My grandma is getting anxiety attacks and she has high blood pressure. How can I calm her?

A lot of good advise......mine is from my own personal experience (my dad is 94 and currently taking anti-depressant and I inherited his anxiety issues)
My dad has been a priest most of his life......prayer is great but many times anxiety and depression are physiological and not psychological and simply require meds to address. I think Haldol is a little over the top for an elderly person). I have had reason to look into this and know that Ativan, when taken properly, is designed to relieve anxiety. I personally didn't get great results from it....but I'm not even close to 94. It also has a tendency to lower blood pressure so that should be monitored. It usually lasts from 8-10 hours and has a shorter half life than say, Xanax. A good geriatric doc will know what to do.

You may also need to examine your grandmother's diet. I deal with my own anxiety, panic etc. and one of the underlying causes was low blood sugar. Make sure your grandmother is eating meals with protein (an egg or a piece of meat the size of her palm) every three to four hours. Have her drink chamomile tea with meals, and give her gatorade or make your own electrolyte drink (just google the recipe) it's simple ratios of salt, sugar, lemon juice and water. When seniors take medications, especially to control blood pressure, their electrolyte levels get messed up and this can trigger huge amounts of anxiety. Additionally, try putting her on an herbal supplement called rhodiola. Do a web search for its benefits. Briefly, though, rhodiola will stimulate and balance her adrenals and hormones, and it acts as a natural antianxiety/antidepressant. All of these things are very inexpensive and have little to no side effects. Don't forget to take care of yourself too...it's harder to help others when your own tank is running low! Hugs and good luck.

I have one simple technique which has worked well for me. Get two washcloths, and make them super warm and wet. Wrap her hands. That's it. After the hands have been wrapped, I do a calming massage of hands and forearms, and speak (silently) words of calm and peace to the elder.

A doctor is giving my grandma 5 mg of Haldol, and now wants to try Seroquel. I don't know which is worse for the elderly. Is it safe to change? She was wayyyy too over medicated on the Haldol, and could barely respond at all. (In the past, she also developed head and hand shakes) One minute, she is completely out of it, another minute she is able to talk to friends, and the next, she is saying random stuff to herself, and repeating or rhyming words endlessly.
A doctor has suggested that she go to a geriatric facility for a while to be treated, but this is over an hour away from me, (and I don't drive much, only around my hometown). I wouldn't be able to go see her or control what she was being given.
The other option is a home health nurse, psychologist, and physical therapist who can visit us to monitor her medicines and help me.

I have experience with this issue. The metropolol may be dropping her BP too high. Anxiety causes the BP to go high at the time, but when the anxiety ceases, a beta blocker is too strong for them, which, causes the BP to drop too low. You may also want to get blood checked for electrolyte imbalances. If all is normal, I would give her some magnesium citrate in a cup of tea daily (whenever the attacks seem to occur most frequently). This calms the nervous system and heart and keeps BP from rising too high. Also, I have taken instrumental Christian hymn CD's and play them for my mother when she is in an anxiety attack and hold her hand and have her breath 3 - 5 big deep breaths when the music starts. Then, I say, we will have quiet time now. Concentrate on the music and allow her to sing along if she wants, but mostly to let the music relax her. Make sure the hymns are slow and relaxing. Then, I do a "talking meditation" w/her if this doesn't soothe. I say, repeat after me: " I now relax my forehead...my forehead is now relaxed." And then I move to eyelids, jaw, mouth (make them drop their tongue off roof of mouth so jaw is slight open) and continue down the whole body. This will relax your grandmother. Also, make sure she feels safe. Write or print out on paper and leave around the house " I AM SAFE, HEALTHY AND HAPPY IN THE NAME OF JESUS" and make her state it out loud many times a day. Keep it posted all over the house so everywhere she sits and walks, that message is affirmed. I administer 1/2 of a beta blocker only if her bp during an attack is around 180. It will drop her bp to 120 in 1/2 hr. Amazing. Be careful w/administering meds. Xanax helps occasionally w/my Mom, but sometimes has no effect at all, which, is why I like magnesium...it will sometimes put her to sleep. Good luck and God speed.

The two medications your grandmother is taking are ones that have a good history. I keep a record of all of my asthma drugs and write my reactions to them. Perhaps this would help your doctors if you keep similar notes. It does take time for the body to adjust to new medications, but contact your pharmacy or doctor if you are worried. I hope you will look after yourself, too.

I myself use Ativan infrequently for anxiety (I'm 46). It is fast acting (within 5-10 minutes) and does not stay in your system. Antidepressants usually need to be taken for 2 weeks for them to begin to take effect. Many people are skittish about using drugs for mental illness; however, if you were suffering diabetes you would never withhold insulin would you? If you had pain from cancer would you withhold morphine? Prescription drugs are only tools that can be used when appropriate and as needed. Don't write them off unnecessarily.

I would also suggest limiting cable TV and radio broadcasts, especially the news (which agitates ME and I'm not elderly). Instead, use DVDs and audio tapes that you know you can screen for content. Movies, music and radio shows that were popular when she was young may help soothe her nerves and stimulate positive memories.

Pastoral or other counseling is always a good idea for all of us during challenging times; however, as we approach our own deaths and we have unresolved issues, this can manifest in a variety of ways. Perhaps there is something troubling her from her past or she is simply adjusting to aging, physical decline and the spiritual concerns that go with it. Find someone soon so she can begin to do the talk therapy she needs to come to terms with whatever is troubling her.

Hope this helps...best wishes
Elaine T.

I took my grandma to the ER and she is in the hospital. I couldn't get her calmed down on my own. The doctor ran tests and xrays, and they looked ok. He put her on a new blood pressure med called Cardizem and is giving her Haldol again (which I worry about). She has only been on the new med for a few days so I'm not sure how it will affect her. It seems to make her drowsy. The Haldol, (which I have heard is dangerous for the elderly) makes her drowsy also. She has been on Haldol before, and got head and hand shakes or tremors. I would like to get her back off this drug as soon as she feels better, but the doctors seem to think it's necessary. The doctors aren't sure if her anxiety or confusion is temporary or the early signs of dementia.

metropolol is not the only drug for treating high blood pressure. Don't quit cold turkey, but definitely talk to her doctor about safely getting off this drug and trying a different one. The drug may not be the cause, and then the behavior will continue. It is not a sure bet but well worth trying!

I am so glad that you recognized this last night. I want to share one of the first lessons I learned as a caregiver. Our roles don't totally alter, but we do have to take charge at times and become the adult. This is just an opinion, but your grandmother needs to see a doctor even if she doesn't want to and argues with you. Tell your doctor's office politely that you must see the doctor and need to be worked in immediately due to your grandmother's behaviors. Describe them just like you have to us. Call a taxi and get your grandmother there. Someone is not listening to you. Your grandmother's blood pressure is just going higher when she is agitated ,and I know you must be upset, too. Take charge and go for it! You can change this for all of you. My brother has been a doctor for 35 years ,but he knows that he is working for his patients and their families. Don't let doctors and nurses push you around; YOU are in charge. Best wishes! I will be praying for both of you.

I think my grandmother's anxiety / outbursts are caused by her metropolol medicine! I gave her a whole 25mg tablet before bed, and I watched her. She was talking calmly. Within an hour and a half, she said the medicine was affecting her, and she began getting confused. Then, the fast speech, trembling and screaming started up again! It lasted continuously for at least 3-4 hours. I will call the dr. and pharmacist to see if I can reduce the dosage.

My grandma is asking me to type things into the computer that she hears on the radio (Gospel songs).(I tell her I do so she will calm down.) We are up every night with something, and neither of us is sleeping well. If I tried to get her medical help, I'm afraid she may get excited and scream. But I don't know what to do anymore. I don't think a sedative is the answer. She is saying children's songs. I am worried that she could have a stroke If I don't do what she asks.

I would offer to take her to church, pray with her and offer to read to her (particularly from the Psalms, ie. Ps. 23 and such). Perhaps give her the daily readings from Stormie O'Martian, or give her a copy of Elisabeth Elliot's "Keeping a Quiet Heart" or Spurgeon's Daily Readings. Give her an old hymnal or a book that has the verses fromt the hymns listed with a brief excerpt telling about the author of the hymn.((Such as Obeck's 101 Hymns and their Stories) Job had many struggles and trials and always had "friends" around to offer all kinds of advice, but Job sought God in prayer and received His true comfort from him alone. We have a wonderful "church down the hall" at my mother's Rehab/Conv. and that has been a blessing. Find other Christians in close proximity who can encourage and perhaps pray with your grandmother. Seek them and let them know of your mother's needs. I will pray for you. This is a difficult time for our loved ones. They are closer to death's door than they have ever been. Being sure they are right with God--repentance, change of heart, obedience to his Word, receiving His and other's forgiveness, His joy and
peace as a result from the above can be attained within minutes and is of utmost importance to your grandmother, my mother and others. Please keep us updated.

Although there are religious things involved. I think you should look to the physical here. I don't think that God operates this way. There are some possibilities -- urinary tract infection (UTI0 comes to mind. Less welcome is that she has had some small strokes that affected certain cells in her brain. This often corrects itself with time if the strokes stop. Some people when they have these small strokes become paranoid. Many think they are being watched by the FBI or CIA. Some feel the neighbors are plotting. My brother actually saw rats that had balloons on their tails with little camera. I call them his "spy rats." They were sent by the FBI -- why, I don't know. The FBI wouldn't have been interested in him for any reason.

You know your grandmother, so probably can figure out if how she is acting is just her. If the change has been rather sudden, I would look toward the physical. Getting a spiritual guide for her sounds like a wonderful idea, too. It would give her someone to discuss things with. She might get a lot from this in helping to soothe her mind.

I believe in God, but I am not informed enough to help her with the religious thoughts, confessing, etc.
She feels that the issues she is dealing with are more important than anything and she has to get her "messages" out. If I try to change her thinking, or get her to do something else besides write, she gets upset or angry. Right now I have to keep the house quiet so any outside influence won't upset her. She has a friend coming over tomorrow. I hope everything goes ok.

My grandma only has me, 2 friends, and a son who lives in another state. She never drove a car and I have driving fears so we don't get out much :(
I had to call 911 yesterday when she got out of control. She was screaming and resisting me when she knew I called them.
I am having chest pain (stress) from dealing with her.
I'm not sure she would allow anyone like a counselor or nurse to come in.
She keeps saying she is thinking fine but what she is writing is highly emotive about things she felt strongly about in the past.

I agree with the one that suggested a Pastor, but since your grandmother won't go to a church maybe she will call a prayer line. Ask her if she would like to call someplace and ask for prayer. There are several preachers on TV that she might follow if you show her the programing. Let it be her choice. Medicine might help for a short time (I have been on antidepressants so I know) but in the long run only Godly counsel will help. She needs to be able to confess her sin to someone that she can trust not to share it or to help her see that she is in right standing with God. Feeling alienated by anyone brings anxiety. Probably it is something minor but in her mind it is big. Sometimes the meds I took made me more angry or anxious. I found that prayer helped me and now I do not take any of the 5 meds I was on. One, Zanax is very dangerous for me. My psychiatrist (the new one) told me to stop taking it. That along with prayer enabled me to get off all the meds. Please ask Grandma if she wants to have prayer and let her tell you whom she wants to have prayer with. I will pray for her. I hope you will consider my experience and also my Mother was on a med that made her have nightmares. Stopped the med and she stopped having them. Everything cannot be fixed by medicine. Medicine is good for certain things and when we find that doesn't work, many people turn to the Lord and He heals them.

I am so glad you are answering everyone's posts. It really helps to have the information. From what you are saying, the medication seems to be the issue. I am not a doctor and hesitate to comment on medication, but I have a specific medication for serious panic attacks which started after I spent a year nursing my Dad who passed away. I have always thought Ativan was a daily medication. Start with a geriatric doctor if you can but go to your regular doctor if you cannot. Summarize what you are saying to us in writing and give it to the doctor before your visit. The fixation on the Bible may be something she really needs to talk out with someone, but people of her generation often revere their Bibles and have been taught to write pertinent verses for memory purposes. I think a different focus on the Bible, a prayer partner (someone her age if you cannot be it), and perhaps the positive devotion approach I mentioned earlier may help. Most libraries have wonderful DVDs and VHS copies of important stories in the Bible. They can be useful for helping her look at Biblical events differently. She may also be comparing the book of Revelation to the world's events which can be frightening. If nothing else works, you may need a counselor for her. There are many Christian counselors that might see her for free or for a very small fee. Does your grandmother interact with many people? Don't give up. We will keep answering as long as you want us to. Rebecca

My grandmother had complete testing, with ct scan of the brain, mri, blood tests, etc. in may of last year. nothing serious was found. she was in the hospital for a week.
Tonight was scary, she had an Ativan .5 around 2:30 pm and then I gave her a metoprolol 25mg around 8:30 pm.(her usual BP med) at 10:00, it looked like she kind of passed out, and it was almost like her eyes crossed for a minute, but she woke up, and was able to see and talk to me.

I don't know your grandmother's history. I have had a couple of serious bouts of panic disorder, so I know her discomfort. My systolic blood pressure would go up to 160 when I was panicking. The good thing was it returned to normal when I calmed. So I feel it is important to get her calm. Panic attacks are often accompanied by a feeling of dread or impending doom. What causes this, I don't know. It may be that she is putting religious significance on those feelings, even if they play not real part in the feeling.

I feel that your grandmother needs a complete vascular and neurological checkup. Panic attacks can be triggered by something going on with the heart. It may be that this has nothing to do with your grandmother's anxiety, but it would be good for someone to have a good look. It also would be handy if she could have a PET scan during a time she was having an episode to see if there could be any seizure activity going on. Certain types of seizures can have behavioral characteristics that make me think of what you described.

I wonder about the obsessive behavior of writing the Bible verses. No, I don't think that the Bible is obsessive. But if she is feeling pressure to perform tasks involving writing the passages, etc., it may indicate something is going on there.

So, I would suggest a thorough examination. Oftentimes physicians only look superficially and miss things that could be going on. It may be nothing but anxiety, since anxiety can cause so many symptoms. If it is panic disorder and your mother is of an age that addiction is not an issue, a small dose of Xanax, instead of Ativan, could be better. Xanax has a slight antidepressant effect and doesn't cause as much drowsiness as Ativan does. It used to be the drug of choice for panic attacks. Your doctor will know if it may be right for your grandmother.

In a similar situation, last year I took my grandma to the ER, but she had worse outbursts, because they just tried to restrain her (holding her down) and with drugs like Haldol, which made her depressed and very groggy. I took her off that because I heard it was dangerous for the elderly.
When I try to turn off the tv, or radio, she gets agitated, saying "you won't even let me watch things." etc. I have tried hiding things that may trigger her, but she wants them back.

I really believe an internist or other doctor who understands the needs of geriatric patients should be advising you ASAP. Call your doctor's office and explain the situation as needing immediate attention or take your grandmother to a good ER during her next panic attack. The problem with not treating panic attacks is that they can have a very negative impact on high blood pressure. Can you control a great deal of the media your grandmother sees? It is frightening at times. Please stay in touch. Rebecca

A doctor has given us Ativan .5 mg for her anxiety and outbursts. It made her drowsy but just briefly, and then she was up again writing Bible verses in a notebook and repeating what she hears on tv, saying there is a connection to them. She says she doesn't want to sleep, or doesn't need it. (But if she doesn't sleep, then I won't either because I worry about her.)

Is Ativan safe? I have read other's stories of elderly having bad withdrawals and other issues with this drug. She also takes high blood pressure medication.

You are struggling with a tough situation because it involves both physical and emotional issues. I can relate to what you are saying due my life long issues with anxiety and my devout beliefs as a Christian. Regarding your grandmother's issues: I would work on the anxiety issues with a psychiatrist or your internist, if possible. There a medications intended for panic attacks as well as others that can be used daily, if needed. You are protecting your grandmother's health if you reduce her panic attacks and anxiety instead of hurting it with more medication. I try to control mine without medication but it sounds like I am much younger than your grandmother and possibly more open to learning new skills. Regarding her panic attacks when dwelling on religion, I would suggest that you join her in a daily Bible study that can be very brief. Start by going to a bookstore that can sell you an UPLIFTING and POSITIVE devotion book. Tell them why you need it. My grocery store has a whole rack of books like this. Provide your grandmother and yourself with spiral notebooks that become your prayer journals and your journals to record special verses. Introduce all of this by asking your grandmother to help you learn to derive comfort from the Bible. Gently and verbally turn her away from the negative or record the negatives in her notebook under things to pray about. There are so many positive sites that provide daily devotions through the web, too.
The changes won't happen overnight, but daily practice for just a few minutes (ten or 15) may give your grandmother a great deal of peace. I hope all of this gets better for both of you. Your grandmother is blessed to have someone who cares about her. :) Rebecca

There are many other antidepressants that could be tried. There are also anti anxiety meds. Her current behaviors should probably be discussed with her doctor.

My grandma gets in a very agitated state of crying, and shaking, so I'm worried because it can raise her blood pressure dangerously high. She has had many tests and has not been diagnosed with Alzheimer's or dementia, so I think this must be anxiety or depression. She sometimes babbles random thoughts, and it can be hard to get her to stop talking. I think she is relying on her religious books for some type of comfort. It's hard for me to understand, because I don't know the Bible as much as she does. My grandma hasn't been to church in years because she had some opposing views and decided to leave, so she doesn't have a pastor now. In the past year or so, we have lost 5 family members, and heard of the sickness of friends, which caused a great deal of stress.
She was on an anti-depressant med before, Celexa, and it gave her a choking cough, so I had to discontinue it.
I have my own anxiety issues, and I'm very worried about her.
Thanks for responding.

I have relatives who get panic attacks. They have been taught some breathing techniques to help them get through them. I know that one sometimes pulls over on the highway and calms himself down before continuing. You might try Googling "panic attack breathing techniques" and see what is suggested. Would your grandmother be willing to try something like that?

What does she do when she feels this anxiety? You meantion not wanting to leave her alone in case she has one. Do you think she might do something harmful? My dad used to have "nerve attacks" and he would call one of us kids on the phone and just talk about anything until it passed. Would your grandmother be able to call you on the cell phone if she had an episode while you were gone? Being resticted to the house with her has got to be stressful.

Since the anxiety has religious overtones, I agree with naheaton's suggestion as well.

Good luck.

I think maybe she needs to be seeing her Pastor rather than an MD.