In crisis and refusing treatment for anxiety/depression

[Anonymous]

My 83 yo old mother suffered from undiagnosed Generalized Anxiety Disorder her whole life as well as bouts of depression. At times she was on anti depressants but always stopped taking them because of anxiety about side effects. She had been off medication and anxious and depressed lately and stopped eating and drinking much which led to a UTI. We have stabilized her but she refuses to go back on antidepressants or anti anxiety medication. What are our options here? I understand no one can force her to take medication but without it she will stop eating and drinking again and likely develop another UTI. Is the only option to let her die of a UTI / get hospice involved? Shes otherwise fully 100% physically healthy. I doubt she would agree to treatments other than daily medication like TMS or a Ketamine infusion. I’m out of ideas but hoping others might be able to help.

[Anonymous]

Could it be dementia? We thought for years with my MIL it was depression and anxiety as she had a long history but she ended up with early onset dementia which of course she didn't understand to be able to tell us. She'd forget to eat, drink and basic care.

[Anonymous]

OP here- it is not dementia, she’s been tested several times and when I get her to take anti anxiety medicine (Ativan) she acts perfectly normal again.

[Anonymous]

If she refuses medication, then yes, it sounds like she will die from not taking care of herself. There really isn’t much you can do about that. A better path might be to try to work out a system that gets her eating and drinking more regularly. Could you set up some system where she know to drink x amount of pedialyte or water each day. Would meal delivery help!

[Anonymous]

Anonymous wrote:OP here- it is not dementia, she’s been tested several times and when I get her to take anti anxiety medicine (Ativan) she acts perfectly normal again.

Ativan is not a good idea for an elderly person. I would consider an SSRI instead.

[Anonymous]

This is a long article but if you scroll down, it explains why medications like Ativan can be dangerous for the elderly.

https://www.mayoclinicproceedings.org/article/s0025-6196(16)30509-2/fulltext

[Anonymous]

Work out an agreement. You will shut up about medication if she follows a sound hydration routine and does not dehydrate.

[Anonymous]

I've taken Ativan for decades and it doesn't make me drowsy. It knocks back the anxiety by half so I can function. The stories are from people who are not used to the medication. I don't even take it to sleep. I take it in the early morning so I can do a long walk without fear of falling. The fear stemmed from being told to get an osteoporosis test. My mother died at 96 and took it or Valium for over 50 years. She didn't have dementia or ever fell from drowsiness. Inherited GAD. Nothing else works. SSRIs give you bone loss by the way.

[Anonymous]

You can get a conservatorship.

[Anonymous]

I would be inclined to give her the medication and tell her it’s a vitamin or something. She’s a danger to herself and if taking a pill is an easy fix, I’d see that she gets it even if duplicity is required.

[Anonymous]

Anonymous wrote:OP here- it is not dementia, she’s been tested several times and when I get her to take anti anxiety medicine (Ativan) she acts perfectly normal again.

Who is prescribing her Ativan at 83?!

[Anonymous]

I’m sorry OP. I know this is hard but it’s her right to choose whether to take medication. She’s still a person, even if she’s old. I agree with the posters who suggest seeing if she will agree to drink x amount per day.

[Anonymous]

Anonymous wrote:OP here- it is not dementia, she’s been tested several times and when I get her to take anti anxiety medicine (Ativan) she acts perfectly normal again.

When was the last time? Was it just a screen or full battery? The screens do a poor job of detecting the early stages. Did she tell you she was fine or did the doctor have no concerns about cognition? There is often a massive surge in anxiety and/or depression before the dementia becomes obvious.

How often do you see her? If you see her daily or several times a week and think she is totally fine, that's one thing. However, if you visit once a month or less, she could be masking/showboating.

[Anonymous]

Also, what is her living situation? What level of help does she have?

[Anonymous]

Can you make her a gin and tonic? That would always calm my mother down when she was in her 90s and getting crazy. Then she would take a nice nap for an hour or two after. I always doubled the gin.