My mom had a stroke 4 month ago. She has recovered very well but she hates been in long term care nursing home, the food, and the fact that everyone is drugged. She has become very depressed and crys to go home. My siblings want to add more antidepressant to her already 2 she is on.. she is 93, has her wits. Any experience is these antidepressant?
Your sibs think it's just a lack of medication. It's probably more complicated than that.
People here tell you it is normal to be depressed after a health loss. But a stroke also is an injury to the brain,and that may make it all the more difficult to treat, and outcomes maybe less you hope.
Has she had a phsychiatric consult with a phsychiatrist? It would be best to have her see a geriatric phsychiatrist, but certainly psychiatrist ( who is a MD ).
Although difficult to do, it's alsohelpful to have reasonable expectations and realize that you, your siblings, and Mom, are feeling the loss that comes with her decline, and her inevitable progression toward end of life.
Talk with her about this, and start talking with sibs too. Since a 93 year old post stroke woman with depression is probably not going home ask her what would make it better to be there. Then if you can try to provide these things.
And be kind to yourself. You are a good and loving daughter.
Anti-depressants only allow the body to do so much--they do NOT "cure" depression, esp situational depression!
Was she home before? Was she alert, active and able to care for herself? If so, she has every reason to be depressed!! Get her out of that NH and back to where she's comfortable.
BTW, she probably is telling the absolute truth: I'm sure the food is horrid, people are noisy and it smells bad.
Trying to take antidepressants in a situation like this is like painting the fence once it's fallen down...a nice gesture, but won't accomplish anything.
The geriatric brain also metabolizes AD's differently than a younger brain. They may actually be making her worse. Find a Dr who will listen to you and MAKE them listen. (They work for you and your mom, BTW, make them do their jobs!!)
And the doctor should decide what medications are appropriate. It's not necessarily the amount of meds that helps. She needs the correct ones. If her doctor can't get them adjusted, maybe she needs to see a geriatric psychiatrist.
It is possible she does not need MORE medication but she needs the correct medication.
This should be a discussion with the doctors and if possible with your Mom.
Where was she living before the stroke? If she was with you or other family member will she be going back or will she stay in a Nursing Home or can she go to Assisted living or if she needs it Memory Care?
If she will be going back to your house or a siblings make sure you have all the equipment you need before she comes back. And make sure you have caregivers lined up to give you or whoever she will be living with much needed breaks.
Keep in mind the fewer transfers to "new" living arrangements she has the better. So to move her in with one family only to find 6 months or so later that they can not handle it and Mom has to move is not a good situation.
Not knowing her level of care as far as her ability to perform activities of daily living it's hard to determine if she would be ok at home. Is her bedroom and shower on the first floor? If she did come home is her home environment safe for her? Do you have resources to provide caregivers in home? Hospital bed? Handrails? It's a lot of preparation.
If she is improving physically & making progress, I would consider a Home trial.
If not, maybe a change in roommates and offering her mental stimulation where she is would be the way to go.
Good luck, it's so hard to see your parent go through this.
It's impossible to know whether adding a third antidepressant is the right next step; adding a third antidepressant is best done by psychiatry, and usually they would want to check that the first two were appropriately selected and dosed.
The ideal would be if you could get a consultation with a geriatric psychiatrist or even a geriatrician. If not, you will need to do research, ask the current doctors lots of questions, consider a second opinion.
Many older people do improve when they return home (or at least, when they leave an environment that's hostile to their emotional wellbeing), but whether that's desirable or feasible depends on a lot of things...
good luck!
I'm very sorry to hear about how sad your mom is after the stroke and being in long term care. Its a lot for a 93 year old to go through. Its only understandable she would like to go home.
Personally, I don't know if more anti depressants it the way to go. My father went from being on no meds to being on 10 meds after the stroke. And the side effects were devastating. And then the doctor wanted him on anti depressants. My father almost starved to death from being on all his meds.
Its not an easy balance to find. Continue to be your mom's advocate if you can. And also try to respect her wishes. I know its not an easy decision to let her come home and if she needs 24/7 care. Try to have a family meeting with your mom and see if there are any other viable options.
She had a rough first few weeks out of rehab. Sleeping, UTI, pneumonia, still on thickened everything.
She told a Doc that she didn't want to do this anymore. What the aphasia didn't let her say was...she meant being in the hospital. They wanted her on anti-depressant and hospice. (I'm stall mad at that hospital).
I got her out of there. It took a week or so for her to get over being drugged.
Take out. Let her have the time to get over the ordeal of the hospital.
With THerapies, social interaction, and engagement Mom has come some way back. She is 90 and has serious heart problems. But, she is depressed because he hates where she is. Wouldn't you?
I'd ask her doctor about other options. Sometimes, it takes weeks before the medication will show an improvement, though, the one that my LO went on showed good results within a few days. If she's been on them for months, I'd ask about the details of when results may show up. Sometimes meds need adjusting or changing.
Also, does she have any mobility problems or reasons that she can't go home, assuming she is okay cognitively? Granted, she's 93, but, was she functioning well before the stroke? What if you tell her that her progress will determine when she'll go home? At least she would have something to look forward to. Does she have physical rehab? Does she really need skilled nursing care or would something else like AL work for her?
There may not be any easy ways to make her content. All you can do is the best you can. I hope something works.
You will need to speak to her Dr. about her depression and her medication. I don't know how long your mom has been on the antidepressants but maybe the Dr. can try something new.
I don't know if this will be any comfort to you, but going home would not cure your mother's depression. I'm very sorry to say it, and I'm sorry for how wretched she must feel, but the injury to her brain from the stroke is going to be there wherever she is living.
I am not saying that it is impossible for an elderly person to go home after rehabilitation, but how could this be achieved in your mother's case? How much care and assistance would she need to live at home? Whom would she expect to provide it?
You then have to think about how much good it would do her, realistically. And although there might be positives, it is not going to be a miracle cure for her depression, I promise you.
I'm very sorry for what you and your family are going through, and I do urge you to ask for a proper discussion with the doctor about your mother's medication.