Elderly, dementia, and anti-depressants.

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My 95-year-old mother had her antidepressant changed three weeks ago from Zoloft to Mirtazapine because she complained of weakness, and one of the reasons for that was reduced appetite. Up to last year her dementia was very mild, more like senior moments, but she has had very bad depression since my father died 20 years ago. In fact, I would say she was a depressed person all of her life but because of her generational view points towards psychology refused to go to one.

About a year ago she started finding clothes in her closet that she couldn't remember, and either she bought them in the past few years or my sisters bought them for her as gifts. She said that one of my sisters was using her closet as storage and she wanted it stopped, or someone was getting into the house somehow and we needed new and extra locks on the doors. It was ok, as it didn't come up every day and the conversation didn't stay focused on it all day.

In March and April I had a caregiver come a few days a week for a few hours to give her a shower and so I could go run errands. She and I both liked the woman very much. One of the things the woman helped her with was going through all of her closets and organizing things which my mom had wanted to do (I'm not a neatnik or clean freak like the rest of my family.) Cut forward five weeks later, my mom says her favorite black pants are missing. I mention the closet organizing which she didn't remember, next day says she did and that the girl stole her pants, that the girl wore black pants every day. I ask how did she get them out of the house, she said she put her regular pants over them and walked out the door. So that's a regular conversation now every day and it's now most of her pants and jewelry and anything else she can't find.

Took her to the doctor because of the weakness and she mentions the pants to her doctor. Doctor says to her call the agency and report her. Thanks doctor. I had tried to tell the doctor a few weeks earlier that the dementia (which her doctor never seemed to acknowledged) had worsened but the doctor said she didn't notice it.

So in the following days she wanted to not only call the agency, but the police and the condo association. On two days she went outside with her walker with me following her as she tried to find the condo president (she thinks the woman who writes the condo letter is the president, she's not.) At one point she screamed that she had been robbed and needed the police. I told the only person around that she had dementia and she heard me, mad her mad.

Brought her back to her doctor. Doctor said to take her off the new medicine and put her back on Zoloft (she's been complaining about how her brain hurts her.) She already disliked her doctor, now hates her and it's been difficult to get her to take the Zoloft but finally managed. The agitation is greatly reduced with the Zoloft, but the talking about the stealing remains. Plus now she thinks my dad just died in the last year.

Today trying a new doctor who has a specialty in geriatrics, her old doctor saw mostly elderly patients but now see that she didn't specialize in it.

My mom can still go to the bathroom on her own, dress herself, sitz bathe herself, knows all of her medicines and what they are for. Reads the newspaper daily, can talk about the George Zimmerman case (two years ago she knew almost every politician, now she sees them, knows their face and whether she likes them or not but can't name them.) Last year she read three books a week, but now says she can't read because of her dry eyes (takes Restasis and erythomiacin ointment four times a day) but I also think it's because of her comprehension.

Her doctor said her mood change may be because of the antidepressant change, but since the stealing comments were made before the change, I think her dementia has worsened. Hopeful that at least the new doctor can answer some of our questions. Thanks for listening.


Long and short of it, she has dementia/alz. Since she can't remember stuff anymore, the only 'logical' thing has to be...someone is stealing from her. She'll misplace things, lose things, put stuff in weird places, start hiding her things and all because she CAN NOT REMEMBER anymore. Tell her doctor in front of her if you have to what's going on. She needs to be on Namenda or Aricept soon to stave off getting worse. Those are the only medications that I know of that will at least buy you some extra time by slowing down the progression. Also, have her checked for a UTI.
It makes me sad to read your post. This is what I have to look forward to with my husband. I wish you the best.
Went to the geriatrics specialist. He asked her the series of questions for dementia/alz. What year, month, day of week, season? Perfect. Gave her the list of three things. Repeated back perfectly. Asked again a few minutes later and she got one of them. Asked her to spell world backwards. She first said she couldn't do it, then she spelled it forward and then spelled it backwards, no trouble. Had her draw the clock face. It was perfect. Asked to put 10:30 on it, again perfect. The stealing was brought up and how her children are horrible for not believing her.

He said he doesn't think she has dementia, but says she does have paranoia and hallucinations. Says to stay on the Zoloft and start taking something like Haldol, something newer and safer, at night. Right now she's mad at us for taking her to the new doctor and says he took our side about her mind. She says she just wants to die, no more doctors or medications, just let her die. I just have to hope she'll take the new medication (went to pharmacy and doc was to call it in, not there, doc's office now closed, so will have to get it tomorrow.)

Anyone know about mental illness and the elderly?
My husband did well on his first "mini mental status exam", but I was sure he was on that road. Two years later, he did only a little worse, but did pretty bad on the full Neuropsych evaluation. She probably does have dementia, just not very bad yet.

The only thing I know about mental illness is that there are lots of meds and you can't tell in advance which one will help you. But so many people on this site report that the right medication REALLY HELPED A LOT so keep trying.
Thanks Jinx. We have an appointment with a neurologist at the end of the month (first available appointment.) Geriatrics specialist said she had some minor memory loss but wouldn't call it dementia.

Last week she was up two night straight without sleep. First night just in her bed, but second night pacing with her walker going through every drawer in the house. I finally got her to sit down in her chair but she just yelled at me. Took her to ER with my sister. Got no help there. Doctor did absolutely nothing for her. Didn't even check for a UTI or dehydration (it had been hot.) She didn't like him either, although he also said it wasn't dementia. He wouldn't give anything for the agitation, someone who knows him said it was too bad we got him because he won't even give a child with a fever an aspirin, he doesn't believe in medication. All he did was say to get her back on the Zoloft and see a geriatrics doctor which we did today.
My mother-in-law got all the initial questions right, but a year later she couldn't retain most of those same questions. I'm of the opinion that those simple tests are NOT how a person tells whether their elder has dementia. Living amongst the craziness is how you tell.
I can't believe the doctor says this is a mental illness and not dementia. She woke up early this morning, wouldn't take any of her meds, went outside (with me behind her) yelling for someone to call the police because she's been robbed. No one out there. We live in a condo, she hears someone in their shower and yells to them her address and to please call the police. And yesterday she was coherent to the doctor that my father died 20 years ago, and now she's asking me to show her the death notice to prove when he died.

I'd like to go to the pharmacy to get the new medication but can't take her with me in this condition. My siblings are talking about putting her in a home and already have appointments today.
I love how other folks, who only see the parent/spouse for a few minutes can determine how bad they are or if they have dementia or a mental illness. I am glad you are taking her to an Elder doctor. I think you will find much better results. Any doctor that would tell a 95 yr old to call the agency doesn't know much about dementia. God Bless
But the elder doctor also said she doesn't have dementia but that the paranoia is just a mental illness, and take something like Haldol to bring her back down.

She does have problems with narcotic medications. When she has been hospitalized for various breaks (hips, pelvic bone) and they gave her morphine, she went psychotic each time. She broke her pelvis last year and we warned them about giving her any narcotics. They said it was a low dosage but she was hallucinating and had the paranoia. She was throwing things. In order to transfer her over to the convalescent home for rehab, her doctor had to give her a shot of Haldol. After that, she was much better. Of course she didn't like her roommate, but that's the way it's been every time she's been at a convalescent home.

I just don't think it's just the change from Zoloft to the other pill, because she started talking about this stealing a week or two before this change occurred. Zoloft does help with the agitation, but it doesn't seem to stop her from talking about the stealing.
This sucks for you. Can they give her something to treat the paranoia?

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