My 85 year old mother with Alzheimer's was admitted to a memory care facility in early August after breaking her right hip, then broke her left shoulder from a fall at the facility a few weeks later. Due to my dad's bad insurance that wasn't covered by the Doctor who visits this facility, she was not being seen on a regular basis. Her mental condition has advanced, most likely because of the traumas which included several hospital stays, several ambulance rides, several non-emergency transports and several different facilities until we found this one.
Since I have been visiting my mom more often than my two sisters, one who is two hours away and the other is a three hour flight away, I have frequently observed and experienced my mom's extreme anger, depression, agitation, and outbursts that cause disruptions to both the caregivers/aides and other residents. it is heartbreaking and deeply concerning to observe these incidents. My mom is normally a soft spoken, loving, caring, thoughtful, adorable person.
One of my sisters who lives a few hours away, who works in geriatric settings as a music therapist, supports my request to my dad, the doctor, the various nurses at the facility and Director of Nursing, and the executive director to prescribe a small dose of an anti depressant to help ease my mom's agitation and sundowning. Ativan was used a few times at the hospital and she responded fine. One facility prescribed Haldol which was a horrible experience for my mom,so I expressed my strong opposition to using this medication at her current facility, which they agree with.
since I visit my mom on different days of the week and at different times of the day than my dad and sister who is out of state, I see the most challenging side of my mom's behavior. When nothing was being done by the nursing staff at the facility nor any action taken by my father to pay out of pocket for the doctor onsite to address my mom's rash and swelling on her legs and her agitation/anger/outbursts, I made an appointment to a doctor who accepts her insurance program, who prescribed a medicine for her legs and Risperidone, which I thought was an antidepressant. that night my sister told me it was an antipsychotic drug similar to Haldol, is not FDA approved for elderly patients with dementia and can cause death .
So I called the facility and explained this to the night nurse, and asked if it could not be given until I spoke to the prescribing doctor and my father, who regretfully has POA. the nurse agreed.
At promptly 9am the following day I called that doctor's office which became a total three ring circus when I was told the dr was out of the office at medical exams, as well as the PA doing rounds at a hospital, so I was relaying messages back and forth between the inefficient receptionist and the PA.
I politely asked for a change in medicine to an anti depressant or ativan, which was initially requested, not an anti psychotic. The doctor, who relayed the information to the PA who relayed it to me, said no and that was beyond their "scope of services??" huh? but they can prescribe an antipsychotic like Risperidone?? It made no sense. After several agonizing hours of trying to get the PA to get the doctor to approve a prescription for something like celexa, the PA said the dr approved it and that she would call it in to the pharmacy right away. I waited two hours then called back and was told it would be called in by the end of the day. that was still three hours away and I had already missed my entire day of work.
Bottom line, it was a futile attempt, because the memory care facility finally convinced my dad to pay out of pocket for the doctor to evaluate my mom, which I thought would be the next day, which didn't happen until a week later.
After that evaluation, I found out that the Doctor still didn't prescribe an anti depressant, nor will my dad enforce it, which my one sister and I do not understand and are extremely distressed, confused and upset about.
Since my dad has POA, none of us are allowed to ask the nurses or staff why this decision was made and when I ask my dad, he blows up, gets very angry like he does with everything. I believe he is cognitively impaired.
I really need advice about what to do because my dad has POA and my sister who lives out of state supports his decision because she flies in to town for only a day or two and visits in the morning when my mom is in her best condition; they never go during meal times or afternoons or evenings when sundowning strikes.
I have called the ombudsman for the region and she did not offer any new options that I haven't already tried. It is heartbreaking, painful and very distressing to see my mom in this state, when I firmly believe that a low dosage of an anti depressant could alleviate her extreme depression and anxiety.
Does anyone have suggestions? I am at my wit's end, like my other sister and extremely frustrated/ depressed about all this