My mother moved to ALF a month ago due to cognitive decline from stroke a month before that. She had mild dementia prior to stroke but significant decline after. She has been anxious and sad both before and after the move to ALF due to the stroke. For the month she has been there, she calls a couple times in morning and many times in afternoon and evening with confusion and anxiousness. She started Zoloft on Saturday. I didn’t hear from her at all Sunday or Monday. Could that be med so quickly? Or coincidence? Or worsening dementia? She also has heart failure/afib/SOB. Could be she’s sleeping due to that. I can ask her or facility. But just seemed so sudden that the calls stopped. I’m relieved and confused at the same time about it.
"It is approved for the treatment of major depressive disorder (MDD), posttraumatic stress disorder (PTSD), premenstrual dysphoric disorder (PMDD), panic disorder, and social anxiety disorder. It is also approved to treat obsessive-compulsive disorder (OCD) in adults, children and adolescents aged 6-17 years."
As her dementia progressed and advanced, one day, she stopped calling cold turkey. I was like you, confused and relieved at the same time b/c all those daily calls were causing me nothing but angst and heartburn; chronic complaining and a LOT of terrible confusion on her part, combined with a reduced ability to use the phone on her part.
She stopped calling me when her Wellbutrin was increased to the max dose, and when she started Ativan for her terrible Sundowning, I think I can safely say, it coincided. BUT, it's when her dementia had advanced A LOT and was to the point where she was unable TO use her phone w/o help. That was really what was going on, I'm convinced of it. She reached that point in time where the phone became too much trouble for her to figure out, and so she stopped using it entirely. I also had a terrible time getting her to ANSWER her phone, so I stopped calling. It really did signify the beginning of the end, in terms of her life. I think she died about 7 months after the phone calls stopped. I would go see her in person at least once a week (then more frequently as her decline increased) and I'd call over to the Memory Care ALF to speak to the staff about how she was doing. Then she went on hospice care 2 months before she passed, and I was speaking with her RN almost on a daily basis until the day she passed.
My mother also had CHF, afib and very bad SOB which signified she was approaching the end of her life. She also started nodding off a lot in her wheelchair in the activity room which was TOTALLY out of character for her; she considered it a 'weakness' to nap during the day, or, to God forbid 'fall asleep' while doing something.
I would think your mother is declining and that's why she's no longer calling you, based on what you've said. Or it could be a combination of her decline and the meds kicking in to calm her down. I saw with mom a VERY quick reaction with the Ativan and when her Wellbutrin was increased, too.
Do you have hospice on board now for your mom? If not, you may want to ask her PCP to write an order for an evaluation. Hospice was WONDERFUL with my mother in her final days on Earth. They came on board only 2 months before she passed; one day, she just felt tired and went into her bed, in a semi-comatose state, and never got up again; she passed away 1 week later; her heart gave out. But hospice kept her comfortable and out of pain and anxiety the entire time.
Wishing you the best of luck. I know how tough this whole process is to witness, and I am sending you a hug and a prayer for peace.
OR
No.., No.., No..
It could be a combination of any or all.
It is difficult to tell what is going on with dementia. There are declines that happen rapidly then things will go on seemingly not to change for a long time then you get blindsided by a decline.
It is possible that her comfort level has reached a point where she does not "need" to call you for reassurance.
If she is doing well, seems to have adjusted take that as a Win!
You can ask her but with dementia take some answers with a grain of salt. Ask the staff at the facility, specifically the caregivers that work with her on a daily basis.
Now, given that I was in my 30s when I first took it, and your mother is significantly older, with heart & neuro problems, I would be very mindful of how much medication your mother is being given. Research is mixed on the safety of Zoloft in heart patients. Sadly, the elderly are most often over-medicated to quiet them. There is certainly a place for medication, I know, but I saw how my grandparents were sedated and over-medicated in their 90s, and it upsets me to think.
Can Zoloft work that fast? Possibly. I am certainly aware when I fail to take a dose on time each day. Still, on the one hand, I'm concerned they may have given her a big dose that really walloped her; on the other hand, given you say you called and she was fine, well - maybe everything is indeed fine (yay!).
But I most certainly would visit, and find out what dose she is being given. Generally, patients are started on a low dose which is raised weekly to midrange. It takes about a month to six weeks for the full effect to become apparent, and the dose can be adjusted at that time. Of course, the dose can be adjusted at any time to reduce side-effects: sleepiness and acid stomach are the two that annoy me.
Best of luck!
It's all enormously difficult. Truly, I can't decide if sudden change is in some respects more difficult but what significantly matters most is that you remember that you are her support. You have to become her champion.
Sounds like you did well. Everything that could accommodate and keep your mom comfortable and safe has been put into place.
Relief is normal. She should be with professionals.
Speak to the doctors or the social workers at her facility to give you clarification and to put to rest your questions.
You should join a support group. It is very important!!!
Just a couple of weeks ago I mentioned, to one of the co-attendees of my dementia support group, a new and particularly gross behavior of my Alzheimer suffering husband. This co-attendee/caregiver was further along in her experience and told me that her husband did the same thing and to ask his neurologist if one of his prescribed meds could be the culprit. The very one she told me to mention did cause the problem. My husband had been taking this med for 13 years and it only recently manifested in a very bad way. If it hadn't been for my support group it would never had occurred to me to think my husband had hit a level of intolerance to this particular medication, almost like an allergy.
Go visit you mom. Learn. And find healthy ways (HEALTHY WAYS) to de-stress.
My sister was able to walk and talk and was going shopping with me before they forced her into one of these places. They started giving her these drugs and she could no longer walk, talk, and was constantly falling. Hit her head multiple times and ended up in the emergency room. Even after the doctor sent a fax saying to take her off the drug, they LIED saying they never received it. I went to the doctor and had them print it off and handed it to them. She recovered very quickly, but never completely after the drug was removed. All the blows to the head from her falling were terrible. The way they treat people is disgusting.
Please avoid antidepressants and sleeping pills with someone with dementia. It is not safe! You can use natural remedies for sleep and calming someone without putting their lives at risk.
So often we become accustomed to chaos, that we actually miss it when it subsides.
FYI: Things to discuss with the doctor
https://www.health.harvard.edu/mind-and-mood/two-types-of-drugs-you-may-want-to-avoid-for-the-sake-of-your-brain
https://www.hopkinsmedicine.org/health/conditions-and-diseases/alzheimers-disease/beyond-memory-loss-how-to-handle-the-other-symptoms-of-alzheimers
Um… how dare you?
Do not assume how mother is feeling and shame on you for projecting your hate of nursing homes onto someone who is doing the best they can with the circumstances.
Trying to get her to dial has become nearly impossible. She has to remember the 9 and 1 to get out and then read the number from her list. But she can't hold the list,dial and hold the receiver. That requires 3 hands.
Maybe you are experiencing some of this. When things go downhill they simply do. Call a nurse and ask them to help her if you feel the need to talk. The last call my mother made to me was all about a new top she thought was missing but it wasn't but I had to get there to solve that.
There is nothing she could possibly need that requires multiple calls a day.
This is NOT about me. I have called her and seen her and took her out to dinner Friday. I am well aware and have seen her medications, doses and her taking them.
She was terribly anxious and crying in the afternoons. She is not over medicated. She is on extremely low dose. She has heart failure and was on hospice a year ago due to her heart and was told she had months to live and she is still with us a year later. It is hard enough for her to live with the impacts of her serious heart conditions and adding anxiety and sadness to the end of her life is heartbreaking. It is no way to live your final days. So I do not need a lecture on overmedicating my mother. I am trying to make her last days/weeks/months as comfortable as possible for HER.
You are doing a wonderful job advocating for your mom and trying to make her last time on earth as pleasant as possible. I was in your shoes for a long time and it's NOT EASY, but traumatic & horrible. To give out free advice w/o having been there/done that is not helpful to those in the trenches. Just ignore the comments that aren't helpful to you, and keep doing what you've been doing. When my mother was Sundowning *HARD* with advanced dementia in the late afternoons, if her doctor said a pint of tequila would've helped her, I'd have driven to the liquor store for pints of tequila. And pushed everyone OUT of my way who told me I was doing something wrong, too! Comfort for mom is the key here, nothing else. Silly people acting like 'drugs' are a horrible thing for dying elders with dementia just DON'T GET IT.
You love your mom so naturally you are concerned about any change that you can't explain. You say your mom has only been there a month so in the beginning she might call cause it's all new and bewildering.
She may have an initial reaction to a new medication added to her regime. Give it time. Ask her if she feels different since starting Zoloft.
I hope you can get this figured out real soon and your mind can be at ease.