My cousin, (in mid sixties) has severe dementia (Vascular and mixed) and is in Memory Care. She used to have a lot of anxiety and obsessions, but had drastic and positive results with Cymbalta, however, recently, she has begun to search in her wheelchair for her parents, who have been dead for many years. The director describes it as a young child looking for her parents. I haven't witnessed it, but I am told that during the day she is very anxious and worried that she can't find her parents and has to be repeatedly consoled. She also takes Seroquel (small dose) at night. The staff report no concerns with her at night.
So, we are discussing options with her Primary and also considering consult with Geriatric psychiatrist. What can I expect with that? My cousin won't be able to tell the doctor much as she is limited verbally. Do they prescribe meds and then see how that works, adjust meds, etc? Just want to know how it works with a psychiatrist and dementia patient who is no longer very communicative.
at both my mom's independent living facility and at her current NH and come to think of it, at the AL she was in briefly, there was ageriatric psychiatrist or APRN who came into the facility to do ongoing assessments and medication management of clients with behavioral and psychiatric issues. so no, I never had to take my mom off site for those services or followup.
my mother is also pretty much nonverbal these days. she has aphasia from her stroke and vascuar dementia. so no real verbal commnication with the doctors or with us. you can tell when she's anxious. she cries, she looks panicked. earlier this summer she managed to say " I have leprosy". she really believed this. she would show us spots on her arm and cry.
psychs have adjusted meds in the past based on our report and staff report. she's currently on Lexapro and Remeron ( both antidepressants) and klonopin for anxiety. she has both regular doses of klonopin as well as PRN doeses for times when she becomes anxious for no discernible reason.
I have no issue with the psychiatrist, it's just having to transport her 60 miles round trip might be uncomfortable for her. She's incontinent and in a wheelchair, so, there are things to consider. Of course, the facility provides the transportation. I must attend as well.
They were giving her Xanax as needed if she got anxious, but I think it stopped working, plus she suffered multiple falls while taking it. Now, she has an alarm on her wheelchair and bed, so, I'm hoping that will not recur.