Mom's in assisted living. They said if she refuses to take Zoloft they'll send her for a psych. evaluation. Can they?

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She is a very difficult person to manage. If she is sent for a psychiatric exam what are the consequences?

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Valjab,
Even those with any dementia, can refuse meds, sometimes it's in their best interests to get them to take them, despite their refusals, as they are not in a rational mind....but that is dependent on proper evaluations.

The suggestion to hide meds in her applesauce or pudding, is a good one.
That usually works for elders who have some dementia, and cannot understand or be made to understand, why they need to take meds.

She sounds like she could use a proper evaluation.
When a patient has difficult behaviors, sometimes the facility might try to get meds to help control the behaviors--which might be preferable to allowing the patient to act out, disrupt or cause harm to other patients and staff.
...and it's likely preferable to them telling you to take her home with you!

Psych meds these days are not perfect, and elders can be overly sensitive and may need smaller doses, but the meds can be far better than allowing very disruptive behaviors to cause other unfortunate consequences.

From the expanded details you offered, she needs other help than antidepressant. An abusive or emotionally escalated person is usually -not- able to control themselves--that does -not- sound like antidepressant territory.

Please do get her evaluated to learn what might be right for her needs--whether it is other meds, or rearranging the ones she currently has prescribed. Or something else.

Please keep us posted!
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I want to add to Burt's excerpt of what I sent him in his hug. I couldn't remember what thread was involved or I would have responded directly. He said the caregiver indicated that the patient was agitated and wanted medication suggestions. What I answered was that my mom and my aunt we're both at you take it out of frustration and anxiousness. Buspar helps with anxious and anxiety problems. The full answer was that it is important to determine what the anxiety comes from because a tranquilizer such as ativan or xanax, or even an anti-psychotic up to and including haldol may be necessary depending on the source of the agitation. Thx Burt fot excerpting to respect the nature of my private message to you. In this question, we keep coming back to the NEED for a full evaluation, medical & neuro psych.
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Valjab,

I think it would do you well to try and investigate Buspar, an anti-anxiety medication.

I personally use it 3 times a day, and it has a lot of solid research behind it.

Maybe it will take off the edge of your aggravated and abusive mom.

Just be sure to get a full-blown psychological work-up from an outside doctor that you hire in her medical insurance network.

You need an unbiased opinion.

As a mental health patient, these are my heartfelt observations.

Please follow-up on the progress in your situation.

-- Burt B.
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CarolLynn has mentioned in a hug, (which is a private message), that:

" Both my aunt and later my mom we're on an anxiolytic called Buspar. Worked very well for both of them. "

She wanted me to pass this along.

-- Burt B.
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Unforunately the ones who are hard to handle in a facility does make it somewhat difficult for the other residents. Especially during sundowning, all it takes is for one resident to be disruptive and it sets off a chain reaction. Have they tried to put her meds into applesauce or icecream? This trick usually works, but even then they refuse to eat it. But if is something that they can do figure out what she likes best, chances are she won't turn it down. Best wishes
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I guess I didn't explain well. I think my mother needs to be medicated, she is vey abusive. It is my mother who is refusing to take the medication. Now she has diarrhea and is refusing to take that medication. She readily takes her pain meds and asks for more.
Valjab
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Why does the AL believe your Mom needs Zoloft? Why not have a psych evaluation? Consider it a second opinion.

As for facilities 'drugging' the elderly so they're easier to deal with, I'm sure it's done. I'm also sure it's not as widespread as families think it is. A person's family members come for visits. They don't see what happens in the wee hours of the night, they often don't really see how their family member interacts with staff and other residents, they rarely see the kind of anxiety their family member is dealing with every waking hour.
They see mom or dad when they're excited to have a visitor, putting on their best face for their children.
I've seen people in a CONSTANT state of agitation and high anxiety - completely distraught all day and night - whose adult children don't want them 'drugged'. It's truly abusive when someone's pain can be eased and their children refuse because they think the staff just wants mom or dad to be 'easy' to care for!
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In my nursing practice, no one can be "forced" to take a medication, unless they are a danger to themselves or others. Zoloft is an antidepressant. What doctor is prescribing this? Anyway, a psychiatric exam is just talking, taking a history, answering questions (and listening to the way you answer them), and a little physical seeing how your reflexes are, etc. Not a big deal. Someone at the assisted living home thinks your mother is depressed. Is she? Maybe instead of an antidepressant she really needs a mood stabilizer, like lithium carbonate (the Gold Standard for bipolar), or one of the other mood stablizers. Maybe it would be a good idea to have a psychiatric checkup just to understand what may be going on with her. Everyone could use a psychiatric consult. Life is very difficult. Best wishes.
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The suggestion to make sure all POA, etc. legal documents get signed, BEFORE your Mom has a Psych eval, is a VERY good point.
As for Lawyers refusing to do legal documents and let a person sign them?? HA! Lawyers cannot diagnose.
IF the person appears, even remotely, to be capable of signing documents, they'll let them. Believe me, one brother in law found a lawyer who had made a great career of forming "plum" estates to manage, not just for himself, but for his son, also a lawyer....the brother in law took fragile G'ma to him, lead her into changing her already set up legal affairs to his favor--totally overturning everything she'd so carefully set up, in ways that she'd NEVER have done, EVER, had she been in her sound mind still...but she still presented a semi-capable mannerism, and it WAS her brother in law--very solicitously caring in his manner.
This kind of scenario is very common.
==DO get her a Psych eval--AFTER you have gotten her legal paperwork all set up.
That anti-depressant is NOT grounds for the Nursing Home to be saying that sort of threat...
==Mom probly has other behaviors they cannot manage.
IF she is having outbursts, an antidepressant is not for that--it is to prevent a person becoming terribly depressed, only.

ALSO, keep in mind, it is a patient's legal right to refuse meds--even the ones who are out of their minds. At least, it has been so at nursing homes I worked in--we were told to do everything we could to get them to take their prescribed meds, but if that failed, then, chart it as "patient refused".
A facility that forces medications, sounds rather out-of-line, and certainly putting themselves on a legal cliff.
Trying to force a patient to take an antidepressant?? Seriously??
IF a patient refused to take meds that keep their breathing open, their heart beating...that might present a greater risk of the person dying fairly quickly after refusing that medicine.
If a patient prescribed anti-psychotic meds refuses, & becomes a serious behavior threat to themselves or others soon after refusing the medication, THAT could be a problem.
But an anti-depressant? The patient is elderly...they may become more depressed--but that usually gives some time to work to change that--either a different medication, or, finding that the antidepressant was the wrong thing to give---but it does not usually become a life-or-death matter for refusing an antidepressant; a depressed person is not very likely to act out and harm others.

The nursing home seems in error for issuing that kind of ultimatum.
But it might help work in favor of better handling of your Mom's estate, if you immediately get legal documents signed [if you don't already have them....THEN do get that psych eval--because that might result in her getting better oversight of her actually necessary meds.
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Valjab & others: Nobody can force a person in their right mind to take a drug they do not want. If Mom is in dementia and you have legal medical authority for her, you have to insist on clarification from the doctor and AL facility people why they want her on this. It could be to counteract the depressive effects of pain meds. If it is behaviorally related, you definitely want an MD psychiatrist (perhaps staring with the facility's psycholigist for some insight on the situation) and only an MD can prescribe anyway. I think it makes perfect sense to do a psych eval BEFORE being put on such a medication if it is behavior related. Valjab, you have given us very little background information, and what else can we do but speculate? Please tell us more.
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