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[quote=Anonymous][quote=Anonymous][quote=Anonymous]

If this is the best you can do, maybe you all need to take a step back and let paid caregivers be more primary in her life. Shaming her for being unable to “shake” a lifelong mental health condition is not going to work. It is especially not going to work when the threat is “or you will die”; she is 87 and will be dying regardless.

If the benzodiazepine was working, she could consider going back on it. Elevated ammonia in someone who is 87 is not like elevated ammonia in a 47 year old. Cutting her off from treatments that worked for the benefit of her long-term health is insane. She is 87; there is no long term.

Have you gotten treatment for your trauma? It sounds like you could use it. Good thoughts to you.[/quote]

Her potential death from mental illness isn't a threat, it's a fact. She is aware and acknowledges that nearly all her decline in the past 5 years of so is because of her mental health problems. Rather than threatening what we are doing is telling her the consequences we are observing. It's a last plea for her to have some agency in her recovery, if she still has it in her.

Stepping back will just trigger further downward spirals. Now she's calling me telling me she's frightened and begging me to come over. We're refusing to come over more than once per day. She's also not in assisted living so there's no paid caregiver to depend on, though that may come in the near future.

The benzodiazepines are not coming back, because they increase the risk of falls and cognitive impairment and also increase the likelihood of high ammonia levels. Have you ever seen an elderly woman with high ammonia levels? In my mom she went from being her normal self to within 2 weeks not sleeping at all, having major tremors, being confused and disoriented with red-rimmed eyes and looking terrified...it is the worst state I have ever seen her in. It's a neurotoxin with major neurological symptoms that are way worse than the anxiety and depression.

If my mom could shake the anxiety and depression she could absolutely live another 10-15 yrs...she has had many relatives live between 95-99 yrs old. It's absolutely not worth it if she remains in her currently state, but I'm not exactly ready to leave her to die now (since you're concerned about my trauma!).[/quote]

With respect: you aren’t making sense. There is no “shaking” anxiety. There is treating it. In an 87 year old person, that treatment may be terminal. It may still be better quality of life than she has now.

She is, as you say, not her normal self now. She is in a state so bad that a significant part of you sees death as preferable to it. You also say that you understand that her disease process may be terminal—not because of her medications, but because of her disease.

So on some level you do get that telling her to bootstrap her way out of a disease that is this intransigent is not effective and it’s not kind. Why are you doing it?[/quote]

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