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Tomorrow we are moving my 100 yr old mother to assisted living. She has spent the last two days with my sister while we move her things. She has gone off the deep end, since being removed from her "safe place". She is nasty, hallucinated a little, thinking she was in her own house, totally impossible. Until now, in IL she has been so so, at least she controlled herself, odd, but doing most of the things she should. Her memory is really bad. The doctor and the IL said she has to move. Based on the way she has behaved the past two days, we're afraid she will be kicked out of AL the first month! She doesn't even know she is being moved. We're telling her tomorrow! Is there some sort of medication (beside a tranquilizer) that can be given to her to settle her down. She is always stressed, worried, negative and is now acting a little aggressive. We have known she needed some sort of med, but hasn't been on anything simply because she could not be trusted to take it. We don't want her in memory care yet as she is still capable of getting up, getting dressed, making her bed, doing makeup, making coffee, going to meals, getting her hair done, communicating, etc. There must be some drug out there that can mellow her out? Oh please, help. We are at our wits end.

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Babalou, no, we didn't reject any drugs. A few years ago she was prescribed Aricept and two days later the whole weeks worth was gone and everything was thrown away. Mom couldn't be trusted to take drugs even then. A few of you are blaming me for not doing something. I knew Mom should be in AL 3 years ago. My sister and I share POA and she refused to move her. Mom refused to move. I fought and fought, knowing that the longer we waited the harder it would be for her to adjust as her dementia got worse. Last year I begged the doctor to please indicate on her IL form that she was not competent to live there. The doctor said she is "not there yet". My sister refused to work with me to move her, refused to accept she shouldn't be there, and mostly didn't want to Mom to blame her for moving her. I tried to hire an aide. Mom wouldn't let her in. It was only this past annual exam that I wrote down all the problems to convince the doctor who FINALLY indicated she shouldn't be there. The doctor said she was good for AL, AL interviewed her unknown (to Mom) and found her lucid and physically capable. All the doctor prescribed was clonzapan 1/2 tab at bedtime even though I asked for something stronger that could be given during the day! She should have been moved, I wanted to move her. I planned to change doctors as soon as we got her into AL, because I couldn't before until I knew where we were moving her. I've been carrying the whole load for the past 4 months, the planning, everything. I couldn't plan it, move her things and take care of her at home, all at the same time, so my sister had to take her for three days. During this time there Mom is agitated, doing strange things, wanting to go home, then saying she lives there, etc. In other words, just this change is traumatic for her, and she doesn't know yet she no longer lives in IL. I know we waited too long and it looks like, without medication, AL will probably not let her stay if she acts like this. They don't have room in memory care. I spent the last three days physically moving all her furniture and belongings. I can barely walk from the back pain and stress. Tomorrow we have a family sit down with Mom, but I think she is too far gone. She can't handle any change. I'm going to call the doctor first thing and see if I can get her to prescribe something, anything to at least calm her down so we can figure out what to do. I have so little faith in this doctor I don't know what will happen, but as you can see, I have to follow thru until I can get an appointment with another one. I don't sleep, I'm totally stressed out. And this is not my fault because I knew this would happen and without Mom's or my sister's cooperation, I could do nothing but try to keep her going. (It took me 5 years to convince her to move Mom out of her house.) I'm mentally and physically exhausted. What I was asking is, what others have found worked on a senior to reduce the anxiety and depression? I know the tranquilizer is not enough especially prescribed at bedtime.
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Amygrace, I've gone back and re--read some of your previous posts and I understand that you've not found a doctor that you're happy with, BUT it also seems as though her doctor has wanted to prescribe "the latest trendy drug" and you rejected whatever that was. Perhaps you need to go back to that doctor, at least temporarily and see if the recommended drug will work, now that she's someplace where her meds can be administered safely.

The idea of inpatient behavioral setting would be ideal, as Capt says. Someplace where her meds could be monitored and adjusted.

As to moving her physically to the AL, I would hire an ambulette to take her. I'm not sure taking her by car is going to be safe. If you have to, make sure she's in the back seat with the child protection locks activated. Make sure she has no cane and that there's not something she can grab to whack the person driving with. I learned this the hard way,
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My mother takes a small dose of resperidone it really help she was wanting to jump off the balcony before she got started on this medication.
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My mom is on Remeron, Lexapro and small doses of klonopin throughout the day. She is not "drugged" in any sense of the word. She is alert, calm and mostly content. It took a long time to get this right.

Mom was started on the low dose of klonopin by the geriatric psychiatrist at her IL. In rehab for her stroke, they started her on lexapro. Geri psych at the nh added the Remeron and it was the final piece of the puzzle.
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I think it really depends on the assisted living place. My dad is taking medications for anxiety and agitation, and has been diagnosed with alzheimer's disease, but he and my mom are in assisted living and the nursing director, med tech and other staff are aware of his issues and his meds. We have also talked to the nursing director of their memory care wing. The fact that they have a memory care wing might make a difference, although other AL's have told me that they can take Alzheimer's residents as long as they are not wandering. It has to do with being able to keep a lock on the door and not let them out to wander, which in AL they are not allowed to do. If the AL has nursing staff and they understand your mom's situation, AL will probably be very helpful for her, especially since she is still doing all the things you mentioned in your original post (getting dressed, makeup, etc.) I'd also concur with the person who suggested having your mom see a geriatric psychiatrist. The AL might even have someone they work with. It's good to talk with all the relevant staff there about what's going on with your mom. I don't think what you're describing is all that out of the ordinary for assisted living - I read the other day a statistic that said more than 50% of people in ALF's have some form of dementia. Wishing you well, let us know how it goes!
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Oh, and Amy, you need two weeks off after Mom is settled. Just do it. Tell the AL to call your sister if there's a problem.
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Amy, it IS sad. But she'll settle in, I hope, with the aid of some meds and staff who will manage them. She's in a place with supervision now and you can grieve a bit. Be good to yourself.
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Amy, I'm praying that the antidepressants kick in soon and that she'll mellow out a bit. Yes, I'm afraid that eventually she will end up in a psychiatric placement. You can look up posts by Emjo, one of our stalwart posters here, whose mom is currently in a psychiatric placement because that's where she needs to be.

Her mother is a classic narcissist and I believe has been diagnosed with a personality disorder. If I recall correctly, Emjo has basically gone "no contact" with her mom who is also 100, for her own sanity. She makes sure that her mother has good care, but does not entertain phone calls.

It would be heartbreaking for you to have to do that but MUCH worse for your mom if you were to die.
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They might. Was she seen by a geriatric psychiatrist? Is there one who calls in at the AL? You might get that person to see her. Amy, the idea here is that wherever mom is, they need to be able to handle her without your constant attention. Tell the powers that be at the facility that you and your sister both have pressing family health issues and that unless mom is needing to be transported to a hospital, they are not to call either of you.

If you are not connected with a geriatric psychiatrist, find one with admitting priveleges at nearby teaching hospital. Put your mother in that person's hands and follow their advice.
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Hi amygrace - emjo (Joan) here. My mother is 102, has Borderline Personality Disorder is narcissistic and has developed paranoia and vascular dementia and is pretty healthy physically.

I had to cut off all phone calls for several months about a year ago as she was plain crazy and it was very upsetting. I have POA financial and medical and also a narcissistic sister who interferes and causes trouble. Mother was way out of control and suicidal. She had been prescribed an antipsychotic but did not take it for long She was in an ALF and had help with meals, laundry and cleaning.

You are absolutely right that no matter what you say she will not feel better, and a new problem is around the corner anyway They don't want solutions, they want problems. Things started being managed when geriatric psychiatrists got involved. Mother was admitted to a geriatric psychiatric hospital and was there just about a year. She went voluntarily but they would have taken her anyway. While there she was thoroughly evaluated and eventually agreed to taking the antipsychotic - risperidone. It treated the paranoia though not the personality disorder, but she became calmer over all. We just moved her to an assisted living facility which specializes in seniors with mental health issues. Even then I had a call a few days after she got there from an LPN saying mother was on a hunger strike and could I call her. I said no as I have never been able to reason her out of anything. Mother forgot about it the next day and accused them of not feeding her!!! She has a phone, but since being on the drug she doesn't call much. I may or may not answer if she does call.

As far as your sister is concerned, she will have to realize that you telling your mum not to call will not stop her. I let all calls go the voice mail and listened to the voice mails enough to find out if there was anything real that needed attending to. Mostly they were crazy and upsetting Your sis will have to let those calls go to voice mail too. You cannot reason with someone in the condition your mother is in.

I moved mother 4 times in 5 years and I am now 77. Thank goodness for my sig other who helps me. The stress has affected my health, With her problems, every place became "dreadful" to her. Six years ago, we had hired a senior nanny who was live in 24//7 when mother was in her beautiful 2 bedroom apartment. The nanny quit after 9 months and I realised that we should have had someone with mental health training. Mother would have also needed the meds and without the hospitalization, would not have taken them.

I am in Canada so the system will be different, I am sure, but no doubt she needs a geriatric psychiatrist, and you should make full use of the case worker and social worker in the facility. Hire a geriatric case manager if she has a decent income. In short, do all you can to put yourself at arm's length. Pauline Boss a psychologist says that in the case of abusive people, be humane but do no further harm to yourself. Go no contact if you need to and arrange for others to do what is necessary.

I saw mother about 2-3 times last year, and a couple of times as we moved her the end of January. I will go down for a case meeting in a few weeks and did not agree to her being present - it would be a zoo. I will visit her when I am down, but if she gets abusive, I walk out and do no more for her that visit. I keep my visits down to about a hour, if things go well. If she was not on the meds, I woud not see her - that was my boundary when she was in the hospital.

Hope some of this helps. Number one - look after yourself. These old people are very resilient and your mum will be as fine as she can be, no matter what you do or don't do. It comes down to protecting yourself. I was about going out of my mind a year ago - now I have relative peace. Get the professionals involved and let them look after her, ((((((((((((hugs))))))))))
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