It's something new every day

fairegoldJuly 27, 2005

And today it is delusions. Out of the blue.

Monday, she thought that one of the residents who wanders the halls and comes into rooms (harmless and the staff all like her very much) had put her name on Mother's wheelchair with tape. Yesterday, we had a tough time trying to understand what Mother wanted, and with the help of an CNA, I figured what clothes she wanted from home, but the discussion went all over the map, and she was quite upset.

At 6 last night (I had left at 4 PM), the lead nurse called me to say that Mother had told the PT that she was depressed over bad news and didn't want to do her therapy. The nurse asked if I knew what that bad news was, but I didn't have a clue.

This morning I arrived at 8:30 to find two CNAs in mother's room, with Mother in tears, because she thought that I had been killed. She said it was her daughter, and of course, the CNAs had no idea if there was another daughter besides me or not (there isn't, just my 3 brothers). I walked in and Mother was truly shocked. I figured she had a bad dream.

So this afternoon the social worker and a nurse reviewed her chart and medications, but found nothing that should cause this. We're going to monitor it more. And tomorrow, I'll ask Mother if she remembers the episode.

Really took the wind out of my sails about a slow, peaceful decline.

No history of memory loss before except what might be expected at this advanced age (95). And ideas? She started on Prozac just 8 days ago, but the consensus is that if this is a drug reaction, they should have seen it sooner.

Jim just made me a martini. Good boy, Jim.....

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Helene- Two of the very common side effects of Prozac are memory loss and delusions. They usually start to occur after having been on the medication for about a week. My father's oncologist even warned me about them before Dad started on the Prozac. It was seven days and the delusions started. A couple of days later, he started with the memory loss. Once he was off the Prozac for about a week he was back to normal.

On a side note, I have such admiration for all of you on this forum. I have been a lurker for a while now, and have never posted here. I do know first hand how difficult it is though. My father lived with us until he passed. Unfortunately for me, I didn't know this forum existed at the time. Now-a-days, the only care giving I do is for our old dog, Bessie. Take care of yourselves. Linda

    Bookmark   July 28, 2005 at 5:24PM
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Prozac does not become systemic in it's affect until after a prolonged period 1, 2, 3 weeks. I'm surprised your caregivers did not pick up on that. Get her off the prozac ASAP!!!! Ask the folks about Lexapro. It is a new class of drugs for depression that instead of forcing serotonin on the system, it helps the nerve synapses better process what serotonin is present. Mom's on it.

Google "Prozac" and you'll se the 411 on what I've mentioned above. Also, check the below link to look for interactions with her other meds.

Good Luck -

Here is a link that might be useful: Antidepressant drug interactions in the elderly

    Bookmark   July 28, 2005 at 5:59PM
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Thanks! I'll talk to them tomorrow. And get her off the Prozac.

Today was quiet, but when she was awake she was combative. She wants this, wants that, (these shoes, move that picture, do this, do that) and pretty unpleasant.

In the past week, she's lost another 2-1/2 pounds, down to 78.6. tomorrow I will also tlak to the head of the PT dept.... They say she can walk okay with the walker and with an aide at hand. Today she walked down to the elevator then to the pT room downstairs. And she was exhausted and went straight to bed afterwards.

So there's the conundrum---- when is PT counter-indicated. Yes, she can walk. But if it tires her out so much, how can I convince her to go downstairs for Mass 3 times a week? She refuses to go.

I'll talk to the PT people tomorrow about that. They're these young athletic people, very cheerful, all cheerleading about getting to go home, and all that. OK, in another 3 months, there won't be anything left of Mother to go anywhere, not at 2+ pounds weight loss every week! I am coming to understand that she won't go back to her apartment ever again. She's going to need too much care.

And she is hating every minute of it, too.


Thanks, Jean and Linda. I appreciate the help!

    Bookmark   July 28, 2005 at 7:45PM
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It's hard to decide what's best. My opinion, which is not generally shared by everyone, is that at her age and particully at her weight, with little food intake, she needs to conserve every bit of energy. I don't think she needs to burn calories with PT. The question is, can she regain strength if she is burning more calories than she is taking in? There is no way to decide which is best except let her do what she feels like doing.

    Bookmark   July 28, 2005 at 8:48PM
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At only 78.6 lbs, I worry about weight-adjusted dosages. Any comments on that? She doesn't take much in other meds, just Plendil and HCTZ, calcium, tylenol if she wants it.

    Bookmark   July 28, 2005 at 8:52PM
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I sorta agree. If going to Communion is important to her, 3 times a week, then her energy should go to that. But she adores the PT staff, and believes everything they tell her.... I could shoot Eric who told her that her SAS lace-up walking shoes are very good. Now that is all she wants to wear, so when she's in bed and wants to get up and go to the bathroom, she wants the CNAs to put on those shoes instead of slippers. Because Eric said they are good shoes. (I have thought about throttling Eric.....)

Look, at 2-1/2 pounds of weight loss a week, I don't think we're looking at what calories she burns, or even conserving energy. I think she's shutting down, and that is acceptable to me. I would like for her to do a few things that are good for her, or that she enjoyed in the past, like church. But if she doesn't want that, so be it.

But she likes the attention of the pT staff. But I think we had better re-assess our 'goals', as in going back to her apartment.

    Bookmark   July 28, 2005 at 9:18PM
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Hard to say....she enjoys the PT staff, it would be a shame to let her miss it. On the other hand, perhaps they don't know that you understand that she is fading. Most family members insist that everything be done to "improve" health. Have you had a chat with them about her chances for gaining strength? That HCTZ could be working off too much fluid. She could be getting dehydrated????? I think that might be causing the hallucinations.

    Bookmark   July 28, 2005 at 9:35PM
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I got to thinking more about that HCTZ. I take a 12.5mg once a day and I weigh 150. It does a dandy job of getting rid of excess fluid. I wonder what strength she's on. Is she drinking much liquid or complaining of being thristy?

    Bookmark   July 28, 2005 at 9:56PM
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PB, she has trouble urinating, emptying her bladder, but she still feels like she has to go. At night, tho, she is sometimes incontinent. I have been trying to get all the staff together on the concept of measuring output. Right now, Mother asks the PTs sometimes to help her go to the bathroom, and sometimes they don't know about measuring output. It's hard to catch every single staff member. Nurse in charge of patient care understands, I think. Mother's not dehydrated, I don't think. She tries very hard to drink a lot of fluids.

One of her little foibles is half-way-understood information, such as the (unfounded) idea that you have to drink 8 glasses of water a day, not understanding that that's a component of all liquids. So she tries to drink more when she can't pee. When we went to the hospital, she had not been able to pee for about 18 hours, yet when they put in the catheter, she was full. It's not a production problem, it's a delivery problem. All it means when she drinks a lot of water is that she gets more frustrated and uncomfortable.

And she's been on the HCTZ for a number of months before this all happened.

    Bookmark   July 28, 2005 at 11:12PM
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The poor soul is clinging to everything she knows that she thinks might help, isn't she!! I can't beging to imagine your frustration. I guess this is one of those times when people who can just shrug things off have the advantage. Trying to get things to "go right" at this stage is like trying to sweep sand off the beach. Please take care of your self.

    Bookmark   July 29, 2005 at 8:59AM
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Hi Fairegold... Were you able to talk with the staff today about taking your mother off Prozak???

    Bookmark   July 29, 2005 at 4:39PM
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We will cut the dosage in half, since she's only 78 pounds. Things were much better today. Talked to the PT staff about changing her schedule and letting her feel comfortable being taken places in the wheelchair... Mother was afraid that she'd have to walk everywhere, but didn't have the energy. this morning she went to communion, and then we had lunch on the patio at the home's monthly staff/resident/family hotdog&burger BBQ. Then she crashed and slept for severl hours.

Tomorrow, since the staff coverage is the same as today and I could tell everyone, I am taking the day off. Jim and I are going out to breakfast, running some errands, and then spending the afternoon grooming 3 big dogs who have been neglected lately!

But today was much better.

    Bookmark   July 29, 2005 at 6:58PM
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Helene- I am so glad that today was better. Here's hoping that you enjoy your day off. It is important to take care of yourself too.

    Bookmark   July 29, 2005 at 7:41PM
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I sure hope you both had a better day yesterday.
And I wanted to thank you for the joke about southerners over on the Cooking forum. It's too true!!! PeaBee4 hasn't paid her dues for the Garden Web, so it doesn't look as if I will be posting over there for a while. Most of the forums that I am interested in are free. The Cooking Forum is the only one that I will really miss.

    Bookmark   July 31, 2005 at 11:01AM
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The latest

Had a nice day yesterday. Today I got the financial quiz. I had taken over Mother's checkbook and all finances several years ago because she would obsess over ever penny.

She wants to leave the nursing home, but I have been advised that it would cost $12,000-$15,000 a month to provide a level of service that she gets at the nursing home, and with her insurance, she gets 100 days, no charge to her. So I can keep her apartment. I have always told her that she has "plenty" of money, and when pressed, I'll break it all out. But she is obsessive, and I have refused to go over the details every darned day. And she's been increasingly low every day, and I don't like to discuss this all the time.

So why can't she return to her apartment if she has "plenty" of money?

Well, I cannot predict how long she'll need care at $15,000 a month, and she does not have money for a lot of that, like years. So where she is right now helps conserve her savings. Who knows how long she will live? WHat happens when her money runs out?

So she wants me to talk to a financial advisor and get advised about it all.

I tell her that I have talked to a number of people.

She keeps pecking away at me (no wonder we had such a rocky relationship all my life!) peck peck peck.

SO I say, do you want to call Bob or John, my brothers, and ask them? They understand all this.

She says, "did they advise you?"

Seeing an out (I told them what I was doing, and they said fine!), I said, "Yes, they advised me to do this."

"OK," she says, "then it's all fine. You can give up my apartment if you want."

I feel like I've been beaten up.

OK, what's worse, losing your mental facilities or your physical ones first? That's the question for the ages, I guess.

    Bookmark   July 31, 2005 at 10:04PM
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