My mother is 87 and lives alone in a senior community because she refuses live in help or assisted living. She has been on seroquel and risperidone and is currently taking Ativan but her condition is getting worse. She is depressed and cries that no one believes her story and she wants to die. The dr wanted to give her an anti-depressant and she refused. I don't know what to do anymore. I feel like I am at my wit's end.
Since your mother is continuing to get worse, I'd ask her doctor about taking her off of risperidone for sure, and maybe the other drugs, and starting over. She'd have to be weaned, which isn't easy, but these drugs can cause the very thing that the doctor is trying to cure.
Each person is unique in how they react to drugs, and when elderly people take a combination of powerful drugs the result can be devastating. If this psychiatrist won't even consider adjusting these drugs, I'd ask for a second opinion.
Good luck with this challenge. I can see why you are at the end of your wits. Please check back and let us know how you both are doing.
Carol
She wants to die? That's a good reason to get a full inpatient evaluation. Talk it over with psychiatrist. They can titrate her meds better in a hospital setting and brighten her outlook considerably.
There is a phenomena called prescription cascading that most commonly afflicts elderly people. It occurs when drugs begin to be prescribed to treat the symptoms of what, in fact, are other drugs. The risk of prescription cascading increases with the more specialists (and health issues) the patient has (with each physician prescribing his/her answer to the problem). The side-effects of each medication can interact in unexpected ways, sometimes to the point where the patient can scarcely communicate or care for him or herself. On a more technical note, many medications are metabolized in the liver by the same chemical pathway. If too many medications are competing for those enzymes, they can either become weaker, cancel each other out or become highly toxic (intensified). In other words, this can be a potentially dangerous situation!
Regardless of what other issues your Mom may have, she may benefit from having her care managed by a geriatrician — that is, someone specializes in the needs of older patients. From what you've said, the psychiatrist currently treating her has not given due diligence to the age of his patient, and her ability to metabolize (or properly benefit from) such powerful medications. If I were you, I'd find another psychiatrist!
When your mom is delusional how do you react? Do you insist that what she's seeing/hearing/smelling isn't real? There's a fine line between supporting her while she's having delusions and participating in what she's going through. It's such a fine line. When she's having delusions have you tried redirecting her attention? Sometimes it can take a while to get someone redirected but it can be done.
Try not to insist that what she's experiencing isn't real. It's very real to her and probably very upsetting.
You're a good daughter to walk down this path with your mom. She's lucky to have a strong advocate like you.
For now, you can help calm her by saying something like, "I can see how it might seem that way to you." The go on with some alternative point of view..."but maybe they have a hard time remembering names and were just looking at you trying to remember yours." Or a reality check she can use. I worked with a couple people who saw others who were not there. They also had pets, but the pets never responded to these unseen others. If strangers came around, real ones, the pets would have barked or hidden, but the pets were just fine with the ones who were not there. One person thought people were coming into her house and could not sleep out of fear. I suggested she place empty soda cans by the door that would make noise if someone knocked them over. It worked.
Good luck with your mom.
However, there are other factors that have made senior dementia and debilitation so commonplace, namely, the garbage that passes for "food" these days. It all began after WW2 with the so-called "Green Revolution" that resulted from transferring chemical poisons from the battleground to the farm in the form of pesticides and herbicides. Since then the adulteration of our food supply has skyrocketed: GMOs; MSG; high fructose corn syrup (HFCS); trans fats; artificial coloring and flavoring; animals dosed with hormones and antibiotics. Add to that the laundry list of drugs that the medical industry routinely and cavalierly prescribes for anyone past retirement age, and is it any wonder that so many of us are struggling with how to care for our out-of-it elders? The very ones who should at this time in their lives be contributing the wisdom of age and experience to a troubled society have been reduced to little children (minus the cuteness) or worse.
I took my own mother (93) completely off statins. The only med she is currently on is low-dose aspirin. I have her taking pro-biotics (which fixed digestion and diarrhea problems), co-enzyme Q10 and a balanced Omega supplement. When I am the one caring for her I have to be sure and make dinner before she gets in the kitchen and fixes herself the same thing she had for breakfast: white bread (which she insists upon buying) and cheese and nothing else. She doesn't eat lunch, but has an early dinner. When I make a dinner of grass-fed beef or fish or other high quality protein, salad of mixed greens, and a side of yams or quinoa or whatever, I simply give her small portions. She always eats it all exclaiming how good it tastes. I'm fortunate that way. I just have to beat her to the kitchen at an hour that is uncustomarily early for me.
With an improved diet and a few natural supplements and NO prescription drugs, she is doing better as far as her attitude and general health. She is still reality challenged, but as long as she doesn't take to doing things that could harm her, who cares?
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