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My mother moved to ALF a month ago due to cognitive decline from stroke a month before that. She had mild dementia prior to stroke but significant decline after. She has been anxious and sad both before and after the move to ALF due to the stroke. For the month she has been there, she calls a couple times in morning and many times in afternoon and evening with confusion and anxiousness. She started Zoloft on Saturday. I didn’t hear from her at all Sunday or Monday. Could that be med so quickly? Or coincidence? Or worsening dementia? She also has heart failure/afib/SOB. Could be she’s sleeping due to that. I can ask her or facility. But just seemed so sudden that the calls stopped. I’m relieved and confused at the same time about it.

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I haven't read everyone's responses but a drug like Zoloft often makes people seriously tired in the first week or two. She might just be sleeping a lot more, and less anxious. Usually after about 2-3 weeks you hit your stride with the drug, and start experiencing the benefits with less of the impact from the side-effects. Based on the timing of what you described, I'd say most logical answer is she's not calling as much as a direct result of the Zoloft. That being said, everyone is different and maybe you can get in touch with the nurse at the ALF to see how she seems on the medication - they should be able to give you an update.
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I didn’t read through the thread so someone may have already said this but she may not remember how to use the phone anymore. I used to speak to my father almost every day. Now he seldom calls me and seldom picks up when I call him. I know it’s because the phone is too confusing for him now. A worry for sure as he lives alone 3000 miles away.
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ptdurkan,
I wanted to clarify a reply I made within to another poster. I was saying I agree that people give up if they realize no one cares. I was speaking in generalities but was ABSOLUTELY, POSITIVELY NOT saying this was the case with your mom because your posts here make it very clear it's not the case and that you very much care!
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Is there any rehab being done for the stroke?? I know of so many who have recovered or significantly improved from the results of a stroke. My heart goes out to your mom. Her whole life's changed in the last month. Must be very frightening for her and she likely needs reassurance and hope. My prayers are with you both.
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Zoloft is working. Work with the staff to set a time when you can call her regularly.
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Bandy7 Oct 4, 2022
Well,...maybe. But It normally takes a couple weeks for Zoloft to start working. Same with all the drugs of that variety like Prozac, etc.
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ptdurkan, ignore people on here who see conspiracy around every corner.

You love your mom so naturally you are concerned about any change that you can't explain. You say your mom has only been there a month so in the beginning she might call cause it's all new and bewildering.

She may have an initial reaction to a new medication added to her regime. Give it time. Ask her if she feels different since starting Zoloft.

I hope you can get this figured out real soon and your mind can be at ease.
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Reply to Gershun
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Zoloft affects the mental state a lot. It can actually cause depression. Might want to check on the doseage maybe, or even wean her off of that. She could be having a side effect. Did they tell you why they prescribed it? It's nothing to mess around with.
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LoopyLoo Oct 3, 2022
I’m sure they prescribed it because it is needed.
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ptdurkan: Since your mother, unfortunately, suffers from dementia, perhaps her telephone skills may be waning.
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The responses to my question are a bit shocking.
This is NOT about me. I have called her and seen her and took her out to dinner Friday. I am well aware and have seen her medications, doses and her taking them.
She was terribly anxious and crying in the afternoons. She is not over medicated. She is on extremely low dose. She has heart failure and was on hospice a year ago due to her heart and was told she had months to live and she is still with us a year later. It is hard enough for her to live with the impacts of her serious heart conditions and adding anxiety and sadness to the end of her life is heartbreaking. It is no way to live your final days. So I do not need a lecture on overmedicating my mother. I am trying to make her last days/weeks/months as comfortable as possible for HER.
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lealonnie1 Oct 2, 2022
Agreed; I had typed out another response to you on the lines of 'please ignore these comments about overmedicating your mother' and do not think you're doing anything 'wrong' here, but then I deleted it. You are obviously a big advocate for your mother! My DH had a liver transplant in April and w/o meds, he'd be DEAD right now! My mother had CHF and her heart would have stopped w/o meds; calming meds for her dementia saved her sanity, and anti depressants saved my father's sanity and her quality of life for a decade!!! Who's kidding who? We hire doctors b/c we trust that they know MORE about these things than we do! And we also know that yoghurt with quinoa isn't going to cure dementia and neither will a few prayers or some ranting about the horrors of nursing homes, which has nothing to do with your situation at all.

You are doing a wonderful job advocating for your mom and trying to make her last time on earth as pleasant as possible. I was in your shoes for a long time and it's NOT EASY, but traumatic & horrible. To give out free advice w/o having been there/done that is not helpful to those in the trenches. Just ignore the comments that aren't helpful to you, and keep doing what you've been doing. When my mother was Sundowning *HARD* with advanced dementia in the late afternoons, if her doctor said a pint of tequila would've helped her, I'd have driven to the liquor store for pints of tequila. And pushed everyone OUT of my way who told me I was doing something wrong, too! Comfort for mom is the key here, nothing else. Silly people acting like 'drugs' are a horrible thing for dying elders with dementia just DON'T GET IT.
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My advice: rejoice

There is nothing she could possibly need that requires multiple calls a day.
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My mother turned 92 last Monday. All sorts of family wanted to talk to her. I put the phone near her. Then I leave. No one responds to my texts or rather they do hours later. No one gets through. I call the first nurses station number. That nurse only answers if she is in the office. I call the second nurses station. They tell me when to have people call as her bedsore dressing has to be changed. Everyone texts me saying they can't get through. I call again and ask them to put the phone near her. They tell me she was sleeping. This all gets repeated today although some do speak to her but I simply can't please everyone.

Trying to get her to dial has become nearly impossible. She has to remember the 9 and 1 to get out and then read the number from her list. But she can't hold the list,dial and hold the receiver. That requires 3 hands.

Maybe you are experiencing some of this. When things go downhill they simply do. Call a nurse and ask them to help her if you feel the need to talk. The last call my mother made to me was all about a new top she thought was missing but it wasn't but I had to get there to solve that.
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Bandy7 Oct 4, 2022
Lol, you brought me a smile Riverdale! Because my mom kept getting mixed up about dialing the 9 or 1 or whatever she needed to do to dial out from the rehab she was at... And she ended up calling 911 a couple times. That wasn't great because obviously the 911 operators need to be available for emergencies. But I'm smiling because of your description and the things that sometimes happen when our parents become older and confused and how a simple phone call out can become quite an ordeal. :)
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Until it’s proven any other way, consider it a relief! But, always call to check on her condition periodically and ask them to send updates if they’re able to. Best wishes💕
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Your Mom is depending on you to be her advocate - please go see her as often as you can so you can see for yourself what's going on. If you can't go see her in person, contact the nurse's station immediately and inquire. Educate yourself on all the medications and dosage she is being given and if it's appropriate. You need to always be "present" in whatever way possible or Mom will most likely be over-medicated and/or ignored due to short staffing. This is a big transition for your Mom, and she is likely confused and feeling abandoned. This is the reality of the people left in AL care, even though it is necessary. Don't worry for a second about bothering the staff - Get answers to her status as much as you need to feel satisfied. Lov2teach's advice about setting up an Amazon Echo is a great one. Virtual hugs to you and your Mom.
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LoopyLoo Oct 2, 2022
“Mom will most likely be over-medicated and/or ignored due to short staffing…. And mom is likely feeling abandoned.”

Um… how dare you?

Do not assume how mother is feeling and shame on you for projecting your hate of nursing homes onto someone who is doing the best they can with the circumstances.
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When my mother forgot how to use a phone, we placed an Echo Show in her room at the foot of her bed where we could see her and talk to her. That way, she doesn’t have the frustration of trying to figure out how to use the phone. I “drop in” on the Echo Show every day and we talk ( I live in another state). I love it because I can see her and she can see me. It’s like FaceTiming but I handle all the technology and she’s just happy to chat. Maybe that would be a good way for you to communicate with your mom so she wouldn’t have to figure out the phone. You can find the Echo Show on Amazon. It was a game changer for us.
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Bandy7 Oct 4, 2022
This is exactly what would have been a game-changer for my mom during the covid lockdowns when she released from a couple mo's in the hospital to a rehab center while still having what's called hospital/surgical/infection/medication induced delirium, which left her very confused and bewildered. Yet unable to see me or anyone she knew because NO visitors were allowed at the SNF Rehab due to covid rules. The facility denied my request to place something like this in her room so I could monitor and talk to her. They said this wasn't allowed, but if I made an appt with social worker they'd take her in an ipad and help her to facetime with me once a week. That was not helpful! She was used to having me with her every single day in the hospital. This Echo Show would would have changed EVERYTHING for my mom! It was so unfortunate that she suffered from a severe illness which wasnt covid and yet her entire path, treatment, recovery, even reasonably-early-identification of her infection and her future life was all affected severely & very negatively by the covid lockdowns of facilities. Thanks for sharing!!!
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Please contact her doctor and maybe set an appointment for yourself with a Geriatric Psychiatrist to get yourself educated on all the different scenarios that can happen (with or without drugs).

So often we become accustomed to chaos, that we actually miss it when it subsides.

FYI: Things to discuss with the doctor

https://www.health.harvard.edu/mind-and-mood/two-types-of-drugs-you-may-want-to-avoid-for-the-sake-of-your-brain

https://www.hopkinsmedicine.org/health/conditions-and-diseases/alzheimers-disease/beyond-memory-loss-how-to-handle-the-other-symptoms-of-alzheimers
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lealonnie1 Oct 2, 2022
I miss NONE of the horrible chaos my mother's dementia caused her or me, not one single moment of it, I'm totally relieved she's not suffering from it any longer. Amen.
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These types of drugs are VERY dangerous to someone with dementia. They often drug people to make it easier to care for them. There is a lot of neglect and abuse in these places. Please check on her right away and get her OFF the medication.

My sister was able to walk and talk and was going shopping with me before they forced her into one of these places. They started giving her these drugs and she could no longer walk, talk, and was constantly falling. Hit her head multiple times and ended up in the emergency room. Even after the doctor sent a fax saying to take her off the drug, they LIED saying they never received it. I went to the doctor and had them print it off and handed it to them. She recovered very quickly, but never completely after the drug was removed. All the blows to the head from her falling were terrible. The way they treat people is disgusting.

Please avoid antidepressants and sleeping pills with someone with dementia. It is not safe! You can use natural remedies for sleep and calming someone without putting their lives at risk.
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ConnieCaretaker Oct 2, 2022
May we know your credentials and which pharmacy school did you graduate from?
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Since your mom had mild dementia prior to her stroke 2 months ago, you haven't had the benefit and the horrible education and skills learned as a result of witnessing the many different phases of decline over a greater stretch of time as most caregivers have experienced with their loved ones. It's shocking for you.

It's all enormously difficult. Truly, I can't decide if sudden change is in some respects more difficult but what significantly matters most is that you remember that you are her support. You have to become her champion.

Sounds like you did well. Everything that could accommodate and keep your mom comfortable and safe has been put into place.

Relief is normal. She should be with professionals.

Speak to the doctors or the social workers at her facility to give you clarification and to put to rest your questions.

You should join a support group. It is very important!!!

Just a couple of weeks ago I mentioned, to one of the co-attendees of my dementia support group, a new and particularly gross behavior of my Alzheimer suffering husband. This co-attendee/caregiver was further along in her experience and told me that her husband did the same thing and to ask his neurologist if one of his prescribed meds could be the culprit. The very one she told me to mention did cause the problem. My husband had been taking this med for 13 years and it only recently manifested in a very bad way. If it hadn't been for my support group it would never had occurred to me to think my husband had hit a level of intolerance to this particular medication, almost like an allergy.

Go visit you mom. Learn. And find healthy ways (HEALTHY WAYS) to de-stress.
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I've taken Zoloft myself for more than 15 years, at a range (seasonally dependent) of 75-125 mg/day. The therapeutic range is 50-200 mg/day. When I first took it, as little as 25 mg worked just fine. Unfortunately, the doctor who prescribed it couldn't believe that 25 mg was sufficient, and pushed me to take more, in keeping with the gospel of the therapeutic range. I couldn't tolerate more, so he switched me to a different medication. Long story. I started taking Zoloft again at a higher dose about 10 years later.

Now, given that I was in my 30s when I first took it, and your mother is significantly older, with heart & neuro problems, I would be very mindful of how much medication your mother is being given. Research is mixed on the safety of Zoloft in heart patients. Sadly, the elderly are most often over-medicated to quiet them. There is certainly a place for medication, I know, but I saw how my grandparents were sedated and over-medicated in their 90s, and it upsets me to think.

Can Zoloft work that fast? Possibly. I am certainly aware when I fail to take a dose on time each day. Still, on the one hand, I'm concerned they may have given her a big dose that really walloped her; on the other hand, given you say you called and she was fine, well - maybe everything is indeed fine (yay!).

But I most certainly would visit, and find out what dose she is being given. Generally, patients are started on a low dose which is raised weekly to midrange. It takes about a month to six weeks for the full effect to become apparent, and the dose can be adjusted at that time. Of course, the dose can be adjusted at any time to reduce side-effects: sleepiness and acid stomach are the two that annoy me.

Best of luck!
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Lulu376 Oct 3, 2022
What happens when you fail to take your dose on a given day? And what is it helping you with?
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Are you able to visit her to find out what is happening? Also speak to the nursing staff at her facility and her case manager at the facility. Good suggestion below also to speak with her doctor.
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Well of course you should be contacting the facility and go make a visit and check on your mom make an assessment. get doctors advice About changing medication if need be. I understand the relief and I understand the concern. go take care of business.
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Yes.., Yes.., Yes..
OR
No.., No.., No..
It could be a combination of any or all.
It is difficult to tell what is going on with dementia. There are declines that happen rapidly then things will go on seemingly not to change for a long time then you get blindsided by a decline.
It is possible that her comfort level has reached a point where she does not "need" to call you for reassurance.
If she is doing well, seems to have adjusted take that as a Win!
You can ask her but with dementia take some answers with a grain of salt. Ask the staff at the facility, specifically the caregivers that work with her on a daily basis.
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I discussed a mild anti-depressant with my doctor at the ALF yesterday. My mom is showing some signs of possible depression. She actually suggested I wait due to the side effects. We are going to watch her for awhile. However, this is a very individual decision. As many say, when you have seen one person with dementia, you have seen one person. I agree that it may be helping with anxiety. That could be making it less “necessary” for her to call.
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Do u really think u need meds for everything. Most of the time it’s praying, communication, hugs, kisses , therapy wither it’s physical or mental. I’m not saying all meds are bad but only when it’s serious. Mom didn’t need that other med till she arrived there.
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ptdurkan Oct 2, 2022
How do you know she didn’t need it until she arrived? You have no idea what she was like prior to moving there. How do you know that I don’t give her all of those things you mention? This is NOT about me. She is terribly anxious and crying. She is not over medicated. She is on extremely low dose. She has heart failure and was on hospice a year ago due to her heart. It is hard enough for her to live with the impacts of her heart and adding anxiety and sadness to the end of her life is heartbreaking. It is no way to live your final days. So I do not need a lecture on overmedicating my mother. I am trying to make her last days/weeks/months as comfortable as possible for HER.
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Drugs r drugs
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LoopyLoo Oct 2, 2022
Your point being?
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Ppl are declined bc of neglect snd not having their love ones at being at home. Most of all at that age taking to many medications. They have ppl that go around to hospital to ask doctors to try new drugs on patients. I know I work in one. They go yo clinics it’s all about the money. It’s not helping ppl. I guess the only way ppl will see is when it’s happening yo u or your family and it’s just to late. Ppl please open up ur mind snd eyes. What perceyof parents or our love ones comes back as a whole. U know when u send them off u gave up than they soon give up. Sad!
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KaleyBug Oct 2, 2022
Reason other then rehab my mom and mother in law where at home until they passed and dad is home. Last rehab for mom, I declined and brought her home. Everyone said you can not handle her. Until they saw I could get mom to stand, turn and sit in a wheelchair which the hospital physical therapy failed to be able to do for 4 days.
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Go to Wikipedia: type in the name of the medication. It will give u full details.
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SacFol Oct 2, 2022
Yes! My mom, 86, was hospitalized a week ago for Digoxin toxicity with her heart rate in the 30s. I looked that up and was surprised at the side effects as they matched my mom’s condition to a great degree. She’d been on it since May but no one was “closely” monitoring the levels in her system as one site said should be done. She’s been taken off of it and, while not back to normal, is much improved.
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Is this ur first time reading all these questions and responses about aging. I’m sorry to here about ur mom. She’s worse bc of all the meds and missing being in control and in her own turf. Ur relieved bc she’s not on u. The calls stopped bc she cannot help herself bc she’s drugged up. H should go and check up on her. Don’t tell any one or the place ur coming snd u will see for urself. It’s so sad how one can give up so quickly on family. If parents have there own homes they should stay home and caregivers come to them. Once h r taken somewhere else all bets are off. The food isn’t healthy they give u. It’s better to be home everyone knows that. One day when it’s ur turn u will than see.
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MattyWelch Oct 2, 2022
Goodness, ur kidding I hope. Ur not making sense, they're not "drugged up".
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When I started taking zoloft, I wasn't a zombie, but I was really tired. All the time.
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Lulu376 Oct 3, 2022
I couldn't continue it, it was horrible. Irritability. Just bad. No thanks
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My mother went into Memory Care with moderate dementia in June of 2019; on Wellbutrin for depression at that time, but not max dose. She was calling me daily, I was calling her, etc.

As her dementia progressed and advanced, one day, she stopped calling cold turkey. I was like you, confused and relieved at the same time b/c all those daily calls were causing me nothing but angst and heartburn; chronic complaining and a LOT of terrible confusion on her part, combined with a reduced ability to use the phone on her part.

She stopped calling me when her Wellbutrin was increased to the max dose, and when she started Ativan for her terrible Sundowning, I think I can safely say, it coincided. BUT, it's when her dementia had advanced A LOT and was to the point where she was unable TO use her phone w/o help. That was really what was going on, I'm convinced of it. She reached that point in time where the phone became too much trouble for her to figure out, and so she stopped using it entirely. I also had a terrible time getting her to ANSWER her phone, so I stopped calling. It really did signify the beginning of the end, in terms of her life. I think she died about 7 months after the phone calls stopped. I would go see her in person at least once a week (then more frequently as her decline increased) and I'd call over to the Memory Care ALF to speak to the staff about how she was doing. Then she went on hospice care 2 months before she passed, and I was speaking with her RN almost on a daily basis until the day she passed.

My mother also had CHF, afib and very bad SOB which signified she was approaching the end of her life. She also started nodding off a lot in her wheelchair in the activity room which was TOTALLY out of character for her; she considered it a 'weakness' to nap during the day, or, to God forbid 'fall asleep' while doing something.

I would think your mother is declining and that's why she's no longer calling you, based on what you've said. Or it could be a combination of her decline and the meds kicking in to calm her down. I saw with mom a VERY quick reaction with the Ativan and when her Wellbutrin was increased, too.

Do you have hospice on board now for your mom? If not, you may want to ask her PCP to write an order for an evaluation. Hospice was WONDERFUL with my mother in her final days on Earth. They came on board only 2 months before she passed; one day, she just felt tired and went into her bed, in a semi-comatose state, and never got up again; she passed away 1 week later; her heart gave out. But hospice kept her comfortable and out of pain and anxiety the entire time.

Wishing you the best of luck. I know how tough this whole process is to witness, and I am sending you a hug and a prayer for peace.
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The phone calls were probably anxiety based. On Zoloft it helped with the anxiety.

"It is approved for the treatment of major depressive disorder (MDD), posttraumatic stress disorder (PTSD), premenstrual dysphoric disorder (PMDD), panic disorder, and social anxiety disorder. It is also approved to treat obsessive-compulsive disorder (OCD) in adults, children and adolescents aged 6-17 years."
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Lulu376 Oct 3, 2022
Alprazalam is better for anxiety. A light dose. Not an anti-depressant.
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