Wednesday, August 19, 2009

In the Beginning - Part One

My mother always hated living alone. She grew up experiencing certain trauma which led to a life of chronic depression. Having family surround her made her feel safe -she could remain outside of her plagued thoughts if she were constantly engaged. So when reports of strange behavior came from the retirement community in which she lived, I thought it was her way of manipulating me to have her live with us. My mother and I have a “past,” and this was certainly plausible.

At first, there were signs of general depression; not getting out of bed, no interest in food, etc. But then stranger symptoms arose, ones I had never seen before; confusing her medications, forgetting to pay bills, not remembering we had spoken earlier in the day.

My instinct was to get her to a psychiatrist, and quick. She had been on the same medications for depression for 8 years - perhaps her body had become immune. The doctor, who was not a geriatric psychiatrist (big mistake), added Abilify to boost her Cymbalta, increased her Xanax to help with anxiety, and advised it was ok to increase her Tylenol PM in the evening to help her sleep. Based on her symptoms, he said she also had dementia (in addition to depression) and added Aricept.

After two months on these meds, and tweaking them bi-weekly, my mother was falling every fifth or sixth step, hallucinating, losing all sense of time, and completely panic-stricken to be alone, claiming every night she was at her friend’s house and could not be there when her husband returned.

Something was seriously wrong.

Around this time, I learned about a program run by McLean Hospital in Belmont, Mass, devoted exclusively to geriatric neuropsychiatry, specifically dementia and Alzheimer’s.* I called my mother’s doctor asking he do whatever it took to get her into the program. Within two days and lots of badgering (of which I am not ashamed), she had a bed at McLean. I left her there, both of us crying and saying goodbye, as she begged me not to leave her.

The program and the highly specialized doctors at McLean saved my mother’s life. Abilify and Xanax increase the symptoms of dementia, and any of the over the counter PM drugs contain benadryl which is toxic to the geriatric brain (anyone over 65).** Her brain was literally being cooked and destroyed. They immediately detoxified her from Xanax, stopped the Abilify and started her on a regimen of drugs that has brought her back as far as she could come.

And then we had a final verdict; she absolutely could not live alone and had to be in a daycare program at least three times a week or her condition would worsen.

I heard that gavel fall and my worst dream came true…my mother would be moving in with us.

*McLean Hospital Geriatric Neuropsychiatry - http://www.mclean.harvard.edu/patient/geriatrics/gnu.php

**One of many articles on benadryl and dementia
http://www.healthcentral.com/alzheimers/news-290406-98.html

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