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Mom lives in a very small world. Has no interests, but also can't see, has problems hearing, and has very limited mobility. She suffers from incontinence, for which she is being treated both with meds and with a regular office procedure. But she spends so much time in bed and is also on diuretics for CHD, that the incontinence continues to be a major factor in her depression. She doesn't have any interest in people outside her two children. Paranoia comes and goes, but is directed against those closest to her, so she lives in absolute misery, when it occurs. Are there mental health professionals available for dementia patients? The one and only drug we could try was a wonder drug for her moods, but increased to the point of danger her hallucinations.

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You’re welcome. As I read your comment on my answer, it occurred to me that you might want to consider consulting another doctor. Palliative care and Hospice are NOT the same thing. Palliative Care, as I understand it, is more “maintenance” care for someone, such as my husband, who has serious health issues and needs personal care as well. Hospice care is care for someone who is actively dying and it is believed they may only have a few weeks to a few months to live. Drugs are provided to ease the journey and the Hospice teams duties are to make the patient comfortable but doesn't use any heroic measures to keep them alive. Her doctor should be aware of the differences.

I’d go along with stopping the incontinence treatments and medication. If she is not already using Depends, she should be convinced to start (hint: do not refer to them as “adult diapers”. That’s insulting to the person who needs to wear them) That will make bathroom visits much easier. But her med intake needs to be surpervised if she’s prone to stopping taking them. My husband complained about his meds at first too (he’s on 9) but his doctor told him they were keeping him alive.

If shes willing, do see a different doctor. There must be a combination of meds that would help her without doing more harm than good.
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I’m so sorry for your mom. My mother was the same way. She was always a recluse and a martyr and when she suffered from dementia in her last years, depression and paranoia were added to the mix, which included hallucinations. She also suffered from Macular Degeneration.

It has to be difficult for your mom to be on meds for incontinence and also diuretics for CHF; seems like cross purposes. Have you tried any other meds for her besides the one? If it was an antidepressant there are hundreds of them out there. I’d ask to try a different one. If she is in a facility, to encourage her to join in some of the activities. My mom’s had vocal and instrumental concerts and daily discussions about current events.
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Bflogal Jan 2019
Thank you so much for posting a reply! It is tricky to balance the incontinence and CHF. My mom is on so many meds, so balancing them is always tricky. And so too with the antidepressant. She is on one regularly, but when we tried the next (actually an anti-psychotic) to deal with the paranoia, she went totally bonkers, tho she wasn't depressed anymore! We do try to encourage her to join activities, but she is not interested. Her dementia is to the point it is hard for her to reason or to follow reasoning. If she agrees to go to an activity, she simply can't seem to follow thru, even Se with help. Other issues come up which she claims to be too difficult to overcome; spending so much time using the bathroom and cleaning up after herself is always at least part of the problem (She lives in an assisted living place but does not want help, even if she needs it!) She has told us that she doesn't want to continue with dealing with her pace maker/defibrillator and she has said she will stop treatments for the incontinence. She had taken herself off of the blood thinner, but then got a blood clot, which hurt. I tried talking to doc about palliative care, but he equated that with hospice. Tho he recommended her for hospice, hospice did not accept her at this time; she is not far enough along. Apparently she is only at stage 4 and she has to be at stage 7. That could take a while, and we can't imagine how we will last that long. Her depression is depressing, and will likely lead to worsening issues, which will mean she won't be able to stay in assisted living, and a nursing home that we could afford will be even more depressing for her...
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