aging parents

I will try to make a long story short and give some background before I ask the questions. Mom is 82, lives by herself, had breast cancer 7 years ago (had breast removed), a stroke 5 years ago (not much physical but lots of emotional residuals). About 3 years ago she went to a therapist and was put on Zoloft and she took it for about 2 months and seemed better. Then she stopped taking it because she said she was not depressed and she didn’t like the way the meds made her feel. We saw a noticeable difference in her frame of mind when she stopped taking the meds. 2 years ago she noticed a swelling behind her ear. Doctors said it was nothing to worry about, it was a saliva gland and that she should drink a lot of water. She kept obsessing about it. She keeps saying it is cancer. They sent her for a CAT scan and MRI but they really didn’t see anything. Now since she did have the breast cancer and she keeps mentioning it they set her up with an appointment for a fine needle aspiration. On her own she set up another appointment with a cancer instate, which I need to find out about because her primary doctor doesn’t know about it. She is beside herself with fear. My brother lives close by her but he is very sick and can’t really help her. My sister lives about 2 hours away but she and my mom don’t get along that well although my sister does go to the doctors with her and visits once in awhile. My mother also doesn’t get along with my brother or her only living brother. I live in another state about 24 hours away. We (my husband and I) have invited her many times to come live with us and she always says she can’t leave. The reason lately is because my brother is so sick. OK so here is the question.

How can I get my mother to take the medication we and the doctors’ say she needs. This seems to be the biggest part of her problems. She takes a ¼ of an Adovan (anti-anxiety) pill once in awhile and she says that is all the medicine she needs. The fear is killing her. Every time we speak on the phone she cries and says she is dying and she doesn’t know what to do. I really don’t think the swelling behind her ear is anything but this all-consuming fear and the thought that no one loves her is robbing her of any life at all. Maybe if I tell her that we want her to come live with us again and tell her I will go there and help her sell the house and move her here but that she will have to promises to take the anti-depressant meds because they will make her feel better so she can enjoy life. My sister may have to move out of state soon because of work and that is something else mom will see as another one of her children deserting her. If anyone has any suggestions please share them. We can’t move there and she can’t/won’t go live with my brother or sister. After the stroke we had suggested moving into an assisted living place but she doesn’t like “OLD PEOPLE” and says she doesn’t need assistance, which she really doesn’t because she gets around fine and has her wits about her. It is just this pre occupation with dying and that we kids and her brother don’t love her. Please offer some suggestions if you can. Thank you!

This is a really tough situation for you to bear. I don’t know if there is a Council on Aging in her area, but it is something you might want to consider. Are there resources for the elderly in her home community or nearby? It sounds like she may need to get some medication adjustment, but the way you describe it, getting the meds and her taking the meds might be the biggest challenge.

If you have a Catholic Social Services or a Council on Aging in your own area, perhaps you could ask them for some advice as well and also get together with your siblings to see if you can come up with a few ideas on how to best help your Mom.

We had something of a similar situation, but it deteriorated so fast that nursing home care was soon in order. What some have done that I know of is to see if the meds can possibly be given by injection by a visiting nurse or some such. Sometimes you can get a version that lasts longer that way. If not that, could someone like the visinting nurse, etc. come by and make sure she takes her meds in return for your not pushing assisted living, which it sounds like she needs anyway.

Your mother is taking Ativan alone on a regular basis without any mood stablizer? Is she seeing a psychologist/psyco-pharmacologist? Ativan is an anti-anxiety medicationthat is highly addictive and INEFFECTIVE for longterm management of anything. If your mother has taken this medication for more than 6 weeks, this in and of itself may be the problem.

Primary Care Physicians may assume inital care of a depressed inidividal but they have neither the expertise nor the time needed to address the complex issues behind these illnesses. Your mother needs to see a competant clinician. That probably will include both a psychologist **and **a psychiatrist.
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Ativan abuse has been associated with increased anxiety and psychosis which are resolved by eliminating the ativan. You may find that this alone resolves your mother’s problems.

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