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essomd Asked January 2018

Parent and depression, I'm at a loss on what to do next.

I was alerted today by the SNF that my Mom is starting to show signs of declining. Previously, she was fairly independent, could transfer herself in and out of bed and to the bathroom. Would socialize daily. After a bout with the flu and her recovery, she returned from isolation and has been moody. Stays in bed constantly. No longer willing to move herself without staff help. She's still eating fine. She has refused bloodwork (says needles hurt so she won't accept it), is diabetic and now I was alerted that she does not cooperate with the Psychiatrist. So they can't figure out what's going on with her and they can't force her of course. SNF wants to try anti-depressants and are monitoring her. I've tried calling and coaxing her. Tried to lift her spirits with my support and love but while she likes to hear from me, is stubborn on all decisions and issues regarding her health care. At a loss on what to do next for her.

ChristineMarie Jan 2018
Have you asked her what she wants? Just a simple, non judgemental question. Sit quietly, listen very carefully and ask her the question. Once asked stay quiet and give her all the time to say whatever she wants to say. Acknowledge her answer, whatever it might be. Ask her what she wants ou to do and what she wants others to do. The clues are in her answers. I don't sense depression. I sense anger. Acting out and expressing her anger the only way she knows how.

MelissaPA2AZ Jan 2018
I would not be surprised either to find she had a UTI. But I will also tell you that my mother, who has Alzheimer’s Disease is generally much worse during and for quite some time after any illness. The fatigue the illness brings on her system just saps any ability to fight the ravages of the disease and the confusion it causes. Your mother my also be lacking the energy to fight any unusual impulses brought on by whatever other circumstances she may be dealing with. This is often why the elderly appear to “go downhill” so suddenly after having been ill. You’ll remain in my thoughts. Remember to take care of yourself!

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Katie22 Jan 2018
essomd, I fully understand your worry and dismay at this sudden change. With my Mom when she suddenly would not walk and had personality changes it always turned out to be a UTI. This always caused people to be confused as to what was going on. You would think people in SNFs would be aware that UTIs cause personality changes in the elderly! Is your Mom on any different medications? Sometimes meds as well as a UTI can cause major changes in personality. I would be looking for the test results for the UTI first.

Countrymouse Jan 2018
When did she have the 'flu? This year's vintage seems to be particularly vicious. Just wondering how long she's had to get back to normal.

golden23 Jan 2018
Has she been diagnosed with dementia? I suspect if dementia has already set in, but is in the very early stages, any trauma or illness will exacerbate it. It does sound like she needs to be checked for an infection, and needs a geri psych eval. and treatment. Hope that she settles down enough to cooperate with the SNF staff. ((((((hugs)))))

Arwen31 Jan 2018
Perhaps she can't differentiate between feeling weak and confused after the flue and what she might see as a general irreversible decline due to age...it's a very fine line between psychological, physical and emotional... my experience is that sometimes they can "decide" it's not worth fighting anymore and to let go cause they think the end is approaching... then dementia and other symptoms become real.

In one word, maybe she's angry because she's scared of how she felt; perhaps you could try to reassure her that all the weakness and confusion comes from the flue, and that is normal, and that even young people feel the same after a bad flue, and that she'll be herself again soon...

Don't know, this seems to have worked with my mother who was "deciding" as well if life was worth fighting for.

I hope your mom will feel better soon.

zam250 Jan 2018
Your mom is exercising her "independence" , and telling those folks where they can go.

Hugemom Jan 2018
It’s super frustrating to deal with a parent who acts out in a facility. Even though you know they’ve seen it all, it’s still embarrassing to hear the staff tell you what’s she’s doing. Staff will probably put her in diapers and she won’t like that either. When my husband was in rehab, he wasn’t that cooperative either. Although he wasn’t resistant to the point your mother is, he could be less than willing to cooperate with the therapists, and therapy was the reason he was there. However, there was one LPN who refused to put up with his “act”. When he’d claim “I can’t do” this or that, she never let up, and he’d do it. My husband eventually came to call her “Sarge” and asked if this Christmas, we could go visit her at the rehab. Perhaps there’s an aide at your mom’s facility like “Sarge”? Sarge wasn’t disrespectful to my husband, but she brooked no resistance when she knew he could do something and just didn’t want to or happened to be feeling sorry for himself. She was a real gem!

BarbBrooklyn Jan 2018
Esso, I'm betting it's UTI as well. Keep us updated!

I'm a bit confused about her non-cooperation.  Are you heathcare poa?  If the decisions she's making are not in her best interest, do you have the authority to authorize a blood test? Have her taken to the ER in an emergency?  Authorize the use if antidepressants or other meds?

Mahea98 Jan 2018
I don't have any helpful words, I'm hoping that you soon find an answer! This post has been helpful to me because my mother has likewise been recuperating from pneumonia (not flu or strep according to the ER doctor). She was in decline previously, but it's now on overdrive it seems! She won't feed herself. She will eat if she's fed, though. At first she wouldn't eat any meal on her own, now she will feed herself dinner. (?) Also, prior to this she was able to go to the bathroom and take care of herself. Now she's in diapers 24/7. She is cooperative when they prompt her every 3 hours or so. But she doesn't remember to take herself to the bathroom. She wasn't able to walk at all at first, (but now she's able to use her walker again, she just needs assistance getting up. That was the way it was previously. She has severe arthritis in her knees, so getting up on her own has been difficult for years.

I appreciate this site, because I'm reminded once again what can happen with a UTI. So I will request that the NP that visits the care home will arrange for that.

Thank you so much!

And essomd, I'm really hoping that you find an answer soon! I understand your frustration and the feeling of being at your wit's end! Take care!

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