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Is it safe for a women 85 years old in a nursing home to take 10 mgs. Virginia has some dementia and depression could be nursing home induced? I have refused any and all antipsychotic drugs. I have been googleing it but still cannot make up my mind to ok this drug as her primary health care person or not.Virginia has been getting better after 60 days in a nursing home but is restless and could use some relief. An ok drug for a 85 year old nursing home women or has anyone experenced bad side effect and not an ok drug?

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Hello
Yes there are the trigger points that she had last night that i think caused her to get fearful. She was put in bed to early(8:pm it was still light out) a trigger point for Virginia or she asked to go to bed but changed her mine plus they closed her door t(his is a trigger point for Virginia) and she could not see her TV another trigger point. She is ok with the morning staff cause she knows them but the afternoon and evening staff have a lot of turnovers and she has trouble with new staff on occasion. The Doctor would suggest anantipsychotic drug. Virginia was very good today nurse said it could of been just a bad day. TY
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Are there any other factors you can identify that might be upsetting her and causing fear and anxiety?

It seems she's reaching the benefit of the doses quite quickly. You might also want to discuss with whichever doctor is prescribing it what the options would be if she reaches the maximum safe dose but is still anxious.
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Since my last post Virginia has gone up for the last 4 days taking Buspar from twice a day 7.5 mg to three times a day 9:am 2:pm and 9:pm . This worked for the 4 days but now Virginia is getting scared again and gets demanding on occassion i reassured her that she is safe and it looks like the dose will have to be raised to at least 10 mg three times a day. I am wondering now how far up i should go? I know some patients take as much as 60 mg of Buspar. Virginia has been helped by the drug Buspar shes been much better since taking it !
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Hello Baralou
It really surprised me the Buspar has helped Virginia so quickly. She is more relaxed not hollering i was told by the Nurse on duty last night. So far its been the thing i been looking for to get relief for her as it does hurt saying no to the drugs offered but i thought they were to strong and i wanted something like this and grateful its working so far. I do see a more relaxed Virginia without the fear i seen before. I know its early and could change but so far working very well.I cannot tell you how much it helps me as well to know finally RELIEF for Virginia. No grapefruit or grapefruit * ty
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AmyGrace
So far its looking good Virginia is not as restless as she was and quieter.After being with her for 4 hours today i was able to leave and her emotions were more under control than usual. Its early yet but so far so good! ty
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I've known folks who have done well on Buspar alone and in combination with other meds for depression and anxiety. Just remember, no grapefruit or grapefruit juice. I'm glad they've found something that you are comfortable with and that gives her relief.
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My mother was 100 and in a nursing home. She was the same - so restless she kept getting out of bed and the wheelchair and very unhappy. It helped calm her down. At that age, we told the doctor give her anything that will make her life less stressful and help her mood (as long as it doesn't make her ill). She seemed to tolerate it very well.
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Oh my glad you asked
Virginia has started taking Buspar (Buspirone) this is her 3rd day i go every day and watch for any changes and or side effects. Happy 4th of July to all Supercharts
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What med is Virginia on 7.5 mg of?
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miface
Thats wonderful it has worked for as long as 4 years i hope and pray it works for Virginia and believe it will! The good news is i can see a bit difference in Virginia now after only few days and at only 7.5 that leaves us with lots of room for adjusting her drug up if necessary. TY miface
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Reno55
EXACTLY what i want a widely used safe drug to see how Virginia does and i have seen less restlessness already but it seems to ware off my evening. Virgina takes 7.5 in the morning at 9:am and evening at 9:pm. I am not completely against drugs but ( i know its necessary in many cases) and has helped many people. TY for your post
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auntie2seven
The evening are the most difficult for Virginia as well. The mornings are not easy but it seems the sundown's are the worst.Virginia is taking a low dose of 7.5 i would think it will be raised afer one week. I read that the drug starts out at 15 mg and that the highest safe dose is 60 mg that not where Virginia is going or your mom but it good to know. TY for you post
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paulahelen2 TY
Good to know it helped your Mom i will keep an open mind on the depression drugs but i am cautious. If the anxiety drug does not work i will keep on looking for something that does work.Sundowns seem to be difficult for Virginia also
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My 85 yr alz hubby has been on it 4 years & turned him from a lion to a lamb. Best thing for him. Should have been on years before but then of course he thought he was perfect.
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A very widely used medication; if you don't see benefits within a few weeks, try another class. I am not sure you have to do DNA testing for a simple antidepressant like this one. My mom is on a similar drug-same class, as was my dad when he was living. They both have benefited. I was on it for 8 years. Keep in mind that this class of drugs can be safely discontinued by tapering the dose. I would not second guess the doctor and your possible bias against medication to treat depression and anxiety. For my dad, it brought back enjoyment of life. For my mom, it is a mood stabilizer which does not cause her to be zoned out. Good luck.
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My mom takes this in the evening because that's when we seemed to have the most anxiety issues. I'm thinking we may have to increase slightly because I don't think 10mg is doing what it should. I'm going to talk to her doctor about it next week.
Good luck!
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hi Baalou if the drug we are trying now does not work and Virginia is not doing as well as i want her to i will again take a look at other drugs such as the one you have mentioned.I do not believe all i read on the internet i do check out the source. Mostly from Doctor's and Medical sites and forums from people who actually have taken the drug.TY for your post i will keep it in mind if needed.I see that they found small strokes that your Mother had undetected that is something i will take a closer look at ty
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I agree with what your saying Grandma 1954.At first Virginia was told whats going on when she was lifted back and forth from bed to wheelchair but the nursing home has it seems to me more than average trun over in nursing aids that are on duty plus she has to be turned over more often because of bed sore she got in the previous month they say as often as ever 3 hours but i do not exactly how often they do.I very doubt that the aids who transfer her talk and explain often enought. She has other trigger points that may not be passed on from one aid to the other especialy on weekends and or holidays.Today i am writing down all the trigger points i know of bu observing Virginia these past 2 months.Something new i agreed to just 2 days was i agreed to permit a anxiety drug for Virginia it started Friday at a very low dose 7.5 mg the drug has a starting point of 15 mg and some patients go as high as 60 mg as safe ( Virginia i was told will not go close to that amount) I said ok to this drug because it is used for anxiety only not for Depression or Psychosis.We will see how she does i just had to do something and i was asking nurses if anyone they know was taking this drug and found out a few were with good results i am watching Virginia closer than ever now she needs relieve with as safe a drug as i can find praying this anxiety drug will work plus i forgot she will be taking 500 mgs of tylenol twice a day along with the drug. The drugs name is Buspirone (Buspar) Thanks for your post appreciate all the post i receiver here in Aging care.
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Supercharts, i hope you don't believe everything you see on YouTube!

All in al, celexa and its generics are good drugs that have been used successfully for many years.

Many older people develop anxiety/depression as they age, i think, due to loss of cognitive skills and because brain chemistry changes. It also seems true ( in my mom's case) that childhood traumas and fears resurface. If the brain is damaged in some way ( my mom has had some small strokes that were not detected, and then a big one, together they resulted in cognitive loss and loss of speech skills). There is no amount of reassurance that helps my mom be calm the way a combination of antidepressants and anti anxity meds does.

I'd give it a shot and see if there is improvement in three weeks or so. These meds take some time to work. Good luck.
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My Mom who has dementia is 91. She started taking citalopram 10 mg about 2 years ago. Shes usually happy most of the time. She's not dopey at all. Sometimes she sundown's and can get nasty wanting the care givers to go home. I wish it helped better with that. She can be good for weeks and then have a bad week. Maybe medication wouldn't help that. Not sure. It's something you could try and if it's not good stop it!
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Sure wish I could correct a spelling error..above post should be ..."hooked me up to a big scary metal bar" not hooded.
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I am curious about something.
If her "trigger points" are when the Hoyer is used to transfer her from bed to chair and back this could be the result of several things.
1. Does the staff take the time to explain to Virginia what they are doing.
2. Do they take their time so the explanation has a few moments to sink in?
3. Is it possible that she is scared during the transfers that she may fall?
4. Is she in actual pain during the movements?
Any or all of these could cause her to yell out.
I do realize in a Re-Hab facility they can not take a very long time due to the number of residents and the limited number of staff. But if they would realize that if you quietly and gently talk to someone while you are doing what needs to be done often the quiet voice and gentle touch can do much more than drugs.
This is not to say drugs will not help but it is possible that a much lower dose could be used along with kindness and understanding.
I know I would not like it if 2 people came at me rolled me to one side, slipped a sling under me, rolled me again and pulled the sling then hooded me up to a big scary metal bar then all of a sudden I am being lifted off my safe comfortable bed or out of my chair. I just might feel safer if someone told me what was going on. Doing this is just as important if the person has dementia. I find my husband is much less fearful when I am telling him what I am doing while I am doing it. I get much less resistance and SURPRISE..that makes my job easier! Win-Win!!
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I have the same opinion i went there because in our Apt. building several older women had been there and found it ok it was close to my bus line and i could go there every day so i choice Augustana nursing home.I too became unsatisfied with the nursing staff but give it a try thinking i could be wrong. I have thought of transferring Virginia to a different nursing home but veto'd that because it would be hard on Virginia to start over. It when down hill more until i started to take notes and pictures they all found out about this and i was a looked upon as not be trusted but Virginia's care improved a lot. Sill its below AVERAGE. The social worker said she needed more than ADL was too weak to get on the lift to transfer her i suggested that come over to my home and see in in action they refused, I also asked for a trial run to see if i could take care of Virginia and if not i would send her back to the nursing home, They refused. The one they want is for her to get on a drug. I have refused the drug Citalopram you tube has some bad videos about this drug and a member in her has pointed me to much info on this drug its a bad drug in my opinion.The staff then preceded to give me a list of 3 more drugs to approve. I will look at two only the first drug Celexa is the brand name of Citalopram. I will look into the other two drugs but have doubts as i can approve any Anixiety and Deoression drug for depression which has not been proven she has. They also want Virginia to talk to a psychiatrist because Virginia wanted to tell the social worker that her Father beat her as a child he was an alcoholic. It feel like i am in quicksand and trying to get out. I think i need more help here in Ageing care. After 2 months they are still working on bed sores on Virginia but no therapy planned at all They are working on her mind but no body strengthening its been two *months now.I did talk to the social worker again today i told her if Virginia was out of the wheelchair it just might solve the bedsore problem the depression the anxiety the hollering and the sleeping problem she said the same ole thing Virginia is to weak i disagree with her on that TY GardenArtist for your post
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@Churchmouse
Well i did find out that Virginia was laboring more than usual and did make an appointment to see a Doctor earlier but was canceled because Virginia did not want to see this Primary Doctor anymore so i looked for a different Doctor and found one that would see her May 10th i thought it was ok to waitt but she got suddenly worse on April 10 and this all started. I do take the blame for a very bad decision to wait.One i have learned from and will continue to go forward to help Virginia best i can. Haldol in my opinion is never the first choice for an 85 year old women. ty for your comment.
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Well, I just had another answer and the site crashed so I lost it all.

I wanted to tell you that I'm concerned about the staffing level, the bedsores, the absence of the primary care doctor, and what plans were made to address the ADL issue when they rejected your plan.

I'm not getting the impression this place offers the greatest level of care. Are YOU satisfied with it?

If you're not, make it obvious by taking notes on everything that you're documenting. They won't know why, but word will get passed around that you are. I've overheard staff commenting when I take notes; the tone of voice suggested some concern.

I've also found that if I don't document and don't address issues right away, problems can occur more easily, meds that are unnecessary or inappropriate are given, and it's harder to reverse than having meetings with staff right away and setting the standards (i.e., in our case, NO substitutions for meds prescribed by the regular treating physicians).
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Ah. If I may say so very gently, 'bilateral chronic venous stasis' would not develop suddenly. I am afraid that the NH and Virginia's doctors may have come to the conclusion, based on her having become so ill before, that it is insuperably difficult for you to look after her well enough at home, even with input from your son. I'm very sorry, and I understand your feeling that she would be happier and better oriented at home, but it does sound as if she needs more assistance with personal care and mobility than it is reasonable to expect of yourself.

But it doesn't have to be the end of the world, you know. She is extremely lucky that she can continue to enjoy your companionship and a good range of activities, but in a setting where she has the professional health care team she needs now.

Also, it's early days; and as she becomes more settled in the NH she may well begin to feel better - all that disruption on top of convalescence from a nasty infection (by the sound of it, that is) is bound to have been a setback for her. So why not ask her doctors - next week is it? - if they don't think it a good idea to wait and see before they prescribe.

The Haldol on that one upsetting occasion will have been given to make her easier to manage - but for the very good reason that the paramedics' job was to get her safely and rapidly to hospital and they couldn't take the risk that she might freak out on them en route. I appreciate that it's a shocking thing to see a drug whacked into someone you care about, willy-nilly like that; but it was the safe course of action.
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Virginia does not act up when i am there she knows we will be active going to her exercise class Tuesday and Thursday, coffee in the cafe,outside for some sun, and talk about how she is feeling etc. She always has a smile on her face when i arrive everyone knows she is waiting for me and i go every day.Virginia had: Bilateral chronic venous stasis,Delirium with possible dementia when i called emergency on April 10-16 she was given 5 mg of Haldol which i was very upset about ! We have lived together for 37 year and we live in the same community for 37 years as well. My Son lives next close by.I am 80 years old Virginia is 85 but we take no drigs outside of my high blood pressure meds.The manufacture of Citalopram is Celexa who was fined 150,000,000 for misrepresenting one of its drug years ago but still not a good sign. Also has some class action suites pending so it makes me wonder. Thank you for the info about Citalopram.
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If you wanted to tranquillise your patients to make them less troublesome, you wouldn't pick Citalopram. It doesn't make you docile or sleepy. Not least because it isn't a tranquilliser in the old-fashioned sense.

Citalopram works by regulating the amount of a specific brain chemical called serotonin which is an important factor in controlling mood. It is one of a family of drugs called Selective Serotonin Reuptake Inhibitors, SSRIs. It is a safe, clean and effective medication in extremely widespread use across the whole population, young and old; and it would probably help Virginia. But if she and her doctors and you felt it wasn't helping, it could be withdrawn safely. It isn't addictive, in that you don't need more and more of it to work and you wouldn't get withdrawal symptoms. The reason it shouldn't be stopped suddenly - cold turkey, if you like - is that the level of serotonin in the brain would plummet if you did that, and abrupt changes aren't what you want. But it wouldn't take long to withdraw a 10mg daily dose in any case.

I think it is difficult to separate out anxiety and depression. I've never found it a very helpful distinction. The person feels wretched - is that because she is anxious, depressed, or both? It's a bit like asking someone to describe physical pain - is it stabbing, wrenching, aching, shooting... It just hurts!

You describe Virginia talking loudly and trying to get the aides' attention because she can't go anywhere without help. You think it's a feeling of being trapped. Is she doing that while you're there? Does she appreciate that you're there? It's just that I'm trying to visualise what you describe, and it's a picture that could fit with dementia.

What was the crisis that took Virginia to the hospital? And was she living with you and your son at the time? - in her home or yours?
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This nursing home has mostly* people that are older like Virginia is but on drugs* i do not want Virginia to get on drugs and become sleepy and emotionless all i think she needs is her home that she left with no diagnosis of Dementia at that time that was JUNE 10-16. She was said to have Dementia by the emergency Doctor not her Primary Doctor because she was changing her Primary Doctor next Month May 9 th. Now her Primary Doctor is the Nursing home Doctor who i have not seen or talked to since Virginia was admitted 5-1-16 I will be talking to him in early July. finally. Also Virginia has had 4 bruises the first 21 days that the Health Department knows about but no bruises since. Also getting over bed sores.Now a drug is suggested it seems somehow wrong as she is doing better and looking better than ever except for some loud taking and trying to get the attention of the Nurses Aids because she cannot go anywhere without help.Its a feeling of being trapped i suspect. Is the drug being giving for the convience of the nursing care staff or for Virginia? Another thing is i had a plan for her but it was refused today because of her not being able to do her Activities of daily Living. And by the way i would be there 23/7 one hour for shopping until she can walk again my Son will watch her for the one hour i am gone. I also have a lift for her to transferred from bed to wheelchair and toilet but they think she is to weak i asked for a trial to see but that was refused also. Does seem to me they could do more themselves with no drugs involved. TY for posting Churchmouse.
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freqflyer
Yes thats the word i remember back in the 50's and 60's i think. I was thinking something like that no need for the depression part that whats scares me the sucisides that have ocured with antidepression drugs. TY
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