My mom is in an assisted living. She is 91 and in pain for a host of issues and has anxiety. The Psychologist prescribed an SSRI. I know they have a host of side affects and neither my mother nor I want her on any SSRI at this age. If she was younger yes, but not at 91. I feel there are other drugs that could be prescribed. Can I as her Medical POA say no to the SSRI? Can I ask the pharmacist not to fill the prescription?
All too often care facilities will drug up their residents to make caring for them easier. If your mom has anxiety, ask her doctor to prescribe an anti-anxiety drug like lorazepam that can be given to her as needed. It works really well for most people and doesn't come with all the side effects of psychotropic drugs.
Say no to the SSRI and yes to an as-needed anti-anxiety drug like lorazepam or xanax.
My mother is 94 and I'd be willing to try ANYTHING to help her relax a bit and get rid of the pain she feels in her legs on a daily basis! Any meds can be discontinued if need be.
I remember when my mother got a small partial plate at the dentist when she was in her late 80s. I brought her some Polident and a denture bath to soak it in every evening. After reading the insert inside the package, she decided she wouldn't use the Polident cleaner at all because it could easily poison her. So she stopped using the partial plate entirely.
Anxiety is an ugly thing and only worsens when left untreated. Whether she approves the recommended meds or not, it's a good idea to get her pain and anxiety treated, one way or another.
Good luck!
I would disagree with you on this one. Elderly people are over-prescribed psychiatric drugs to an obscene degree. Like they're being used as guinea pigs to see what these psychotropic drugs will do. It's ten times worse when an elder is in a long-term care facility.
It's always better to start off small. Like maybe trying an as-needed benzo like lorazepam to treat the anxiety episodes as they arise. Not start off with a mind-altering psychotropic drug.
You start a campfire with some kindling and matches. Not with a flame- thrower.
I was surprised to read that a Psycholgist was allowed to prescribe medication since they aren't Medical Doctors. But seems the states of Louisiana, New Mexico, Illinois, Iowa, and Idaho allow it if they have the training.
She assessed my LO, and we immediately met to discuss her proposed recommendations.
When I asked that a VERY SMALL DOSE of medication(s) be tried, the PA immediately agreed with me, and that was what was done.
I did not feel that her age, 91 at the time, was the most important factor in her treatment.
Before Covid, she was seen every 3 or 4 months, and now, having been vaccinated, she will be seen again. She is also carefully monitored by the staff in her memory care unit.
I have contacted the PA many times with questions about my LO’s behavioral and affective issues. If you are able to do so, you might have the chance of addressing and clarifying your concerns faster than attempting to have to evoke your POA.
Hope this works out well for your mother.
Have you discussed your concerns with the person who is doing the prescribing? In general, psychologists don't have prescribing priveleges; many work with an MD or Advanced Practise Nurse to do the writing of the prescription.
I find that, in general, doctors are willing to let you follow their thought process in why they are chosing a certain med, or class of meds for a particular issue. So for example, a straight anti-anxiety med might be prescribed for a younger person in this sitation, but they often lead to falls in an elder, making an SSRI with antianxiety properties a better choice.
I am curious why you don't want your mom on an SSRI. Is it due to a heart issues, as CM describes?
Then mom had a stroke, which resulted in a diagnosis of vascular dementia. My mom's level of anxiety skyrocketed. She wept, wrung her hands and seemed to be in a near- constant state of dread and fear.
We consented to a trial of Lexapro, an SSRI. I was concerned about side effects, as are you, in part because mom had tried Zoloft once and it hadn't gone well. (In retrospect, I think she read the package insert and developed side effects listed there due to suggestibility).
Lexapro was a lifesaver for mom and for us. As her brain deteriorated, another antidepressant, Remeron, was added and she tolerated that as well.
I think of dementia as having a "broken brain". The chemicals that maintain good mental health are sometimes in short supply and need supplementing. Not sure why you wouldn't give this therapeutic medication a try.
And if I hadn't happened to have had SIL on speed dial? I might well have been chewing my nails off for fear I was poisoning my mother!
Having said the above with all the emphasis at my command... If you (or anybody else) are not happy about a practitioner's prescription or recommended treatment of any sort, the thing to do is talk to the practitioner.
Your mother is suffering pain and anxiety. The relationship between pain and anxiety is close - one feeds the other, and your poor mother is the victim. SSRIs do have side effects, this is true, but I imagine her psychologist has taken the potential risks into account and has concluded that the potential benefit of relieving your mother's anxiety outweighs those risks.
Her age has no relevance at all. Why would it become okay for her to live with pain and anxiety because she's 91?
But the psychologist, or any other prescribing practitioner whose patient she is, can tell you far more about this as it applies to your mother than we can. You as MPOA have concerns, questions and reservations - so talk to the psychologist about them, ideally with your mother, and decide together what's best.
A few years ago, my sister and BIL had a PCP who, in addition to his MD, also had PhD in pharmacology, and he provided excellent care, but unfortunately is no longer available. He was also trained in acupuncture.