Totally agree. And no PA in place of the MD.
And just now, my mom fell. 
So sorry about everything going on with your mom. I would be very careful about passing around your motherâs credit card. You/they really should be added on as authorized users if her card is going to be routinely used.
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Not annoying at all. I appreciate your insight and experience. I agree that it seems like theyâre just piling on meds. I do have medical POA. Its frustrating trying to communicate with the professionals who donât call you back. I really feel like Iâm being tossed around. Mom is 2 hours away which complicates things.
Itâs awful when you canât get a response from healthcare professionals. Momâs and dadâs docs were good about calling me back and being very responsive. Fortunately my folks werenât on my
any meds and werenât combative. Iâm sure that just makes things so much more complex.
@Mansfield do you have access to your momâs patient portal? I got my proxy invoked by the doctor (for dementia) and could legally communicate with docs at that point. I used the portal for communication.
Some of those meds require a tapering so getting off is complicated. I do know that a lot of experts are using gabapentin for folks with dementia anxiety, off label. I personally distrust Remeron! Depakote is potent!
Do you administer meds? Do you have to work through the CCRC? The aide? You could get permission to taper Remeron first. For some, the standard âbut in half for a week and stopâ is not good at all. It might take longer.
Depakote is a strong drug. It is true that it is used for mood stabilizing but that seems like something that could be tapered once she is off Remeron. Note the âaggressiveâ side effect. Maybe this should be first! Also needs to be tapered and blood sugar can get low since depakote raises blood sugar.
Sometimes a âmed washâ is done meaning stopping everything and starting from scratch, but that needs to be in a hospital and with the need for a slow taper of each, I would hesitate. There is a lot of info online about how to taper certain drugs. One strategy with SSRIâs is to go on Prozac,which has a longer half life and is easier to get off, and after a month or two, tapering that. Not sure if that applies to Remeron.
I wonder if the PA is aware of withdrawal and that is the reason they are making no changes. But noone should be trapped on these drugs! See below on withdrawal symptoms:
Remeron (Mirtazapine) Withdrawal Symptoms + How Long They Last - MentalHealthDaily
Depakote (Valproic Acid) Withdrawal Symptoms + How Long They Last - MentalHealthDaily
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we have found it best to be very specific with doctors that arenât as responsive as weâd hoped. âIwant to talk,about Momâs meds/pain/backâ isnât as effective for us as âWe want to have Mom given more effective pain relief and need to talk to you this week about thatâ.
It certainly is frustrating , especially at a distance. A patient portal is super helpful, but only ifone exists.
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Honestly we as proxies (if invoked at least) have the right to request med changes. Insurance wonât pay for appointments without the patient though. So patient portal worked best for me unless the doc found time to actually call. Holiday season illnesses and busy practices makes it hard right now. (I was at two docs this week and was told that.)
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Oh dear, I hope it was a minor fall with no broken bones.
The sibs may be getting to point that they realize she may need nursing home care soon, worried that it will go through all her savings and more.
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Often, with various medical providers responsible for medications, I believe it is helpful to have some easy to follow written history on medications - so you can simply follow along with the health professionals on what meds were done, why switched, what was tried, what happened. Additions/subtractions and various symptoms and what is going on now. Then listen to what they say.
Christmas time and various holidays do bring about emotions, and end of year is often very difficult for people with psychological issues.
Hugs to all of you having various difficulties during what should be a very festive time.
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I have access to momâs patient portal. However, its a bare-bones portal and I canât message the doctor directly. All messages go to the front desk where they will likely be ignored - just like my phone calls this week.
The aide gives the meds. This is another battleground area. Mom is highly suspicious of all the pills and doesnât think theyâre all necessary. Sometimes she fights about the yellow pills and the next day is an issue of too many round pills.
Thanks for the info on new drugs to try and withdrawal of old drugs. This will help when I talk to the doctor.
My SIL reminded me that his mother hit her aide (as well as used very colorful language) when she was in assisted living. The facility sent her to the psych floor of the hospital for 3 weeks while they adjusted her meds. She ended up on seroquel which calmed her down but basically sucked the life out of her. I hope weâre not going down that same road.
In my experience the front desk will give a message to the doctor and the doctor will respond if it is important. Your mom might be right to be suspicious of the pills!
My mother also went to a psych. unit. Those units can be helpful but I described what happened with my mother! That would be the safest place to do a med wash.
A specific thing you could message in the portal is info on a geriatric psych. unit. But with dementia it is always disturbing to go somewhere else.. Still, the kind of behavior you describe is good reason for a hospital unit, especially since it is occurring while on those drugs. Either they arenât helping or they might even be causing some issues!
I donât envy you. I am tired and probably have PTSD from dealing with all this stuff and my mother has been gone a little over a year. Sorry to increase your workload!
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I hope itâs OK to post this question on this thread. I thought the folks here might have some ideas for me.
Does anyone have any recommendations for medical alert devices? My mother is in an apartment in assisted living and has had a few falls recently. She has had a knee replacement and shoulder replacement and once she falls she struggles getting up. Her apartment has an emergency device in the bathroom she can put and a button she can press in her living room but she would need to be get to them if she falls.
Last night she fell and scooted herself to another room and soon after a CNA came to adminster her medication and found her and helped her. But she had a large cut on her arm and I donât love the idea that she might have sat there a long time before someone came in. Sheâs not the best about asking for help either but Iâd like to think if she was wearing something she might press it if it was necessary. Iâm not at all confident sheâd wear something around her neck - I think sheâd be embarrassed and take it off when she went down for meals and then forget to put it back on. It would need to be something sheâd put on and leave on or some other simple system.
Thanks for your help!
My mom has VRI and wears it around her neck but the website mentions a wristband. She keeps it under her shirt. It has to be charged so it is off of her during that time.
She also wears her cell phone in a fanny pack, but in one fall her glasses fell off and she had a hard time dialing (so then I taught her to use Siri) and then another time it was during the night and she was rushing to the bathroom without her phone on her and Siri couldnât hear her. So she decided to supplement with the necklace.
(Note: She is off the meds that were causing the falls, so itâs not the problem it was for a couple of weeks but she likes having the life alert)
My agreement with my mom - who lives independently - is that she always carry the phone with her and that if she falls she call me immediately (I live close enough that I could get there fairly quickly if she fell). She still has a landline so mostly carries the receiver with her and charges it at night. She also has an Alexa downstairs where are spends most of her time and supposedly that is set up to call either me or 911 if she asks it to. I check on her most evenings on the way home from work so hopefully if she couldnât call me I would find her. I do skip occasional evenings though, so thatâs the risk of her living independently which we both accept.
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My motherâs assisted living provided buttons on a necklace or bracelet. (Of course she took it off at night when she most needed it for bathroom trips!)
I wear an Apple Watch 4 which is not the latest but it updates. You program it on your iPhone as to your age.
A few days ago I fell running up on the concrete stairs to our front door. I luckily did not get hurt. My watch had a warning that said that they were going to call 911 if I did not respond. I pressed the I fell but am OK option. Iâm not sure if it would have called 911 if I did not respond. Anyway there are newer watches and maybe more safety things on it. I do not have a separate cell payment for the watch only and my phone has to be near me for it to register.
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My I-watch has asked me multiple times if I fell (I hadnât). The trouble with a watch is you have to wear & charge it. There are bracelets and necklaces that have fall detection and donât need charging. my mom had 24/7 companions.
My aunt had a fall detection bracelet or necklace that she was supposed to wear 24/7. They have bracelets that are difficult to remove. You may wish to ask the discharge planner at your momâs local medical center if they have any recommendations as some companies are more reliable than others.
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Both assisted living facilities my MIL has been in require the residents to wear their medical alert necklaces. They provide constant reminders to them about the importance of doing so. Even though MIL wears hers, she is reluctant to use it, though. And when she does, sometimes it takes awhile before a staff member comes to her (at least on weekends). Iâm not sure that there is any best practice, other than trying to get her to wear the necklace and to use it.
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My dad had to press a buzzer in his apartment each morning by 10 am or they come check on him. Of course sometimes he forgets!
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