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Dr. Mark
Dr. Mark, Psychotherapist
Category: Mental Health
Satisfied Customers: 5158
Experience:  Dr. Mark is a PhD in psychology in private practice
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old people depression

Resolved Question:

old people depression
Submitted: 1 year ago.
Category: Mental Health
Expert:  Dr. Mark replied 1 year ago.

Dr. Mark :

Hi! I'll be glad to help you with this issue.

Dr. Mark :

Type in a hello and we'll get started, okay?

Customer:

hello

Dr. Mark :

Tell me more about the situation and what you are needing help with, okay?

Customer:

okay

Customer:

my father he is 80 years old

Customer:

he suffered from few things since marsh

Customer:

first he had high calcium level in blood

Customer:

after that he had alzahaymer symptoms

Customer:

then thy symptoms went away with medecations

Customer:

since it came suddenly the doctor told us impossible to be alzahaymer

Customer:

after he get well which lasted for alomst 3 months

Customer:

he had the symptoms back

Customer:

since he did not eat well

Customer:

and he was dehydrated

Customer:

so the case become worse

Customer:

he stopped eating or drinking

Customer:

and calcium levels were high again

Customer:

also criatenen levels were high

Customer:

he was hospitalized for 3 days

Customer:

and every thing started to be good again

Dr. Mark :

Wow, this is really difficult. You're going through a lot of worry, I am sure.

Customer:

he get back to walk eat and drink

Customer:

yesssssss

Dr. Mark :

Alzheimer's is ruled out if there is any sharp improvement. What are they diagnosing now?

Customer:

this good case has lasted for 2 months

Customer:

since 2 weeks his case is baaaad

Dr. Mark :

He's taking the Lamictal and Zyprexa for the depressive symptoms or for more?

Customer:

the diagnosed him with Delusions

Dr. Mark :

I see.

Dr. Mark :

And is he still having delusions?

Customer:

and they refer every thing to his age

Customer:

yes not seeing persons

Customer:

but he is controlling my mother

Dr. Mark :

This must be very frustrating to you that they refer everything to his age.

Dr. Mark :

But, what do you mean that he's controlling your mom?

Customer:

he does not want her to move from her bed

Customer:

my mother is sick also

Dr. Mark :

is this because of delusional thinking or is he controlling for a different reason?

Customer:

she has diabetes bad symptoms on hr brain

Customer:

no because of her illness and Delusions

Customer:

because of clots in her brain

Customer:

she had little cots in her brain

Customer:

so he wants us to treat her as a dump

Customer:

not talking to her

Customer:

ao disscussing any thing with her

Customer:

some times he does not wnat her to go to bathroom

Dr. Mark :

Do they have in home caretakers or is it time for them to be moved to residential facilities so that your mom can get proper care?

Customer:

she is not that bad

Customer:

you bearly notice she is sick

Customer:

but she is not as before

Customer:

also every day he tells us he is going to die today

Customer:

and he might not see me tomorrow

Customer:

evry day

Dr. Mark :

This is really very hard. You are going through so much.

Dr. Mark :

How are you holding up?

Customer:

yes

Customer:

and it is only me

Customer:

yes i know

Customer:

and there is a home made

Customer:

she helps

Customer:

when i go to doctor he just increases the medicine

Customer:

and nothing is getting better

Dr. Mark :

I am very concerned for you.

Dr. Mark :

You are trying to do more than is humanly possible.

Customer:

thank you

Dr. Mark :

Your father is really showing severe symptoms.

Customer:

yes i am tired

Customer:

yes

Dr. Mark :

His doctor is right in one sense:

Dr. Mark :

Your dad is too old to do effective testing for these types of controlling, sometimes delusional, semi-paranoid types of symptoms.

Customer:

yes

Dr. Mark :

It's just too hard because of his age to isolate whether there is onset of dementia or a thought disorder, etc.

Customer:

aha

Dr. Mark :

So I'm not so angry with his doctor because I have sympathy: your dad is not easily diagnosable at this age.

Customer:

yes they do nothig

Dr. Mark :

My concern is that you don't know what the next stage of symptoms will be for him.

Customer:

he sets with him for 10 minutes only

Dr. Mark :

And you're trying to do this on your own.

Customer:

yes

Customer:

and the medication just make him weaker

Dr. Mark :

I wish that it were different. But it may be time for you to have a conference with his doctor.

Dr. Mark :

About residential treatment.

Dr. Mark :

As for the meds making him weaker:

Customer:

you mean stay at hospital?

Dr. Mark :

we have to accept that the medications are all we have to work with and they have side effects. And at his age, they tend to make the person weaker.

Dr. Mark :

As for hospital, no.

Dr. Mark :

I'm talking about an assisted living facility.

Customer:

aha

Dr. Mark :

Where he can be monitored, have activities,

Customer:

we don't have here

Dr. Mark :

Oh dear.

Dr. Mark :

How far are there any?

Customer:

we can't move him to such places

Dr. Mark :

Why not?

Customer:

it is not accepted

Dr. Mark :

What do you mean?

Customer:

we can't leave our parents in such places

Customer:

we should take care until the end

Dr. Mark :

I see.

Customer:

you don't have any advice about the medicines ?

Customer:

it is not depression?

Dr. Mark :

As for the medications, you might ask the doctor to consider adding Risperdal to help with his aggressiveness.

Customer:

and the other medicines ?

Dr. Mark :

Zyprexa is often very agitating for older patients and you could ask the doctor if he would consider withdrawing the Zyprexa.

Dr. Mark :

It does not sound like depression, no.

Customer:

what about haldol

Dr. Mark :

It sounds like your dad is having possible thought disorder (either independent or part of dementia onset).

Customer:

aha

Dr. Mark :

You see, Haldol and Zyprexa are both effectively used with thought disorders.

Dr. Mark :

So I was suggesting discussing withdrawing one since you are noticing lethargy

Dr. Mark :

and adding

Dr. Mark :

Risperdal

Customer:

aah

Dr. Mark :

as the Haldol with Risperdal may be less side effects than both anti psychotics with

Customer:

you suggest to withdraw zybrexa

Dr. Mark :

Risperdal.

Dr. Mark :

As a trial, yes.

Customer:

yes

Dr. Mark :

His doctor might be concerned, though:

Dr. Mark :

you have to understand:

Customer:

what about solian

Dr. Mark :

the number one concern we have is that the psychotic, or delusional symptoms need to be kept in check.

Dr. Mark :

This is for your and your mom's safety as well as his.

Dr. Mark :

So your doctor has him on a few antipsyhotics including Solian.

Dr. Mark :

I don't think his doctor is going to be comfortable withdrawing too many to start with until it is seen if he maintains lucidity with taking away one medication.

Dr. Mark :

That's why I thought you might start with Zyprexa.

Customer:

you know something solian is newly adde

Customer:

s

Customer:

added

Customer:

2 days ago

Dr. Mark :

But discuss with his doctor which might be the best to try withdrawing, and since Zyprexa can cause mood changes easily, I thought you might start by bringing that one up.

Dr. Mark :

Again, we have to have mercy on his doctor (I hope that made you smile.).

Customer:

i am worried from this too many medicatiom

Customer:

medication

Customer:

:)

Dr. Mark :

Your dad is not an easy patient.

Customer:

yes

Dr. Mark :

So, I can tell you that talking to his doc about LESS medications could be scary for the doc.

Customer:

:)

Customer:

the solian is added by another doctor

Customer:

i went to anoterh one since his doctor not making him better

Dr. Mark :

Okay. You see that the doctors are thinking differently than you are: you want less meds and the new doc added more meds....

Dr. Mark :

That's what I mean.

Dr. Mark :

The main concern here is the delusional symptoms and keeping them at bay.

Dr. Mark :

But that doesn't mean you can't talk to his new doc about streamlining the meds. He's on a cocktail of antipsychotics and you could bring up your concern about the lethargy and go from there. What do you think?

Customer:

ok

Customer:

we will start with zybrexa

Dr. Mark :

One thing important:

Dr. Mark :

your and your mom's safety. and

Dr. Mark :

his safety.

Dr. Mark :

So let the doc know you're on his side. That will help you in having him willing to consider it, okay?

Customer:

ok

Customer:

resperdal 2 or 1

Customer:

?

Dr. Mark :

Let this be the doctor's choice.

Customer:

ok

Dr. Mark :

You need to bring up general possibilities, okay?

Customer:

ok

Customer:

also he has kidney problems

Dr. Mark :

You're truly a remarkable person.

Customer:

because of that i am worred

Dr. Mark :

You'll discuss it with the doctor. Because you have to trust that he and you are on the same team and ask.

Customer:

ok

Customer:

thank you

Dr. Mark :

I'm being sincere:

Dr. Mark :

they are SO fortunate to have you there.

Dr. Mark :

Okay, I wish you the very best!


 


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Customer:

thank you :):):)

Dr. Mark :

All the best to you, and let the doc feel like he and you are on the same team. And keep on being such a good person.

Dr. Mark :

If you could give a rating before you leave, I'd appreciate it. All the best, XXXXX XXXXX

Customer:

sure

Dr. Mark, Psychotherapist
Category: Mental Health
Satisfied Customers: 5158
Experience: Dr. Mark is a PhD in psychology in private practice
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Dr. Mark
Dr. Mark
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Dr. Mark is a PhD in psychology in private practice