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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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Probably anything really effective would need a script from her MD like an anti-anxiety/depression med. Call her MD.
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Amy, you need to call her doc and get a script for Xanax or ativan, or something else that works quickly and is out of her system just as quickly. You need to get her to a geriatric psychiatrist as soon as you can to assess her depression/anxiety/dementia and to advise you on what level of care she needs. I do believe that this advice has been given in previous posts.

You say "not a tranquilizer". Was that suggested and rejected by you? You recognize that your mother requires meds, but have you sought medical advice on this? What did the IL doc suggest?

The fact that she can no longer function in IL does not necessarily mean that AL is the right place. Did the AL assess her and agree it was the correct level of care? I'm curious why she wasn't transferred directly from one place to the other, without going "home". This must be brutally disorienting to her, not to mention the stress on you all as well.

I'm sorry that this is not going as smoothly as you had hoped. She can't control this. Call her doctor right away. If she becomes dangerous, you take her to the ER.
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Definitely call her doctor! There are many meds that could help. Sometimes you need to make a suggestion to the doctor, like saying you would like to try Aricept, or an anti-depressant, etc. Her age may be a deciding factor with meds, though.
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memory care isnt a penal colony , only a designated wing in most nh ' s that just has a more home-y setting and specially trained staff . my mom was given haldol injections for the last 2 months of her life and by her own admission it made the hallucinations much less distressing . my mom was able to die at home like she preferred but it was indeed a bumpy ride for about a year . ideally , docs would like to have the patient in a rehab setting for a few weeks so they can try different meds and monitor their effectiveness .
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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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We give mom an ounce of dry red wine and she mellows out. But mom knows where she is. Your mom sounds like a memory care patient, sorry.
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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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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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Today we moved Mom. She was very upset when we told her. She cried, denied, threatened to kill herself, wished she was dead, etc. We had to go over it several times before she "got it" or maybe it was just she didn't want to accept it. My sister slipped her another 1/2 tranquilizer so she was a little woozy and out of it when we got there. We met for a long time with the staff, nurse, etc. They are putting her on maximum care level the first 30 days until such time as they determine what she can do and what she needs assistance with. That means checking on her hourly, taking her to meals, observation, showers, incontinence maintenance, etc. The place is lovely, upscale, cozy and welcoming as were the residents who took her in like a mother hen. They got her hearing aid working, fed us lunch, and best of all, the nurse said she MUST use a walker and found one she could use until I can fill the prescription for one. I'm making an appointment with a new doctor for next week to get her evaluated and maybe on some meds, try Aricept or something to help her confusion. Of course tonight, she tried to call my sister four times, but we decided no contact for several days. What makes it difficult for Mom is the fact that she has NO interests, ZERO interests or hobbies - ever, in her life. She bores herself which is why she is agitated and antsy - she does nothing to amuse herself. Its very sad, but she isn't going to change now. But, bottom line is the AL is wonderful and we hope she will adjust. If she doesn't, it won't be for lack of their trying very hard to help her. I feel better just knowing that she is getting the care and attention she should have had years ago. Maybe if she had been moved and on some meds, the move would have not been such a shock and she would have been much better mentally and certainly happier, but water under the bridge...........
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Amy, I'm sorry if a any point it sounded like I was blaming you! I know that you have been working tirelessly to get your mom moved, with a lot of obstacles in your way.

Clonozapam is Klonopin, which is an antianxiety drug ,short acting but effective. But it sounds as though your mom would benefit from a more systemic med like an antidepressant. Is there a geriatric psychiatrist at this new AL?
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AmyGrace,
Has your Mom been checked for a UTI which can cause sudden and drastic behavior changes. It seems that is the first thing they SHOULD check. If so, and she doesn't have a UTI, then talk to her doctor about something to calm her.
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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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Thanks everyone. Mom is all moved in - absolutely wonderful lovely place. She is confused and for the next 30 days she is getting full care, escorts everywhere because she can't find her room etc. I'm taking her to a new doctor tomorrow and hopefully he can put her on something to help the depression and confusion. She is very unhappy (of course, she has been unhappy wherever she is for the past 40 years) and the first 24 hours she tried to call my sister 12 times! Oh Babalou, I do need two weeks away from her, you are so right. Once I get the doctor thing taken care of and then the hearing aid issue, I plan to disappear! She hasn't been checked for a UTI because we can't get her to go in a cup. Maybe the doctor can figure it out. She is basically uncooperative and stubborn. She refused to use the walker they gave her. Oh man, this has been some awful month!
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Amy, you are in my thoughts and prayers! You'll get through this, promise! good luck with the new doctor tomorrow :-)
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Docs and labs have hats that fit onto the rim of the toilet to collect a specimen. There is also the catheter route if that is required. Even with hats to get specimens from my Mom we always get the specimen with a cath because of problems with contamination using the hat. Nothing wrong with the hat, mind you, but Mom's cleanliness routines.
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Same problem here. Mom didn't take a shower for at least 2 years. My sister forced her before we took her to the AL. Today they were supposed to get her to shower again. I'll find out tomorrow how that went! Problem with collecting a specimen is that she is so dehydrated. But, now that she is in AL, I'm sure they can get one easier than I can. Tomorrow is her doctor appt. Hopefully something can be done to help her.
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Doctor appointment went well. He seems so much better and actually examined her (as opposed to the last one!) Mom seemed to like him (she is partial to male doctors - that's the generational thing) He's doing blood tests and then will decide what to do. Bottom line though is you can't fix dementia or memory at 100, but can maybe give some antidepressants to increase appetite and interest in things around her. Mom was still confused (always will be) but she did say some nice things about the AL. Her only interest besides her family has always been clothes shopping, makeup and how she looks. So she is liking people paying attention to her, even had her hair done yesterday. I think we will be ok for awhile but we know eventually the dementia will get worse until she does not know where she is. We will sign a DNR for her and let God decide when it is time. I wouldn't want extreme measures taken for me at that age, especially if I'm not aware of what is going on and it causes my children emotional stress.
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God bless, amygrace! I'm glad things are looking up. Now, book a cruise.
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Of course, this morning it was back to same old same old. Phone call to my sister and then one to me - "I hate this place, they have taken all my furniture. I want to leave, etc" Both of us just hung up on her because 1) she can't hear us on the phone anyway and when she does, if she doesn't like what we say she says "what?" (very selective hearing) 2) she won't remember she talked to us in five minutes anyway. Sigh.......... its so sad not to be able to reason with the person who was once my best friend.
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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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I don't think she is going to make it there. If she has to have full services, she can't afford it. From what she could do in IL, we assumed some assistance, but she is not cooperating. I paid $3600 for the room and they just added $3000 for full services for 2 weeks. That means $9000 a month if she doesn't start helping herself, just impossible for us to pay and she has too much income to qualify for VA assistance. What a laugh. Even though her income is about $36,000 a year (which just broke even paying for independent living, it disqualifies her from VA help for AL which is 3x more expensive) The trouble is, part of her problem is dementia, the other part is she is a spoiled brat. I hate to say that about Mom, but its true. She has always been a manipulator. She had someone else do everything for her, would never listen or help herself, and always dumped doom and gloom and problems on me and my sister. Today she is obsessing about her social security, calling and wanted to know why she is not getting a check. Funny, she can hear just fine on the phone when she wants, when she doesn't want to listen "I can't hear you". I've been paying her bills for 6 years and now this. I told her she was going to get herself kicked out of this place too if she didn't stop finding problems. She is not that far gone - she said "they don't listen to me on the phone". I said "Mom, you are driving me crazy with this (I've explained it at least 50 times to her). And guess what - she hung up on me. If we can't get the cost down, if she is going to behave like this, refusing to help herself, we will have to find a cheaper place and move her - and this time, to a mental home. We are still working on clearing out the old apartment and she is calling saying they have taken her furniture. But last night she called and she was fine and happy. She sits in her room and broods (because she has no interests, never had any interests) until she thinks of something to complain about and then here we go again. this has been going on for years. I can't keep doing this.
To all of you out there - whatever your parent's personality is when young - that is what it will be when old except 10x worse.
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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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Thanks Babalou, that's good to know. I will look at Emjo's posts. I am becoming a stressed out mess. She is taking up so much of my time, both physically and mentally. I get no help in doing all the research, making all arrangements for everything, making appointments, and usually taking her there too. I'm tired of having all the responsibility. Just when I think I am off the hook a little, it looks like we can't afford where she is. She's a Dr. Jekyl/Mr. Hyde. I know she is slowly getting worse, and I'm quickly aging! I hope we can find an affordable place to put her and, sigh, I will again have to make all the arrangements etc.
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Amy, can you tell the facility that you need to take a week off from this, give them a number to call only in a true emergency and not answer mom's calls? A lot of folks here recommend that with parents who are bottomless pits.
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Well, I could except my sister's husband is not well and she keeps asking me to tell Mom not to call her because it upsets her and she has enough to be upset about. Someone has to be the grown-up and business person who figures out the finances, etc and that would be me and no one else as it always has been. At this point, and this is cruel to say, but I don't really care about what is upsetting my mother at this very moment. She is going to forget whatever obsession it is and start on a new one tomorrow anyway. No matter what I say to her, it won't do any good and she won't remember it any more than she remembers the 50 times previously that I said it. I don't want to be around her because at their point I am angry and short tempered and I'm sorry about that, but I have no more patience left. I thought this place was the answer, but not if they expect $9000 a month. I'll put her in an apartment and hire a 3/4 time aide for less. Do you think anti-depressants will make any difference at all in her paranoia and obsessive thoughts?
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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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I should add that the drug is injected every two weeks so there is no fear of her not taking it. I have told them to give it to her whether or not she wants it, as she needs it. Her quality of life without it is terrible - her mind is tortured.
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