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Dementia for a few years, exasperated by major surgery. So anxious she can't enjoy life at all.... she cries a lot wakes and destroys her bedding, removes clothing. Tried many medication approaches but nothing is sustainable.

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Ah, Waldo, that is sad! Who is prescribing her medications. If it isn't a specialist who treats dementia, such as a geriatric psychiatrist or behavioral neurologist, perhaps you should take her to one of those.
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