My mother-in-law has been in a nursing home and they've adjusted her medications, but it's not helping her depression. Any ideas?

cdnreader: Thank you.

I have to agree with Llamlaover47. I think she is on too many meds and maybe they should take her off everything and slowly introduce one thing back at a time. Hopefully her doctor will help her with this.

I'm going to add that it's not atypical for elders to experience "faux" thoughts/experiences. That still doesn't mean that she shouldn't try to be assisted by a geriatric psychiatrist.

Her primary care physician should be notified right away. In addition, she should, if possible, be seen by a geriatric psychiatrist.  Her "cocktail of medications" should be checked because it sounds like these meds are sending her down the road of hallucinations.

At 97, and after all she been through, she has every right to be depressed. Antidepressants are not effective in more than half the "normal" population, and that number drops dramatically in the very elderly.
Also, general anesthesia in the very elderly OFTEN causes long term problems. (My DIL is an anesthesiologist and she has confirmed this to me when my mother wants to have yet another surgery!)
I'm sorry for your MIL, but you may have to accept that this is the new norm for her. No one lives forever---and this may be what you have to accept. We all wish we could have the exact life we want and pass the way we want--but few of us get that.
Your MIL is obviously loved and well cared for. Accept that she is probably not going to get a lot better, or be "happier". I know that's hard.

My husband watches tv all day

What is a fidget board? My husband sits all day and fidgets with lint on his pants, crumbs on the counter, specks on the floor.

I just reviewed a study of Aricept on PubMed. Is your mother taking this drug? They were studying ALZ patients who had psychopathology when they started the drug. That is, they already were having delusions, depression, anxiety, etc. Many of them showed improvement in the 20 weeks of the study.

Ironically, one of the side effects of Aricept can be delusions and other psychopathology.

Aricept was very beneficial for my husband.

If she hasn't already tried Aricept, I think I would consider it for your mother. At least she is in a place where any side effects could be closely monitored.

Delusions (the belief that people are trying to kill her or she has killed someone) are very difficult to treat. There is a lot of information on this disorder on the internet. Finding and reading a few good sources might give you some insight, if not solutions. Consulting a geriatric psychiatrist or even a behavioral neurologist very experienced with dementia could be helpful. It is not a sure thing, however. Maybe further adjustments to the meds will help, or maybe not.

The going into other rooms and helping herself to "her" things is extremely common in some kinds of dementia. The book "Creating Moments of Joy" deals with that at length. (It also has some good advice on improving quality of life for those in nursing homes.)

My mother couldn't walk and needed help transferring in the NH. Of course they couldn't restrain her, but they did attach a tray to her wheelchair. This allowed her to spread out her newspaper or magazines or crossword puzzle book. It easily swung off and hung on the side, but I don't think Mom ever figured this out, and while not a restraint it did tend to discourage her thinking about getting out of the wheelchair.

It is wonderful that you can visit every day! Please don't take her inability to be happy personally. It is Not Your Fault!

I've heard it mentioned that when a person goes on hospice and many of the meds are removed the patient seems happier. Since she has had time to become acclimated to her surroundings might it be possible that she would be happier off the meds now? I know my mother was never herself after she had to start taking meds. As soon as she got out of the hospital and off the drugs she would settle down a bit. Of course I'm sure there were many factors that contributed. So hard to know. When you find the geriatric psychiatrist perhaps you can ask him if that is an option. And I also wanted to mention that the anesthesia damage can get better over time for some patients. It did with my aunt.

Joanne,
That's tough. Considering the falls when she attempts to get out of wheelchair, I might ask them to try an alarm on her wheelchair. It's a seat belt, that they can undo, but, it alarms and alerts staff to attend to them. My cousin has one and since getting it, no more falls...Knock on wood. She will undo it, but when it alarms, she snaps it back. lol

I suggested Nature Sounds with tranquil music CD's for my cousin and her psychiatrist said it was an excellent idea. There is proof that it helps with agitation. It's worth a try. Of course, the staff has to make sure to put the music on and see to it she is in the same room. It plays sounds like surf, water falls, birds with soft music.

I'm not sure there are any answers. Sadly, some people do not respond to our efforts to calm, after a certain amount of progression.

Thanks for all the helpful answers. She was living home alone until July when she went AL. We were beginning to see come confusion then. She was adjusting well there and was on no medications. After two months in AL she broke her hip. Spent the time in hospital and rehab and was discharged to the NH where she is now. She has been there five months. It se ms like after the anesthesia for the hip surgery, her mind was not right. Then the depression set in. I might add that she has not been happy since 2010 when her husband died--even though her four children did everything they could making it possible for her to stay on her home, going to see her really often, taking her places, etc. I k ow sh gets bored at the NH. They have activities like Bingo, arts and crafts, but she does not want to participate in any of them. As for the pet therapy, she doesn't care much for animals. 😩 So you see what we are dealing with. The only thing she cares for are the devotionals and singing groups that come. She wants to stay in her room, but they can't let her stay there alone because she tries to get out of her wheelchair and falls or she will go into the bathroom and fall. She has to have assistance moving from the chair to anywhere. So they pretty much keep her in the common area. She gets mad if they won't let her go up and down the halls and into people's rooms. My husband and I got to see her every day and I take her to her room and let her go through her things and arrange everything like she wants it. That seems to satisfy her for a little while. I don't know if there are any geriatric psychiatrists around here, but I will ask. There is a Christian counselor and psychologist who works with some of the primary care doctors on medications. May try that. Thanks again to all who answered. It helps just to write it all down. As for the UTI, the NH checks all of the residents for that pretty regularly. I dealt with that with my own mother. Did not realize it could affect the elderly in that way.

Make sure she is tested for a Urinary Tract Infections. They can cause these kinds of psychiatric symptoms in the elderly.

It's been my experience that when there are multiple issues with a person that requires medications for agitation, anxiety, depression, etc. that a Geriatric Psychiatrist may be a good idea. They often can examine the patient, situation, condition, etc. and approach it differently than a primary care doctor. I'd work on that and see if further medication adjustment is in order. Also, sometimes, it takes awhile for meds to start working.

Still, there is no guarantee that a person who has dementia can be made happy. They suffer with brain damage and sadly, that cannot be reversed. Some patients find it difficult to be content or find happiness.

 It's tough on the family, but, I would try to work with the facility to come up with creative ways to bring her some cheer. I"m not familiar with how things work in a NH, but, only AL and MC AL, but, have they tried some kind of pet therapy? Music therapy? Fidget board? I wonder if something to keep her occupied and interested might help her relax.

I'm going to bump this up so others can see it.

I'm sorry your mom is so fearful and confused, it sounds as though the move has been fairly recent? I'm sure you already know that moves can be very hard on those with dementia and it may take a very long time for her to settle in there. Finding the most helpful medications can be a process of trial and error. It would be best if she was being seen by a geriatric psychiatrist, who is an expert in this area.