My mom is depressed and my siblings want to add more antidepressants to the 2 she's already on. Any experience with this?

While the hallucinogenic thoughts seem all to real to the patient, we lucid caregivers know that they are just pure fabrication. You may want to take her to a geriatric psychiatrist.

Sounds like this is really a hard time for you. Anyone would be worrried about what is best for your mother.
Your sibs think it's just a lack of medication. It's probably more complicated than that.
People here tell you it is normal to be depressed after a health loss. But a stroke also is an injury to the brain,and that may make it all the more difficult to treat, and outcomes maybe less you hope.
Has she had a phsychiatric consult with a phsychiatrist? It would be best to have her see a geriatric phsychiatrist, but certainly psychiatrist ( who is a MD ).
Although difficult to do, it's alsohelpful to have reasonable expectations and realize that you, your siblings, and Mom, are feeling the loss that comes with her decline, and her inevitable progression toward end of life.
Talk with her about this, and start talking with sibs too. Since a 93 year old post stroke woman with depression is probably not going home ask her what would make it better to be there. Then if you can try to provide these things.
And be kind to yourself. You are a good and loving daughter.

I'm so sorry for her mom--I'd be depressed too.
Anti-depressants only allow the body to do so much--they do NOT "cure" depression, esp situational depression!
Was she home before? Was she alert, active and able to care for herself? If so, she has every reason to be depressed!! Get her out of that NH and back to where she's comfortable.
BTW, she probably is telling the absolute truth: I'm sure the food is horrid, people are noisy and it smells bad.
Trying to take antidepressants in a situation like this is like painting the fence once it's fallen down...a nice gesture, but won't accomplish anything.
The geriatric brain also metabolizes AD's differently than a younger brain. They may actually be making her worse. Find a Dr who will listen to you and MAKE them listen. (They work for you and your mom, BTW, make them do their jobs!!)

Consult a doctor.Many antidepressants are not suitable for the elderly. She may need s different med or a different dosage.

I would encourage the family to assess her needs and determine what level of care that she needs. Does she have mobility problems? Does she have dementia? Does she need continued nursing care? If the answer is no, then, she can decide to go home if she wishes, as long as she has the ability to function at home. If she's not able to function in her home, then, I'd approach it differently.

And the doctor should decide what medications are appropriate. It's not necessarily the amount of meds that helps. She needs the correct ones. If her doctor can't get them adjusted, maybe she needs to see a geriatric psychiatrist.

Unless your siblings are Medical Doctors how can they just assume that more medication added to what Mom is on now will help?
It is possible she does not need MORE medication but she needs the correct medication.
This should be a discussion with the doctors and if possible with your Mom.
Where was she living before the stroke? If she was with you or other family member will she be going back or will she stay in a Nursing Home or can she go to Assisted living or if she needs it Memory Care?
If she will be going back to your house or a siblings make sure you have all the equipment you need before she comes back. And make sure you have caregivers lined up to give you or whoever she will be living with much needed breaks.
Keep in mind the fewer transfers to "new" living arrangements she has the better. So to move her in with one family only to find 6 months or so later that they can not handle it and Mom has to move is not a good situation.

I would ask for a care conference with her providers to ask what they expect to achieve with these medications as to me, 4 is way too much. During the conference discuss what her prognosis is as far as recovery - is she able to stand and pivot from bed to chair, is she swallowing foods ok, ambulating, able that get to a commode, etc.
Not knowing her level of care as far as her ability to perform activities of daily living it's hard to determine if she would be ok at home. Is her bedroom and shower on the first floor? If she did come home is her home environment safe for her? Do you have resources to provide caregivers in home? Hospital bed? Handrails? It's a lot of preparation.
If she is improving physically & making progress, I would consider a Home trial.
If not, maybe a change in roommates and offering her mental stimulation where she is would be the way to go.
Good luck, it's so hard to see your parent go through this.

I'm very prey to hear this about your mother. Often times after a stroke, or any other catastrophic event depression can be a side effect. I would strongly advise that you meet with her interdisciplinary care team at her facility before just "taking her home". Of course she wants to go home but that's not always the best answer for her and you. Long term care is a tough transition especially after 93 years of essentially living independently in her own home. Most long term care facilities aren't going to recommend that someone stay there unless they truly need it. As far as being drugged, it may seem that the residents are, however, the regulations that SNF's are under are very strict when it comes to medications. I'm not saying that it never happens, but facilities are monitored both by how many meds residents are in as well as type of medications. They're also required to try to reduce medications, especially psychotropic medications. I would speak with her physician as well as a psychiatrist (facility should have one available) prior to adding a new one. It's fairly uncommon to be on that many antidepressants. Is she participating in any activities? Does she have a roommate? What's her roommate like? Maybe a different room might help. Let her know that you're there for her. Although she likely will never return to her "home" she needs to know that people still care about her very much! Try to increase your visits if possible and strongly encourage her care team to giver her extra TLC.

Take her home. Now.

Sometimes an older person's depression symptoms are quite related to their situation, sometimes less so.

It's impossible to know whether adding a third antidepressant is the right next step; adding a third antidepressant is best done by psychiatry, and usually they would want to check that the first two were appropriately selected and dosed.

The ideal would be if you could get a consultation with a geriatric psychiatrist or even a geriatrician. If not, you will need to do research, ask the current doctors lots of questions, consider a second opinion.

Many older people do improve when they return home (or at least, when they leave an environment that's hostile to their emotional wellbeing), but whether that's desirable or feasible depends on a lot of things...

good luck!

Dear Amarie,

I'm very sorry to hear about how sad your mom is after the stroke and being in long term care. Its a lot for a 93 year old to go through. Its only understandable she would like to go home.

Personally, I don't know if more anti depressants it the way to go. My father went from being on no meds to being on 10 meds after the stroke. And the side effects were devastating. And then the doctor wanted him on anti depressants. My father almost starved to death from being on all his meds.

Its not an easy balance to find. Continue to be your mom's advocate if you can. And also try to respect her wishes. I know its not an easy decision to let her come home and if she needs 24/7 care. Try to have a family meeting with your mom and see if there are any other viable options.

My Mom had a stroke last year. Listen to her story.

She had a rough first few weeks out of rehab. Sleeping, UTI, pneumonia, still on thickened everything.

She told a Doc that she didn't want to do this anymore. What the aphasia didn't let her say was...she meant being in the hospital. They wanted her on anti-depressant and hospice. (I'm stall mad at that hospital).

I got her out of there. It took a week or so for her to get over being drugged.

Take out. Let her have the time to get over the ordeal of the hospital.

With THerapies, social interaction, and engagement Mom has come some way back. She is 90 and has serious heart problems. But, she is depressed because he hates where she is. Wouldn't you?

Your mom has made her decision, She wants to go home.

Is your mom's contention that the food is drugged a delusion or is there any truth to it? Do you know if she is lucid and just depressed or if she has suffered significant brain damage from the stroke? You say that she has her wits, but, without really examining her cognitive abilities, I'm not sure that would be sufficient to determine how she might fare at home.

I'd ask her doctor about other options. Sometimes, it takes weeks before the medication will show an improvement, though, the one that my LO went on showed good results within a few days. If she's been on them for months, I'd ask about the details of when results may show up. Sometimes meds need adjusting or changing.

Also, does she have any mobility problems or reasons that she can't go home, assuming she is okay cognitively? Granted, she's 93, but, was she functioning well before the stroke? What if you tell her that her progress will determine when she'll go home? At least she would have something to look forward to. Does she have physical rehab? Does she really need skilled nursing care or would something else like AL work for her?  

There may not be any easy ways to make her content.  All you can do is the best you can.  I hope something works. 

Experiencing depression after a catastrophic illness isn't unusual. Add to that your mom's homesickness and being with people she has nothing in common with I think her depression is understandable. Are there plans for her to return to her home?

You will need to speak to her Dr. about her depression and her medication. I don't know how long your mom has been on the antidepressants but maybe the Dr. can try something new.

Depression is a common after-effect of stroke. Whether or not it will be relieved by the antidepressants your mother is taking, or by more of the same ones, or by new ones on top, is something you should ask your mother's doctor.

I don't know if this will be any comfort to you, but going home would not cure your mother's depression. I'm very sorry to say it, and I'm sorry for how wretched she must feel, but the injury to her brain from the stroke is going to be there wherever she is living.

I am not saying that it is impossible for an elderly person to go home after rehabilitation, but how could this be achieved in your mother's case? How much care and assistance would she need to live at home? Whom would she expect to provide it?

You then have to think about how much good it would do her, realistically. And although there might be positives, it is not going to be a miracle cure for her depression, I promise you.

I'm very sorry for what you and your family are going through, and I do urge you to ask for a proper discussion with the doctor about your mother's medication.