Elderly, dementia, and anti-depressants.

Follow
Share

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.

This discussion has been closed for comment. Start a New Discussion.
19

Comments

Show:
Last rehab place she was in were pushing their assisted living section for her, where she could use walker. Problem is the paranoia, she didn't have it at that time.
(0)
Report

Question whether or not a NH that has most patients in wheelchairs most of the time is the best place for your mom if she can still navigate with just a walker.
(0)
Report

Update: Neurologist called and we got her in a week early. He gave her the short cognitive test again, added subtracting 7 from 100, then from 93. She got to 51. Said she doesn't have dementia. Doesn't want to give her an MRI, I guess because of her age. Says "Old age is not for sissys." Prescribed 12.5 Seroquel to be taken at night, can be increased to 25 mg. Come back in three months. Doc was one of three neurologists recommended by primary, this one got the best reviews, in fact very good reviews.

12.5 didn't work, she woke up after 4 hours, agitated but not as bad as before. Not going through drawers or trying to go outside. I sat with her for 2-3 hours as she ranted what horrible children she has telling doctors and neighbors she's crazy. Says the caretaker did steal her clothes and no one will listen. She did tell the doctor about the clothes. He didn't respond one way or the other.

At this point I don't know what to say. Siblings say next step is looking at homes. One question there, when she was at nursing homes in the past for rehab, they said she had a balance problem so they would not ok her to use walker unless doing physical therapy. I noticed most of the residents were in wheel chairs. Will they take away her walker? She absolutely hates it, but will hate a wheelchair even more.
(0)
Report

Re her medication. It is important that you keep her on the dose that the doctor ordered. It needs to be kept at a certain level in her blood stream. Be careful with OTC drugs as they may interfere with her medication. Ask the pharmacist about drug interactions.
(0)
Report

The situations you mentioned about your mom are very common. She will imagine things and as you described blame someone for stealing or misplacing her things. Your description of her long term memory may be hard for you to deal with. Just go along with her 'reality'. Her short term memory is harder to deal with and the most difficult since you're explaining over and over again something you just said. You might want to look up the symptoms on the computer so you have a better idea of what to expect with your mother's condition.
(0)
Report

Talked to my siblings, it's not 5 mg, it's .5 mg. Checked the label and saw the decimal. She woke up this morning and was agitated again about clothes. Wouldn't take medicine. I got on the floor of the door of her room and said she couldn't go out until she took medicine, refused. Eventually she calmed down somewhat and said that she had been awake since 4 am, got out of bed at 6 am to dress for church, and was tired and wanted to go back to bed. I still think dementia is involved. I think a lot of these clothes she remembers, she may have had 20-40 years ago.
(0)
Report

After reading about Haldol, I really want to keep her to the 5 mg at bedtime. That doctor said 10 mg was not that much. But it is. Glad I didn't give her more that night and that her primary doctor said 5 mg at bedtime and only every 8 hours when agitated. But then that was followed and nothing happened, she remained up for 48 hours without sleep. Other doctor said he would ask primary to order MRI of the brain so we could bring it to the neurologist appointment at end of month.
(0)
Report

Since her regular doctor wasn't in on Thursday, got an appointment with one of the other doctors at the end of the day. She had been up two days straight. I couldn't go as I had a doctor's appt, so my siblings took her. He prescribed 10 mg of Haldol every four hours. Got her home and gave it to her, she slept for four hours. When she awoke, she was no longer agitated. Told me that her leg was weak. Looked up side effects and leg and arm weakness are side effects of the drug. Decided not to give her the next dose. Let her have the 2 Tylenol PM that she normally takes.

Next day took in urine sample to lab at her doctor's office. Saw the two doctors talking, could overhear they were talking about my mother so I joined them. Told her doctor about the leg weakness. Regular doctor said to give her 5 mg of Haldol at nighttime, no Tylenol PM. Said the benedryl in the Tylenol may be causing the psychosis. And 5 mg if she's agitated. Friday she was fine and only needed to gave her 5 mg at bedtime.

Saturday she woke up and was fine. Then she talked about the clothes but wasn't agitated. One sibling came over to give me time to go grocery shopping and some time to myself. Just before I walked out the door, sudden change in her temperament and she was psychotic again. Clothes stealing, favorite dress missing, ugly one left in it's place. Police need to be called. Detective needs to be hired. Needs to get a lawyer because children don't believe her. All of this is being screamed. Wanted to talk to my cousin about having her take care of her. Telephone her, cousin says to her she couldn't because she had husband, no room at her house and couldn't move from her city. My mom told me later cousin no longer welcome because she said cruel things to her. This cousin is only cousin in regular contact with family, now she wants to talk to nieces and nephews she hasn't talked to in five years since her birthday about being her guardian.

While I was gone sibling got her to take 5 mg of Haldol. She was asleep within 30 minutes. Woke up two hours later and is much better. Is watching Jerry Lewis movie on Comcast ondemand, laughing, says she likes it because it's funny. Never goes to church but wants to go tomorrow. Would not take another 5 mg when four hours passed because she said it makes her tired, took 2.5 mg.

Seems like if the Haldol isn't in her system, we are back at square one with her refusing to do anything in the agitated state. I don't know if the 2.5 mg will hold her over til bedtime.
(0)
Report

Doctors don't know as much as they think they do......After a tough time with my dear sweet hubby (who now has severe vascular dementia) I'm not sure I can remember what day of the week it is, etc.!
(1)
Report

This sucks for you. Can they give her something to treat the paranoia?
(0)
Report

This discussion has been closed for comment. Start a New Discussion.
Related
Questions