Does an elder who cries constantly after a spouse's death need an anti-depressant?

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Q: I am caring for my mother-in-law and her husband just passed away. She whimpers, sighs, and doesn’t sleep. I try to cheer her up and involve her in activities, but have a hard time. Any suggestions?

A: Please ask the doctor if you can try an anti-depressant on your mother-in-law, as there are so many choices these days and it is unnecessary for someone to suffer so much. Put yourself in her situation and ask yourself how depressed you would be if your husband or close loved one had passed away? I know, a lot of people are against them, as was I… until I saw the huge benefit in both of my parents. Of course, the anti-depressant that worked on my father didn't work on my mother and vice versa, but by keeping daily symptom logs on them and working with their doctor, we finally found the right medications.

Within a couple weeks I noticed improvement in my parents' moods and then gradually it was just amazing how much better they were in terms of wanting to get up and be involved in activities and life again. I just wish someone had advised me to try it sooner, as there were so many sad days that could have been improved. And yes, there are side effects to all medications so be sure to research what the doctor prescribes on the Internet so you are very aware of what to watch for.

Also discuss with the doctor starting her on the lowest possible dose to see how she tolerates it. And if she is a small person like my mother, ask the doctor if you can cut the lowest dose in half and then gradually increase it. You don't want her to have any adverse reactions on the first try and then refuse to take anything else.

Once you get the right anti-depressant in place, if she is still having the sleeping problem, discuss with the doctor using a lower dose of Ativan or a different medication--and ask about staring with the lowest dose cut in half. Everyone is so individual that it is a lot of trial and error until you find what works best.

Also, be sure to consider a Senior Center or Adult Day Care for her so she is occupied most days with fun activities. They feature socialization, exercise, nutrition, games, current events, singing, dancing, movies, interaction with pets, field trips, on and on. I just can't say enough good things about them. To locate one contact the National Adult Day Services Association at http://www.nadsa.org/.

Jacqueline Marcell is a former television executive who was so compelled by caring for her elderly parents (both with early Alzheimer's not diagnosed for over a year) she wrote "Elder Rage." She is also an international speaker on elder care and host of the popular Internet radio program "Coping With Caregiving."

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