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Mom is 91. She has had a fracture of the sacrum, massive rotator cuff tear (inoperable) and now a fractured knee. We cannot care for her at home. We moved her into a very nice AL facility close to both my sister and me. We visit almost every day. Mom is extremely distressed since the move and has been experiencing severe panic attacks. Today she clung to me and begged me not to leave her. She said she does not want to die alone in this place. She is convinced that she is about to take her last breath. The nurse gave her a Xanax and I waited one hour for the pill to take affect before I could tear myself away. She doesn't seem to be responding to the Xanax because she called me hysterically an hour later accusing me of leaving her in the midst of her trauma. She told me to come back there right now and get her out of there. I promised I would, but I didn't. I can't come to grips with this. My sister is feeling the same way. How can we leave our mother in such emotional distress?

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Poor Mom. Poor you. Poor sister. This is a hugely distressing situation for all of you. My heart goes out to you.

Was Mom subject to panic attacks before the move? Is she on any new drugs? Does she have cognitive impairments that prevent her from understanding where she is? Does the staff report that she has these attacks when you are not there?

Has a doctor seen her specifically about the panic attacks? Perhaps a medication (other than xanax) would help prevent these distressing episodes.
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Panic attacks are just horrible. I used to have them many years ago. My mom has had them too until recently. I'd discuss it with a doctor who can review medication options with you. Medication has really helped my mom tremendously. My cousin, who has dementia also had extreme anxiety. Medication really helped her too. Most of the people I know were prescribed a daily medication for Anxiety and depression. It doesn't make you drowsy, but offers around the clock treatment for the distress.

You might inquire about Cymbalta since your mom has a lot of pain with her bones. My cousin had a fracture in her spine when she was placed on it and it really helped. This med also treats pain of the bones. Of course, everyone is different, but, I'd explore the options.

I'd also explore if you mom is having memory problems. Sometimes, when people have different reactions in a short period of time, it's due to them forgetting what just transpired. They have no memory of what might have happened shortly beforehand. That can be very frightening to the patient and they get scared, then have the panic attack.

I'd try not to blame yourself. You have to do what is best for your mom, regardless of her dislike of the place. I'd try to get her relief from the panic attacks and give her more time to adjust.
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Is there is a geriatric psychiatrist who calls in at the facility, or one v that you can get mom to? She needs meds gor her anxiety and agitation.
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Panic attacks are horrible and the person having them truly thinks they are going to die. The trick is to take a tranquilizer before they happen to prevent them. Your mother is adjusting to AL and it is frightening her, which is probably why this is happening.
My mother had them for years - after my stepfather passed away. She lived alone in a house but refused to move to AL. At least once a week she would call my sister saying she was dying, having a heart attack - because one of the symptoms is a racing heart (they always occurred in the middle of the night) She was taken by ambulance to ER dozens of times, then sent home in a few hours - always the same. Some were so bad she would vomit or defecate in the bed. After a while it became obvious that it was caused mostly by fear she was alone in the house and she was always needy for attention anyway. My poor sister had to get up at 3 am time after time and go down the road and help her. She never had an attack when she slept at our houses.
The doctor prescribed clonzapam which she was supposed to take every night before bed, but half the time she didn't and kept having them.
When we finally forced her to move to AL, she had only 2 attacks the first few months, went to ER and was sent back. She was embarassed and finally started taking the tranquilizer as she was supposed to, and sometimes she would take 1/2 if she felt one coming on during the day which they never did. The attacks stopped completely after she was in AL for a few months.
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I agree with the suggestion for Cymbalta, which treats depression, anxiety and neuropathic pain. It takes a few weeks to be fully effective. Make sure her fracture pain is properly controlled too. See the head nurse tomorrow.
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Thank you all so much for your helpful insight. I should clarify that my mother does have dementia and I realize that this is a contributing factor with her panic attacks. I certainly will look into different meds for her. Now all I need is meds for me.
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I hope you can get her some relief. I know that when that happens, it makes it so much easier on you. Take comfort that things may get better when they get her treated.

Also, I might discuss the matter with the AL staff. Do they have many residents who have dementia? I know that when my cousin was in regular AL, they didn't seem to understand how she was not really in a position to make phone calls at any given time. They would call me on her behalf at the drop of a hat or less. This resulted in multiple phone calls for no real reason. Like, she was upset that she couldn't find her hairbrush. Or, she she didn't like her lunch. To me, once she got into Memory Care, they understood this. If there was a need to call me, they would, but constantly calling me, for non-urgent matters ceased. The staff needs to recognize what is happening and work towards her staying calm, without constant phone calls. BESIDES, she would forget the call was made 5 minutes later, so they really didn't help matters.
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aferrino, sometimes one has to combine Xanax along with a small dosage of anti-depressant. Panic attacks are tough, it can make you feel like you are "disappearing". It took time for me to find the right combination of pills to work, all very low dosage.

It is my understanding it is best not to visit anyone who just moved into Assisted Living for at least 2 weeks, so that they can adjust to their new location. By then the person would have made friends with their table mates during meals.

For my Dad, since it was his own idea to move to senior living... yay.... I tried to make his bedroom the same footprint as the one he had at home. Thus when he woke up in the middle of the night, he could see his highboy dresser was right there on his right. His night stand on his right, the other night stand on the left, etc. And night lights all over his apartment which is also had when living at home.
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afferino, best wishes for you! I'm glad you have some great suggestions here. She's amazing, you two care so much, she's lucky to have you.
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oh this story reeeaaally hit my heart strings! so glad that i never had to leave my mother and see her in such distress. heartbreaking for you girls ... so sorry, hope the medications help her! take care...
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I take clonazepam and celexa for my anxiety attacks. I take them regularly; after the first dose, I felt my normal self again. My mum used to suffer from anxiety too, but it never occurred to her even to speak about it. Once, she was given an AD and didn't know she had to take it every day, so she thought it didn't work. Didn't occur to her to ask the doctor, didn't occur to the doctor to ask her. Such needless suffering.
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I recommend that she see a geriatric psychiatrist, who can give her an RX to lower that anxiety.
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It helped my mother to have a stuffed bunny to hold. Also, I made music CD's and put headphones on her, and asked the staff to set times for her to just relax and listen to the music she liked (my sister's piano playing, and us singing), and she would sing or hum along. Also -- she could not mentally process audiobooks -- but storytellers on CD -- she could follow those stories and they were a relaxing diversion, And the headphones helped block out the roommate's noise. . (Jim Weiss Greathall Productions is wonderful. and he has two CD's of relaxing pre-sleep stories Good Night and Sweet Dreams.) Very helpful.

Also make sure the staff isn't leaving her TV on randomly. Even short ads can show a violent crime show, disturbing images, and they think those are real, or the general stress of the images affects them and adds to anxiety.
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