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TriciaU Asked July 2013

Is it dementia or anxiety/depression?

My mother n law has always had anxiety and depression. She was treated by a psychiatrist and therapist for many years. We removed her from her home b/c she was a hoarder and the conditions were unsanitary. Her mother died from alzheimer's. Over the past 2 years we've seen a sharp decline in her ability to engage with people, participate in activities, etc... We are not sure how much is forgetfulness vs. dissociative. She falls asleep right after eating which tells me some of it might be related to blood-sugar. We are at a loss as to how to help b/c she refuses to go anywhere, engage in social activities, and tells us and the doctor that she's "fine." She is angry if I show up at her doctor appts and will not tell us anything but "I'm fine" when we ask about the appts.

amitebird Jul 2015
TriciaU I have the same problem with my mother's doctor - he did the same, a short mental test, then said, "wow you did better than most people 20 years younger". Personally I think he's a chicken and doesn't want to be the "bad guy". Great, so I will get that designation. My mother says her doctor is her friend (ergo no access for me). I feel for you, walking a fine line to take care of them without angering them and starting down a really awful path. Good luck!

pamstegma Jul 2013
I feel your pain. My MIL eventually overdid her coumadin and fell, hit her head and only then would accept help. It's like an addiction, you can't help her until she lets you.

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TriciaU Jul 2013
pstiegman, your answer was totally not helpful. I can not allow her to go to the doc alone because the doc is then getting no information about her. For example, my mother in law was taking 2 blood pressure meds and wasn't telling the doc and wouldn't listen to me that one was stopped. Your suggestion is to just let her go on taking a double dose of meds so she doesn't get mad at me?! As for her daughter--she lives an hour and a half away. We moved my mil 5 min from us to take care of her. This is my role b/c we made it our repsonsiblity and my husband just can't take off work for every little thing. These blogs can be helpful but people should be careful what you presume.

pamstegma Jul 2013
If she doesn't want you at MD appointments, the MD can sense it and won't work with you. I had the same problem; I stopped going. She knows she's losing it, eventually she will accept help, but likely insist it comes from her children. Stay in the background but monitor things and keep her son up to date.

AgingCareCM Jul 2013
Hello TriciaU,

Our writer published an article that may be helpful to you regarding dementia and depression. I am attaching the link below.

https://www.agingcare.com/articles/dementia-depression-link-158881.htm

Warm regards,
Melissa R.
The AgingCare.com Team

TriciaU Jul 2013
Some more information: My mother n law is now 70yo....She was on a slew of drugs 5 years ago--we didn't know this. She was over prescribed a ton of meds from a psychiatrist and started hearing xmas music and falling in the middle of summer --this was 5 years ago while on STdisabilty b/c she was not able to function at work... we always knew her house was falling apart but she kept the front room neat and only let us in that far. she landed in the hospital and that's when we went through the home and decided to move her out and in with us...3 months later she went into her own apt 5 minutes from us. the house was cleaned out and sold. In the past few years we have seen a sharp decline. always a quiet "I'm fine" person but now just "the lights on and nobody's home." I have all the paper work with the doc's office. I speak with them freely. My husband has Power of Attny. She will not tell me when her appts occur--I call and ask when she scheduled it for and then show up and surprise her---if I insist on picking her up she will just get agitated and angry. A woman from church is nice enough to take her and then I go in the doc's office with her and take her home. She HATES this. The doc did a "memory test" --asked a few questions. He ultimately said "She is happy and well taken care of." Gee thanks. I tried to sign her up for a local Dem/Althz study/clinic and as soon as I put "depression & anxiety" on the 10 page application--they said "oh, no she is likely not good for our clinic since we don't know if her symptoms are related to that."

She has a thyroid condition so I took her to an endocrinologist (sp) who said that as long as she is taking her meds...these symptoms shouldn't occur due to that... She was taking arisept (sp) awhile back but then decided on her own that she didn't need it. :-(

She's been divorced for 30 years. She says she loves coming to our house to see the kids and be with everyone but then sits for 8 hours not speaking or interacting with anyone other than to say hi, bye, how is everyone. She obsessively has to watch the tv but then can't repeat anything that she is watching. I don't interrupt her at the doc's...I want him to see that she can't answer his questions. I have a call into the doc to discuss what needs to happen next...

angelwhyspers Jul 2013
Depression and illness in older adults and the elderly
Depression in older adults and the elderly is often linked to physical illness, which can increase the risk for depression. Chronic pain and physical disability can understandably get you down. Symptoms of depression can also occur as part of medical problems such as dementia or as a side effect of prescription drugs.

Medical conditions can cause depression in the elderly
It’s important to be aware that medical problems can cause depression in older adults and the elderly, either directly or as a psychological reaction to the illness. Any chronic medical condition, particularly if it is painful, disabling, or life-threatening, can lead to depression or make depression symptoms worse.
These include:

Parkinson’s disease
stroke
heart disease
cancer
diabetes
thyroid disorders
Vitamin B12 deficiency
dementia and Alzheimer’s disease
lupus
multiple sclerosis

angelwhyspers Jul 2013
You make no mention of a spouse, so I can only assume that he is no longer among us. How long has he been gone? Anxiety, depression and dementia seem to all go hand in hand making it hard to tell which is happening. How was your relationship with her before this withdrawl? Did she get along with you? It maybe that she is showing signs of dementia, which should not be all that surprising given her mental stability. With the lack of activity they do tend to tire easily. I think that you should maybe get POA for her so you are able to get more tests done on her as well as blood work. Best wishes

balexander9 Jul 2013
Many dementias, particularly FTD dementias, first present as behavioral problems. My husband was diagnosed with depression and anxiety 15 years ago and was treated for this until he was diagnosed with dementia 5 years ago. Looking back, I feel the the depression and anxiety were the first symptoms of what turned out ot be dementia. (He also developed Parkinsons-like gait difficulties before the memory problems became obvious.) It is often hard to tell when dementia begins but sometimes, looking back, you are able to make sense of things that weren't that obvious at the time.

pamstegma Jul 2013
Removed her from her home to where? Who takes her to doctor's appointments?
Who is we? If she has had long-term issues with depression, aging will actually amplify them, and medications may need to be changed. Look over all her test results and ask questions. Do not interrupt her conversation with the MD or answer for her (sooo many family members do that and it drives the doctors nuts). If a detail was missed ask " What about xxxx?" and take lots of notes.

Roadrunner Jul 2013
That is a tough one! Dementia can also show signs of anxiety and depression. You definitely need a caring doctor's diagnosis. My Aunt is also a light hoarder and has Dementia but we could not remove her from the home because she lives with her 51 year old son that has Schizophrenia. We thought removing them both from the home would completely stress both of them out. So, we are in the process of slowly cleaning up to make their environment livable. Anyways, my aunt would not leave the house either. But, she got hooked up with a home-bound doctor that comes to her house to check up on her. Try contacting the local Senior center for some resources on doctors that make house-calls. Or, even try the company that delivers meals on wheels(Senior Serv in CA), sometimes they have vendors or resources that they can direct you to get a doctor to come out her. I hope that you can get her out of the house or find a house-call doctor!

Iwentanon Jul 2013
removing someone from their home is a difficult decision but not more tragic than the person it happened to. Did anyone try therapy for OCD's as that is the most common complaint of people taking care of dementia/alz.
After removing her from her home did anyone then employ any coping mechanisms, because such a thing could have been traumatizing to her.
You do not state where she is living currently, but there in addition to meds there are tests that need to be done like a neuropsychological assessment and evaluation.
Despite symptoms, putting someone on meds without assessment and evaluation clouds the issues, that could be happening to her.

In our case we found, not only did she have dementia, she couldn't be left home alone, because without the protective bubble she didn't know what to do, about anything on her own.on her own and her son thought I was exaggerating, but it turned out to be quite true!

ShadowChild1 Jul 2013
I have discovered that anxiety and depression and any related medications can complicate any other possible illnesses. Your mother in law's doctor cannot talk to you, but you can talk or write to the doctor. Your husband should help you by also signing any letter you might send. Sometimes doctors will pay attention to something in writing when they don't have time to listen. It shouldn't be that way, but many doctors are always on the run. If you make the doctor aware of your mother in law's past issues ( mention the hoarding), he or she is really required to act on information by examining your mother in law very carefully. An adult daycare center that provides supervision and activities may help all of you. Ask your health department for that kind of information. In the end, your husband may have to legally obtain POA in some form. The description you have given us of your husband's mother sounds like she needs some serious medical evaluation. Best wishes!

ferris1 Jul 2013
Do not assume anything about why she falls asleep after eating. Only a qualified doctor can correctly diagnose conditions she may or may not have. If her condition is deteriorating, get a POA from her, and take her to the doctor yourself. It is your job to be her advocate and do not believe anyone with dementia who says they are "fine". They all want to believe nothing is wrong. Stay strong, be firm, and get her some needed medical help this nurse advises.

LuAnnSmith Jul 2013
Boy this is a tough one. Signs of depression can often mask as confusion and memory loss. The challenge is that she might be dealing with all three: anxiety, depression and memory loss. Maybe she was depressed then her memory got worse which made the depression worse then she isolates etc... If she won't "allow" you to help her you're stuck between a rock and a hard spot. I agree with skinonna that you need to start working on the legal aspect of helping her by obtaining a POA or trying to dialogue with the doctor, which isn't always easy. At the very lease, a meeting with an elder law attorney to outline what your options are may make you feel better. Good luck!

skinonna Jul 2013
You have a tough one there. How old is she? And where is she now living? I find it hard to tell what the source of the behaviors are in a similar situation. I have oberserved that as they lose the ability to understand and keep up with the world around them, older folks seem to live in a smaller and smaller world..first just a few friends, then just in their house, finally mostly in their bed. or favorite chair...this even when they seem fairly healty otherwise...They want to be left alone because they cannot cope or feel they have any control...And it just gets worse...Is your MIL on any meds? Antidepressants sometimes help a bit...It seems you try to interact with her quite a bit...will she give you or your husband a POA so you can call the Dr. etc.

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