We had talked to her doctors a while back about anxiety medication, but she’s already a fall risk, so chose not to go that route. Now it’s getting worse and affecting her sleep. Any suggestions?
When you love an elderly person who has multiple physical difficulties, your options diminish.
My LO entered her AL specifically because she was a significant fall risk who had been living in a home with numerous stairwells, soft loose rugs, old sidewalks……
She had been born in a bedroom in THAT HOUSE, and I dreaded taking her out of it and selling it out from under her. HER decorations, HER pictures, HER memories…
After we placed her, she often attempted to “go home”, cried, begged for her caregivers to “call a taxi” for her. She’s the last living of my 8 aunts and uncles. It broke my heart.
With the help of a very fine geriatric practice, support from her social contacts and religious community, and the skill of her caregivers, everything ultimately fell into place for her.
You are at the heartbreaking point, as we were, when no “good” choices are left to her.
Now you must weigh her comfort against her safety. If her care is “affecting her sleep” it’s affecting YOUR sleep. I slept on the floor beside my mother’s bed to protect her from falls, and based on my experience I can guarantee, that doesn’t work either.
As a nurse, you understand this. The hardest, most impossible decisions, when based on love and safety, become the best ones.
Mom was a fall risk too. She also was extremely susceptible to side effects and drug interactions, so I was very concerned about adding another drug to the mix.
After Dad died she was so depressed though, that she needed some anti-depressant medication to cope. We wanted to allow her to grieve as she needed, but her sorrow was becoming detrimental to her health. Some of my siblings were becoming financially predatory and Mom just wanted to die (in fact, she was diagnosed with “heartbreak syndrome”). She didn’t want to get out of bed and would weep until she had no energy.
She was able to see a geriatric psychiatrist who prescribed a very light dose - this made an immense difference for Mom. He also spent time talking to her which was also very helpful for her. I strongly recommend taking your mom to a psychiatrist over any general practitioner for the best specialized care.
This new medication did not cause any additional balance problems and to the contrary, it helped her regain her life, lower her blood pressure, become more active and get stronger, physically and mentally.
It took about a month for the medication to become effective - there was no change initially (but after 30 days she improved like someone had flipped a switch).
About the fall risk… (Look at your mom’s other medications too - we believe that some of Mom’s heart medications (prescribed by a general practitioner (DO) and random doctors doing rounds on hospitalizations) were contributing to her balance issues - once a new cardiologist got involved, changed some medications and tapered some of the dosages, she regained more balance and better health. After her overmedication, which nearly killed her, we stuck to MDs and specialists only.
Her balance was not perfect, but much less dangerous.
Mom remained in the antidepressant for the rest of her life without any problems).
My dad took Zoloft for anxiety for a few years. Before it, he was very unsteady on his feet, had several falls, and was riddled with anxiety and sadness. After the Zoloft, he was very unsteady on his feet, had several falls, and was much more content, happy, and not fear filled. I’ve found that falls are going to happen, no matter what’s done to prevent them. And Zoloft was a definite help in calming fear and anxiety for which I was grateful. Wish you the best in finding a good path forward
We took my dad off several meds he was on because side effects were causing him too much grief. My dad was in his late 80’s, had AZ, RA, cancer and was in a wheelchair. We tried Charlottes Web CBD gummies. They were tasty and really seemed to help. He slept better while taking them, too. Note: CBD doesn’t always play well with all drugs. You can check it online easily though! Best of luck!!
I have a medical mj card (CT) They have packets of honey the size of ketchup packets that contain 10mgs CBD for tea. They also sell CBD tea bags and sublingual strips. Its safe and effective. Kudos to you for verbalizing this option. 🌿 👨⚕️
I would suggest that your mom see a geriatric psychiatrist for evaluation and treatment. He/She can help with deciding on treatment that would be most beneficial.
In the meantime, your mom will probably benefit from a consistent routine and streamlined home environment. Less things to trip over or knock over can lessen her anxiety. However, don't strip all her beloved decorative items from her room(s). Just find ways to display stuff so they are visible but not a hazard.
She is very old and with that comes anxiety. Try some suitable medication. Also consider safety bars on the bed at night so that you can get the sleep YOU need. Also consider a caretaker for the night. You cannot avoid falls - they will happen - so just be prepared as best as you can. This comes with old age.
I have found that medications affect dementia patients differently than normal people. For example, neither Zanax nor Ativan, nor Lorazapam had ANY effect on my mother! Their brains react differently. You just have to experiment and monitor very closely. Even the doctors don't know what works for different dementia patients. My mother had extreme anxiety with the onset of her dementia. She didn't sleep at all! I don't know how she did it. I tried every natural remedy possible, even CBD oil. She would also cry nonstop day and night. She now takes 100 mg Sertraline (Zoloft) daily and 50 mg Trazadone in addition for anxiety. She is calm without being "drugged up." Even though Tazadone is typically a sleep aid, it doesn't affect my mother. She can take up to 3/day. Doesn't make her drowsy or affect her balance at all. Note, it took 6 months for her to work her way up to 100 mg Sertraline. She started off at 25. But, again, everyone is different. Just try different things. I've heard others use Gabapentin. There's another one called Seroquel. Good luck!
"Anxiety medication" is not limited to JUST things like Xanax or Valium (tranquilizers) which increase the fall risk for elders. Anxiety meds come in the form of anti-depressants like Paxil & Prozac which work to reduce anxiety in a different way. I personally used Paxil in 2000 to help me with crippling anxiety & had 100% success with it, suffering no adverse side effects. Of course, I wasn't elderly at the time, either, so that fact has to be taken into consideration.
Sleep problems come with age for most elders. I would have a chat with your mother's PCP and figure out a medication to try to help her with the anxiety, first and foremost. Why should she live with such a thing? Don't take no for an answer b/c she's 'a fall risk'..........all elders are falls risks to begin with! Nobody should be plagued with anxiety and if your mom's PCP doesn't understand or address that fact, then it's time for a new PCP who does.
You do not mention your mom suffers from dementia so the addition of an anti-depressant/anti anxiety med like Paxil or Zoloft shouldn't be a big problem for her to try. If it doesn't work to help with sleep AND anxiety, then the doctor can move on to plan B. It's really trial & error to find out what works by finding out what does not work. My mother has dementia, so all the medications make it worse, plus she's fallen 77x over the past few years (that's not a typo), but the doctor works with me to find a care plan that minimizes her confusion and falls AND keeps her anxiety & depression relatively at bay.
Wishing you the best of luck demanding comfort for your mother & finding a good solution!
Agree, I got put on Zoloft after our house burned down in a fire. It takes 6 weeks to be fully effective. The doctor said that it doesn't seem to make a lot of difference, but you realise that you feel a bit better than you did earlier. It's side effects seem to be minimal.
My LO entered her AL specifically because she was a significant fall risk who had been living in a home with numerous stairwells, soft loose rugs, old sidewalks……
She had been born in a bedroom in THAT HOUSE, and I dreaded taking her out of it and selling it out from under her. HER decorations, HER pictures, HER memories…
After we placed her, she often attempted to “go home”, cried, begged for her caregivers to “call a taxi” for her. She’s the last living of my 8 aunts and uncles. It broke my heart.
With the help of a very fine geriatric practice, support from her social contacts and religious community, and the skill of her caregivers, everything ultimately fell into place for her.
You are at the heartbreaking point, as we were, when no “good” choices are left to her.
Now you must weigh her comfort against her safety. If her care is “affecting her sleep” it’s affecting YOUR sleep. I slept on the floor beside my mother’s bed to protect her from falls, and based on my experience I can guarantee, that doesn’t work either.
As a nurse, you understand this. The hardest, most impossible decisions, when based on love and safety, become the best ones.
Be at peace with what you decide.
Starrting with a very low dose to get the required effect is kind of a learning curve, but it can be done.
People are so very negative about addiction--which is so ridiculous when our LO's are in chronic pain or anxiety/depression rise up.
Time for a dr visit to discuss this.
After Dad died she was so depressed though, that she needed some anti-depressant medication to cope. We wanted to allow her to grieve as she needed, but her sorrow was becoming detrimental to her health. Some of my siblings were becoming financially predatory and Mom just wanted to die (in fact, she was diagnosed with “heartbreak syndrome”). She didn’t want to get out of bed and would weep until she had no energy.
She was able to see a geriatric psychiatrist who prescribed a very light dose - this made an immense difference for Mom. He also spent time talking to her which was also very helpful for her. I strongly recommend taking your mom to a psychiatrist over any general practitioner for the best specialized care.
This new medication did not cause any additional balance problems and to the contrary, it helped her regain her life, lower her blood pressure, become more active and get stronger, physically and mentally.
It took about a month for the medication to become effective - there was no change initially (but after 30 days she improved like someone had flipped a switch).
About the fall risk…
(Look at your mom’s other medications too - we believe that some of Mom’s heart medications (prescribed by a general practitioner (DO) and random doctors doing rounds on hospitalizations) were contributing to her balance issues - once a new cardiologist got involved, changed some medications and tapered some of the dosages, she regained more balance and better health. After her overmedication, which nearly killed her, we stuck to MDs and specialists only.
Her balance was not perfect, but much less dangerous.
Mom remained in the antidepressant for the rest of her life without any problems).
They have packets of honey the size of ketchup packets that contain 10mgs CBD for tea.
They also sell CBD tea bags and sublingual strips.
Its safe and effective.
Kudos to you for verbalizing this option. 🌿 👨⚕️
In the meantime, your mom will probably benefit from a consistent routine and streamlined home environment. Less things to trip over or knock over can lessen her anxiety. However, don't strip all her beloved decorative items from her room(s). Just find ways to display stuff so they are visible but not a hazard.
Sleep problems come with age for most elders. I would have a chat with your mother's PCP and figure out a medication to try to help her with the anxiety, first and foremost. Why should she live with such a thing? Don't take no for an answer b/c she's 'a fall risk'..........all elders are falls risks to begin with! Nobody should be plagued with anxiety and if your mom's PCP doesn't understand or address that fact, then it's time for a new PCP who does.
You do not mention your mom suffers from dementia so the addition of an anti-depressant/anti anxiety med like Paxil or Zoloft shouldn't be a big problem for her to try. If it doesn't work to help with sleep AND anxiety, then the doctor can move on to plan B. It's really trial & error to find out what works by finding out what does not work. My mother has dementia, so all the medications make it worse, plus she's fallen 77x over the past few years (that's not a typo), but the doctor works with me to find a care plan that minimizes her confusion and falls AND keeps her anxiety & depression relatively at bay.
Wishing you the best of luck demanding comfort for your mother & finding a good solution!