My 85-year-old mother has been in memory care for 5 months. She is negative and has for many, many years complained at the drop of a hat -- if there's a listening ear, she's going to complain. Before moving her to MC she did not have a primary care physician -- my mother rarely saw a doctor in her life. The MC doc visits once a month. Last week the doctor called me and said that my mother should be on a low-dose of Paxil for her depression. She said that in her monthly visit with my mother the latter complained of feeling "worthless" and "wanting to die." I told the doctor that my mother loves to complain and I didn't want her on Paxil. The doc got upset with me, called me "Honey" a couple of times, and said I was withholding treatment for my mother. I am sure that was registered in her file on my mother. BTW: the nurse manager at the facility agreed with me, but privately. I really like this facility for my mother, but a doctor who comes around once a month and bases giving my mother a drug on a 10-minute conversation, I feel is problematic. Am I wrong? Any advise?
If there's not another MC doctor, can you avoid the monthly MC doctor visits if your mother gets her own PCP?
Even though your mother is a complainer, I would encourage you to seriously consider whether she also may have some level of depression. It's possible depression is long standing and has contributed to her always being a complainer. If you think that's possible, I would suggest finding a geriatric psychiatrist and having a full evaluation before considering medications.
You say your mother has "always" been depressed and negative, that doesn't mean she might not have had a better quality of life and a more positive outlook with the help of an antidepressant (and perhaps still could). Suppose your mom avoided going to the doctor because she didn't respect their opinions and didn't want to follow the advice she was given - do you feel the same way?
The fact that she has always been depressed doesn't mean that she won't respond to an SSRI .
I agree that the doctor who saw your mother needed more than ten minutes to diagnose her. My former doctor was what we call “a pill pusher” as well and I wound up on anti-depressants for over 20 years. I tried them all and finally realized that none really worked. IMHO, they only work if used in conjunction with therapy.
My mom was the queen of negativity, drama and paranoia. She also had dementia and all that stuff really kicked in. When the staff doctor recommended Effexor for her, to be honest, I said “Sure. Why not.” They are started on the least dosage and even that takes a few weeks to kick in. It’s trial and error and in very few cases does it seem to make much difference.
If you can trust Mom’s facility to closely monitor Mom’s behavior and watch for side effects, maybe give it a try. But I predict you truly won’t see much difference.
There are othings to try but a geriatric psych appointment is a good start.
Why do you think that negativity is not depression speaking loud and clear? Distorting one's experiences so that one is always a victim, never successful or satisfied can certainly be a symptom of depression.
Certainly you are within your rights to refuse a trial of this med, but it might make your mom's last years more peaceful and fulfilling. She can't be making many friends in her facility.
I am leaving it as-is for now, but will discuss with the doc to see if we should go back down to a lower dose.
Now she is in hospice care, and they had her on another low dose antidepressant to try to get her to eat, and Xanax for anxiety and paranoia, which was probably brought on by the antidepressant (which has been discontinued because it did not increase her appetite one bit). I was hesitant to try the new antidepressant due to our bad experience with the first one, but guilt over not trying everything to get her to eat won out.
That's what you believe depression is? Oh boy.
Depression manifests itself in many different ways, to many different people. Your definition is one symptom, sure. But so is sadness, lasting more then two weeks. Over eating, under eating ,sleeping too much, not sleeping, seeing the dark side in everything and everybody, loss of sexual desire, over sexed, short tempered, weepy, crying, feeling unloved, ugly, unworthy, less then, better then others, listless, under achiever, over achiever, abusing alcohol and/or drugs, and the list goes on and on.
Youve already done what you felt was right anyway. However, it's always wise to educate yourself as much as possible before shooting down a trained professional.
Growing up with your Mom's negativity is all you know. It is YOUR normal. Kids that grow up with abusive parents think that's normal too. Why, because that's all they know.
You were too close to mom to see something was/is off. Again, if she was always like that you think it's normal. But Dr saw clearly. He's looking from an objective point of view.
It would be really smart to keep an open mind. You just might be able to put a little sunshine in Mom's dark world
Good luck
Now that she can no longer get in my car, I still transport her via the facility van to her own outside PCP and neuro and I monitor her meds very closely
Mom barely ever took an aspirin and didn't take any prescription meds til her 80s, and so I always bear that in mind - I still offer her the choice of taking Tylenol rather than just giving it to her