) to my mother and so far it's worked. I buy it off Amazon but you can find it at your local Sprouts or Whole Foods store. She's been on Lemon Balm for the last few years. She's on no meds yet for her agitation symptom of dementia. I'm not against using traditional medications, I just prefer trying clinically proven naturopathic treaments first.
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I'll add to my earlier post about WHY a doctor that specializes in prescribing psych meds could make a difference. My mom is on Alz meds. She'd been taking a bunch of other meds prescribed by different "specialists" (rheumatology for arthritis, cardiology for A-fib, neurology for strokes/Alzheimer's.) NOBODY was aware that while there wasn't an "interaction", some meds were rendered less effective by another by virtue of how they worked in the brain...until the Psychiatrist who is very up to date on the subject matter pointed this out. Most PCPs, pharmacists, etc. can only know so much about "everything". So when it comes to brain chemistry that is complicated by a deteriorating disease (of which there are multiple types) and affects the day to day functioning/well being, I will never again rely on a PCP guessing what will work best based on a cursory review of their electronic tablet. It might not kill them, but might be completely useless. I make this distinction because the symptoms the dad is exhibiting sound like classic dementia...In which case, this would be reason enough for me to rely on an expert who is exclusively up to date with all the latest studies, nuances, etc. How much trial & error do you want to subject a senior to? I guess that's what it boils down to. On another site dedicated exclusively to Dementia/Alz that is very active 10K+ members - you might be surprised how differently the most commonly used meds can send someone into a tailspin - to the point they have to be admitted to a psych ward - where a psychiatrist then has to unravel everything the well-intended PCP tried to do to fix a symptom or two or three. Just because a textbook says something will alleviate this symptom or that - when you're dealing with a deteriorating brain, it's no longer textbook. Just because any doctor "can" write a prescription, doesn't mean they "should" give it a whirl.  (We've all heard about the opioid painkiller epidemic.)  Anyway, I've foregone having "opinions" when it comes to dealing with my mom's plethora of problems - I find it interferes with making informed decisions. As for living in fear of "meeting our maker"?  That is precisely why I don't subscribe to "organized" religion - it conflicts with my soul's purpose.
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.... Barb... if you' yourself had had a good experience then as I said before so be it. ...But in all honesty can you sit there and tell me that what the psych did for your mom a regular physician could not have, and does your mother today benefit from all the hours spent 'evaluating her, or is it the meds and your attention to her is what's created the enjoyable life ... and I'm sorry if you do not find the word on a good note but the word 'evaluating is exactly what is done. ... And not to say that is not what a physician does, and I would be hard pressed to believe that if you began with her physician that he or she would not see cognitive decline?? No way, If you mentioned to the physician what you've noticed your mothers behavioral symptoms were a competent GP (general practitioner) or geriatric practitioner would not have said take an aspirin and call me in the morn. Absolutely not, what they would have done as any competent physician would have, is gone down the medical history of your mother then went down the same exact med path as your psych but the general or geriatric practitioner has freedoms and obligations to check her physical condition and to monitor her physical condition of any meds prescribed, which your Geri psych does not. I see the time and expense of a psychiatrist to be extreme and a misguided path when the same meds prescribed from her (any aged individual) regular doctor and the very real genuine attention and care from her family could have perhaps had the same results if not better ... 

I mean in all honesty once again, if you look at it like this.. that by your taking your mother to all the appointments, causes you to spend time with her,  and there's no harm in her being talked to by the psych (just means more attention for her) ... So knock yourself out, take her to a psych or to the zoo, because it probably doesn't matter where you take her,  she's recieving your attention and that's probably worth far more than you know. 
Lastly,  all due respect Barb, these are simply my opinions, you may believe they float or sink, doesn't matter to me, your loved one is not my responsibility to decide what to do or not. ... they are yours.  
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Tired, as the daughter of a demented mother who will be 94 next month, I wish I discovered the fact that geriatric psychiatrists are the last MDs in the system who actually seem to see the whole person, not just an organ that is malfunctioning.

A geriatrics psychiatric evaluation is not whatever you imagine it is. No one is trying to dig deep into the else's psyche. Rather, the doctor is trying to gauge levels of depression and anxiety, in a skillful and gentle way that is beyond the skill set of most internists.

All three Geripsychs that my mom has seen were caring and gentle and took care to reassure my mom. They didn't simply "medicate the symptom" the way her PCP did, each took time to talk to mom and to us about her prior history and why her anxiety was ratcheted up so high.

It was the geripsych who realized that mom was experiencing cognitive decline and who sent her for an evaluation that revealed the extent of the damage to her brain.

Once mom was on the correct meds, she was calm and happy and able to enjoy life.

I will not have my mother living in mortal fear of whatever demons are tormenting her on any given day.

That, to me, is showing respect to and honoring my parent.
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Don't rule out a UTI or new (or changes to) medication.
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... I want to mention somthing about the ''sudden surge of talk of and the over whelming saturated advice to seek geriatric psychiatrists that I've been reading on this forum lately  ... Listen folks, although it may have worked or helped an aged loved one according to you, think about what the mere title is will you please... then match that to someone in their late 80's to 90's... I mean come on. These elders of ours if they begin having deep memory moments or mind confusion why in the h*ll would you haul them off to a psychiatrist ????? even before you speak to their general physician? (as long as the physician knows them well they are more than capable of prescribing a mild sedative or managed anti-anxiety meds without going through any unessasary psychiatric evaluations. 
If you begin thinking age related deep memory recall or lapsed memory, or confusion, are signs of a psychiatric condition in 80 and 90 year olds, then in my opinion there's a problem with how you yourself view the aging process, or perhaps you have limited education of how the aged mind works. 
A general physician is far more capable of finding (if any) possible underlying causation (if there is any) than a psychiatrist, and a general physician is more than capable of prescribing a mild sedative or anti anxiety meds if it means the individual will benefit from such a need.

I cannot help but feel a need to remind many of you that these aged individuals, are to be respected as human beings and treated with the dignity of being human and need to be allowed to 'think as they wish and should be allowed to 'live as well as possible  (as long as there are no harm to themselves or others) and should be allowed to live as dignified as possible ... So, in closing; to be mentally evaluated in the last years on earth is an absolute disrespect to their own being and to whom they are in this world. Now if you' need to go sit with a psychiatrist to talk about the effects of 'their ageing and what it's done to you, then do so, but when anyone begins to haul 80+ year olds to psych evaluations, I personally think thise individuals Doing the hauling are the ones needing evaluating.
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Sudden changes in living environment can cause this at night, or it could be sundowners, I would check his doctor for a bedtime medication to calm him down and help him sleep.
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I wrote a long comment on another question so I wont elaborate here...my mother is 83 and its funny but she is remembering things I never heard of...she has been diagnosed with alzheimers and psychosis..she sees things she says...she is very religious catholic and uses it over her friends...like she is special because she saw some spiritual visions. she keeps saying how lonely she is...well, that is understandable because my father died in 2014 and then my brother died 2015...he was taking care of her after dad died...we were 5 kids now minus 1....I have a brother who lives near mom but has cut her off..he had to because she was ruining his job and family. my two sisters live in Washington state and Delaware...couldn't be farther away and the one in Delaware just lost her husband. I'm 4hrs away...we tried staying there when we went down to help her but cant...she went through 15 visiting angels and one had to get psychiatric treatment. she has been black listed....her loneliness tho could be taken care of by taking an SSRI....I might suggest here that your father be taken to see a psychiatrist or a doctor for the elderly and he probably would do well with an SSRI...something mild...im on paxil...30mgs but starting out at 20mgs would be okay...there are many kids of helps like this....but I would push you more towards the doctor for the elderly....he is 91....so if he can feel better..for what time he has left....that is what I would want....God bless
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This message is actually addressed to Dontask4handout. I found your posting not only to be unhelpful to jilzz101, but also entirely inappropriate. This is a forum where we can help each-other with the various physical and psychological trials of dealing with age, it is not a pulpit for you to pontificate about Christianity. There are people of all faiths who post here and we try to treat each-other the same as any other person, regardless of faith. There was absolutely nothing in jilzz101's post that indicated that her father was having a crisis of faith or that a fear of eternal hellfire was what was behind his behavior. What if jilzz101 is Jewish? Or Buddhist? Or has no religious affiliation at all? Is it really helpful, then, to poke her with your holier-than-thou, only Christians go to heaven kind of theology? She came here looking for emotional support, not to hear about hellfire and damnation if her father hasn't been "saved." I am not anti-Christian or any religion, but I do dislike the idea of using a forum that is supposed to be about sharing our experiences with caring for our elderly loved ones to proselytize and scare posters about the fury of a wrathful God should our parent not be a Christian. You probably meant well and were hoping to "save" her father, but it was inappropriate.
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... There are a few anti anxiety meds you can discuss with his physician (a phychyatrist is not needed to prescribe, his general physician can) ... Saraquil and larazapam are two others that in lower doses create a steady calming, a leveling of mood if you will by knocking off the edge of anxiety but does not create a foggy mind nor immobility or balance issues. Work closely with his doc to find out and then manage the dosage that works for your grandfather. My mother is on a daily small dose of saraquil, and then larazapam is a secondary med used as needed if her anxiety still peeks.
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I finally had to put my DH on Zoloft 50mg - and there have been no side-effects to date other than he is no longer worried all the time. He is 95 so I hear where you're coming from. I held off for a full year after it was recommended by his prime physician because I was worried about what it might do to his kidneys and liver.

I have no regrets having finally put him on it - I have days where I'm tempted to join him. For myself I looked to supplements instead of medication. The supplements didn't work for him.
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In my situation it was my husband who emptied his closet every night and looked for the suitcases so he could be taken to the Air Field and do his job. He was back in time, said he had never married etc. and just wanted to go back to work. He had been in the Air Force and that is where his mind has stayed. He is now in long term care, talks about his parents etc. but no memory of marriage, children, grandchildren, etc. One just has to let it go. I think for our children it is very difficult. If those memories make him happy so be it.
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My mother often said this at night. She had been a strong Christian all her life and certainly had no fear of "meeting her maker". I believe she looked forward to heaven. Her favorite hymn was "I am but a stranger here, Heaven is my home". I agree with an evaluation by an MD with a specialty in dementia for the proper meds. Night time is often a challenge for many. I think it is a stretch to interpret this as a faith crisis.
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Be careful giving Tylenol PM to an elder because it has been known to create horrendous problems with delusions & hallucinations & can be deadly to older people. There was a very informative write up recently in the Health section of the Washington Post newspaper in which a woman gave that to her mother and had to be sent to the ER as a result. The ER doctor was shocked that someone would do that to their parent, but she claimed she didn't know. I myself just learned of certain medicines that we take on a common basis like Benadryl and Tylenol PM that are toxic to older people who are so vulnerable.
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My husband's doctor has given him medications which do render him pretty much immobile throughout the night but wear off by morning. Since I'm always with him at night, this is not a problem.
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Look up sundowners syndrome. I hate to say this, but you'd need to hire a CNA to watch him at night or put him to nursing home. You could try giving him Tylenol PM.
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I agree with BarbBrooklyn...seek out a psychiatrist who deals with the geriatric population - someone who has experience prescribing medications from a broad standpoint, rather than a well-meaning GP simply looking at a symptom and trying to match it to whatever prescription med they throw a dart at. I am not sure I'd be worried about mobility affects, if he were given an elephant tranquilizer, of course, but most of the meds a skilled doctor will prescribe shouldn't lead to that. It's not easy to always find the specialists you will want to work with - sometimes it's like a needle in a haystack, but they're out there.
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Believe it or not, I had an elderly friend in his 90s who showed very similar behavior toward the end of his life. He had spoken of wanting to go home and even started talking about his deceased wife and even talking in his sleep as though he were talking to her from a distance sometimes, even calling out to her in his sleep. I knew deep down he must be in the dying process just because of how he was behaving at times. He had macular degeneration and even started saying it was "getting darker", which was why he said he always left all the lights on 24 seven. I just knew deep down he must be in the dying process and sure enough not long after we met he ended up having to be put into a facility and then he died at a medical center near the facility. 

Did it ever occur to you that even though he wants to go home he may actually be very worried about meeting his maker and being judged? This would be the right time to get right with his maker before it's too late and he can do this by accepting Jesus as his Savior so that way he has no worries. Have you ever wondered why people are so nervous toward the end? That's why, people are nervous because they're not right with their maker, and we will all stand before him one day and give an account for our lives and what we've done with our lives. What will really matter besides having Jesus as our savior is how much did we love one another, especially the least come on us. The poor are always with us, did we help the less fortunate or did we just pass them by? These will all be  counted against us if there's anything not right and we will lose rewards and miss out on them forever if we didn't earn those rewards. How much we love each other is more than just words, it's in our actions because actions speak louder than words simply because actions reflect what's really in our hearts. Yes, an awful lot of people are very anxious when they're nearing the end because they know deep down they're not right with their maker. Hate me if you want, I'm just simply speaking the truth and I won't back down because I know why people are afraid to die toward the end, I know why people are anxious, I saw it happen at least once
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Jill, a lot of on here have had great success with having our parents with dementia evaluated by a geriatric Psychiatrist. Sometimes, it's not as simple as an antianxiety med in dementia. There are antidepressants with antianxiety properties that often seem to work well on those nameless fears and worries.
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