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My mother has been in her Memory Care for about 12 weeks. She has moderate dementia.


Her thyroid numbers are fine. She is already on an antidepressant and an anti anxiety Rx.


Before she went into the MC, she was absolutely terrified of the world around her. She was afraid of being alone, afraid of windows (convinced that someone was looking in at her), afraid of running out of money, afraid of trees, and on and on. At the MC, they have adjusted her prescriptions, because the terror continues, and because her OCD has gotten out of hand.


Mom will not participate in activities, and only leaves her room for meals. The dining room is twenty paces away. Then, it is right back to her room, shades drawn, and blankets pulled up to her nose.


The staff is kind, compassionate and caring. They can’t force her to join in with activities, or just to be out with other people. She refuses to have the sweet activities director come in and do individual activities with her.


Mom refuses to have the tv on any longer. Books, movies, music, listening to books being read, looking through old pictures...all get a firm “NO!” I understand that some of those things could be cognitively too difficult for her. Name a past-time of ANY kind, and the answer is the same. Just NO.


This is a beautiful new MC, with a low staff to resident ratio. I am FREQUENTLY in touch with various members of her care team. They are concerned about Mom’s terror and depression and anxiety, and have have referred her to their psychiatrist. That doc will see her, then give me a call.


What kinds of questions should I ask this doc? Anything I should be wary of? I don’t want her to be a zombie, but, I don’t want her to have to suffer this terror and anxiety, either.


Thank you.

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CX, I'm so sorry that your mom is going through this. For me, seeing my mom in a terrified anxious state was the worst. The one thingI ever promised her was "no pain" and in my mind, that included psychic pain.

I think a lot of us 1950-60s "kids" equate psych meds with zombie-hood. I think of it as the Jack Nicholson effect (a reference to One Flew Over The Cookoo's Nest).

Psychopharmocology has come a long way since those days. After a dx of vascular dementia, mom's new geriatric psychiatrist switched her from Xanax to regular small doses of klonopin. This did not sedate her, but the constancy of the dose meant that mom needed a lower dose because she wasn't taking the med AFTER the anxiety kicked in. Getting ahead of the symptoms was key.

After she had a major stroke, mom's anxiety skyrocketed. A cocktail of Remeron, Lexapro a nd a pediatric dose of klonopin kept mom calm and happy. No zombie effect!

Work with the psychiatrist and understand that psychopharmocology is an art and often requires trial and error. Much good luck!,
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What a terrible situation your poor mom is in! I think you should tell the psychiatrist that your only goal here is to stop her from being so scared and anxiety ridden, period. Whatever meds he feels should be tried to accomplish that goal, go for it. I didn't want to put my mother back on Cymbalta for her neuropathy pain bc last year it worsened her confusion. Well, by this year, her agony had increased to the point where I was willing to try ANYTHING to stop that pain from happening. So back on Cymbalta she went. Her pain is greatly improved and her confusion is heightened as well. It's a decent trade, I think. Nothing is perfect in the world of advanced old age and dementia....so you make compromises, you know? Your mother can't function with THIS level of fear and anxiety, nor should she have to. So if she's prescribed a med that makes her a bit zoned out, hey, it's better than hiding behind her darkened curtains all day, right?

Allow the doctor to help your mom improve the quality of her life. Take Barbs advice and rely on his knowledge of what's best to try here. Put aside your worries and give something new a try.....bc what's happening now isn't working.

Good luck!
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Thanks, ladies!
My twin sister is coming in next week to see Mom before Mom can’t recognize her any longer. That brings up a whole level of other feelings, since I have been doing ALL of the caretaking. But, that’s another story. My hope is that the psychiatrist can get something on board before then. Just to take the edge off.
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We have wonderful psychiatric services at my LO’s residence. She has done well with her medications (until dealing with 2 cases of Covid), BUT- she was NEVER a joiner, and at her BEST, she was spending a lot of time in her room and sleeping a lot.

Still, she was peaceful, attended Church weekly, and was basically cooperative.

You do the very best you can, and sometime that means settling for 50% even if you’d love her to have more.

As to questions, I had requested that she be tried on small doses, and the psychiatrist agreed almost before I was able to ask.

You seem very attuned to your mom’s needs. Hope your experience turns out as well as ours has.
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My dad is 90 and in the exact same situation your mom in is last February 2020. He lived in FL in a assisted living home where my other sibling s lived, I lived in OHio and tried to visit monthly. When I took him to the dr, she asked me why my dad couldn't live with me. After a few fights with my brother and sister-in-law I moved my dad to Ohio in my home. What a world of Change he now watches TV, reads the paper, has conversations with people, and has a whole new look on life he even can get around better, at first I had physical therapy come in and alot of extra help to get him up to par! You can contact your Area on Aging and they will set you up with someone to come in your home to help with him doing all sorts of things to help you. They even deliver prepared lunches for him. If you mom has any amount of time left where she can have a quality of life I would strongly suggest taking her in your home, It has been hard I won't say it hasn't but the rewards outway the bad. If you would have any questions, please contact me.
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lealonnie1 Feb 2021
Not everyone is in a position to take a demented elder into their home and I find it shocking a doctor would even ask such a question! The OP is not asking whether to leave her mother in MC or not, but how to deal with the psychiatrist during the visit.
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Sorry did not mean to offend anyone, just wanted to mention that my dad is doing wonderful with me, but then again I must be the type of person that can handle it, not all people can do it. As for the person that mentioned its hard to believe a dr would even mention that I would take my dad into my home I can give you her phone number if you would like to check with her? She is in Cape coral Fl. Our family has had a LONG STANDING patient doctor relationship with her for like 20 years she knows all of us very well and only gives us the best advise for my dad. I will be sure to never give another opinion on this site again since your are all so sensitive!
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