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My 92 year old mother has been acting nasty and mean more than usual. Everything is constant negativity and unhappiness from the moment she wakes up. She has always had this propensity towards nasty behavior (personally I think she has mental illness) and her some of her family members acted the same way. But lately, it has become worrisome because she is getting worse. I asked her if she is depressed because of my father's death (one year anniversary) and she said yes, which is what I figured. But, her form of depression is being super angry and difficult. There is never a normal conversation, she makes no sense and screams instead of talking when upset, which she has always done. I have been nothing but nice and she still acts nasty, so nothing is going to please her. Don't ask me to be patient, cuz I live with her and no one knows what I go thru with her. It is hard to be sympathetic when she is being so shitty towards me. She probably needed to be on medication a long time ago, but I think she would benefit from a mild anti-anxiety and/or anti-depressant now for her depression. I mentioned this to her and she went ballistic. I made an appointment with a doctor a few months off (because of Covid) and I plan to discuss this with him. Forget about therapy or grief counseling because she is not evolved enough for those things. Any advice? Thanks.

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I would suggest Mirtazapine. It helps with sleep. I know of other elderly people being on this medication. I think you should try to communicate with her doctor by phone and not wait until the visit

If she is frustrated by lack of sleep you could tell her this will help. That is the truth. Has she ever been on any medication for her moods? My mother is on a variety of medications for her health. When she tried to refuse them I told her that they were keeping her alive and a specific problem would come back if she did not follow the doctors orders.

I am sorry for what you are dealing with
If she is under your roof I would suggest an ultimatum indicating that if she lives with you there are guidelines. I realize it may not be pleasant confronting her with this issue but the present situation certainly isn't. I hope you are able to get some relief.
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92 is elderly to start on any medications that alter the mind, and that these DO. Remember that one of the side effects can be anger, lashing out, worsening depression, suicidal ideation. I am not certain that depression is not a proper response for what we face down at the end of life. All that said, this is a decision for patient, care givers and doctors, so I will bow out with that. Remember that some require some time, up to two weeks to feel better. There is almost always a very individual response to all these meds, and for both those with depression or with other disorders, it is anything but an exact science. Doses get played with, medications get changed, and sometimes you end up with a drug cocktail that works for a while, then doesn't and needs adjusting. The important thing here is to find someone EXPERIENCED with these meds in the elderly. Then follow the advice of someone good. Good luck.
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1st thing I would do is get her checked for UTI. The escalating ugliness is a symptom in seniors.

I would recommend getting her a geriatric psychiatric doctor to help find the right meds for her.

Maybe her insurance can get one to come to the house and use therapeutic fibs to get her treated.

Great big warm hug! I can't imagine how hard this is for you. I have found that my mom stops when I tell her that she is behaving in an unacceptable way and enough is enough. Doesn't last long but works every time. Use whatever amount of force it takes for her to hear you. Sometimes we have to raise our voice or come across angry to get the point across, that is okay to do.
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HanaLee May 2020
Thanks for the reminder about UTI, could be...
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Sometimes depression and poor sleep are interrelated and this can be addressed from the sleep side of things as well. Medication can be taken at night to regulate her sleep and help her get quality sleep each night. It might improve her functioning and attitude during the day as well. Elders often have trouble staying asleep and then are tired and in/out of naps all day. From what you wrote, that may well not be all that she needs, but I think it's worth a look.
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HanaLee May 2020
Yes, you are right, she wakes up a lot during the night and does nap during the day. I am not sure a good night's sleep will help her attitude though.
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My mother has done fairly well with Wellbutrin. I say 'fairly well' because there's really NO medication on earth gonna 'fix' something THIS unfixable. Women like this are chronically miserable, it seems to me, no matter what. Life is always unfair to them, or they've been dealt a bad hand, or or or. My father died in 2015 and my mother was actually HAPPY about it.

Your mother sounds like she may be on the dementia road, actually...........behavioral changes can be indicative of such a thing. My mother has mental illness *has for the 63 years I've known her* AND a case of moderate dementia going on at the same time.........so it really makes for a horrible situation all the way around. When speaking to your mother's PCP, bring up your concerns in both areas (depression AND dementia) and see what s/he has to say. Also, pay attention to any changes you see happening with her..........is she having trouble with knowing the day of the week? Memory problems? Putting things in odd places? Write it all down.

If the doctor prescribes medication and mother dear refuses to take it, I'd issue her an ultimatum: take the medicine or move into Assisted Living, YOUR CHOICE. Because you need to be DONE being a doormat for bad behavior. Nobody has the right to treat you badly, even your mother. I placed my mother in Assisted Living back in 2014 (she's 93 now) because there was no way on earth I was going to live with her and put up with hideous behavior 24/7.

Remember; YOUR life is important too. This is not just about your mother, nor should it be. It's not okay to be suffering every day in your own home.

Wishing you the best of luck getting mother medicated or into residential care.
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HanaLee May 2020
Yes, I have noticed a cognitive change in the last few years, so she probably has some dementia. I never thought that it could affect her behavior cuz she has always acted this way,,.but you give me a lot to think about.
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