Archive for September 2nd, 2013|Daily archive page

Not my imagination

I went back to visit Mom today, this time in the middle of the morning to see if it would make any difference in her mood. She laughed when I stepped in front of her and said hello. I took that as a good sign. An aide had told me on the way in that she had recently been taking a cat nap. I sat down in a chair facing her and asked how she was and told her she looked good. She spoke briefly and somewhat quietly. She nodded her head forward as if she were trying to get some more sleep. I gently rubbed her shoulders, hoping it might help her drift off. She had said a few nonsense sentences, but as I sat there with my hand on her shoulders, she said, clear as day, “I don’t like this.” I removed my hand. I moved my chair so I was out of her line of vision, hoping she might be able to fall asleep without the distraction of me sitting there, staring at her and trying to hold her hand. Her head would drop forward, but then she’d raise it again. She had her arms crossed and didn’t look at me much, seeming very withdrawn. She didn’t say she hated me, but she didn’t seem to like me, either.

I decided once again that my presence was no comfort to her, so I kissed her forehead and said goodbye. I stopped two aides and asked if Mom had seemed more irritable lately. “Yes,” one aide said emphatically. She described Mom as more difficult to deal with in the shower and now completely unwilling to sit down on the toilet. She yells out that she hates people and told one aide that she wanted her to die. “Thank you for asking,” the aide said. This convinced me that the lack of Zoloft is affecting Mom’s mood, for her to suddenly have turned into such a persistent sourpuss and not just the occasional willful Bonnie she had been for so long.

I stopped at the nursing station to share what I had heard about Mom’s behavior, as well as my own observations. One nurse immediately added Mom as a topic of conversation to the agenda for the next planned behavior meeting. I asked what had prompted the doctor to try weaning Mom again when it had not gone well the last time it was tried. Well, it turns out that it is a regulatory mandate to try to get nursing home patients off of medications. I am not a hater of the government. In fact, I’m a proponent of big government. However, the more I learn, the more I become dismayed by government regulations – I’m most aware of rules imposed by the state – concerning nursing homes. Especially at nursing homes exclusively for patients with dementia, many of the mandates just don’t make sense. “We’re on your side,” one of the nurses said. In fact, the two had recently talked about how Mom has been much more vocal lately, shouting her displeasure for all to hear.

So, I’m hoping this behavior meeting with the doctor will produce results, and that Mom will be treated again. One nurse said that the doctor might try Celexa instead of Zoloft, because Celexa has been shown in studies to be effective in Alzheimer’s patients through the end stages. “All I care about now is Mom’s mood. I don’t want her to be sad, or scared, or mad,” I told them. I also said I hoped the fact that Mom is more difficult for the aides to work with would bolster an argument in favor of restarting antidepressant treatment. There is no reason why she should have to suffer any more than she already is and has for many years.

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