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Mom was in assisted living and after a fall she was hospitalized for a week with a brain bleed. The bleed is stable, no surgery needed. The ordeal has escalated her dementia so she needed to move into memory care. She gets anxious in the afternoons so the staff recommended anxiety meds. I’m taking her to see her doctor tomorrow to see what he recommends but I wanted to know if anyone would share their experiences with good and bad results. Thank you

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I had a very good experience putting my father on antidepressants. He was very anxious at night, and with the help of his Doctor we tried anti-anxiety meds, but he became afraid of how much they made him sleep. The Doctor switched him over to the antidepressants and he calmed down and didn't feel so drugged and out of it.
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DimplesToo: Your mother has some lingering effects from the brain bleed, of course. She should also see her physician for medication for the 'sundowning.'
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So, my loved one has tried several SSRIs. They caused her to have low sodium. She tried Trazadone, which caused severe edema in her legs. She was on Xanax three times a day. This has now been reduced to just the evening, which is good. She tried Ambien, caused her sodium to drop which caused a huge fall. Now, she's on Risperdal, which seems to be helping quite a bit of with anxiety, agitation, anger, and aggression. She tried Seroquel, and it didn't do a thing for her aggression. To keep this post short, she was involuntarily committed to a geriatric psychiatric ward in February. She was there for a month. Namenda also helps her. Last fall, she fell on her head, which resulted in her having seizures. She now takes Keppra and Zonegran. The Keppra caused a lot of rage, which the Risperdal is helping tremendously with the aggression. The last year has been a super rough year, but I've got to say that with the geriatric psychiatric facility starting her back on the Namenda, starting her on Resperdal, and neurology lowering the seizure medication, there are days when I feel like I'm actually talking to my mother again. So, yes, medications can work. Out of caution, I recommend having her doctor start on a super low dose of any kind of medication and go slow.
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lynn1992 Apr 23, 2024
Before I read some of these posts, I gave an answer that from experience, I know that a lot of these medications can cause falls. Now I see I’m not the only one. Your loved one hitting her head is so sad. I’m glad that she’s doing better. Fish oil,magnesium and D3 are essential. Our loved one was put on a medication and we only gave her a half dose. This was to calm her down and she fell and had to have a vertebrae cemented
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Anti anxiety medications do help.
It might take a bit to get the correct dose but they will help her.
It can not be pleasant to be anxious and upset. So giving her a medication that can ease that feeling would be good.
NOW...there is a possibility that some medications can make her a fall risk. But any medication can do that and many people with dementia are fall risk anyway due to poor gait.
(and if mom also has Vascular dementia that puts her at risk for falls anyway. And Vascular dementia is known for rapid declines.

If it helps your mom be more comfortable it is worth trying.
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Dementia can escalate when given anesthesia, so should always be taken into consideration for minor operations. But your mom had a major issue so it was the best thing to do to save her.

Anxiety drugs and sleeping pills also have very negative affects, especially for people with dementia. When they gave them to my sister (after being told not to by the doctor) ...she started having severe falls. Had to be rushed to the hospital multiple times because of the severe falls. I had to hand them the doctor's order by hand to get them to remove the drugs finally and her falls stopped!

Before rushing to drugs that can do more harm than good, you may want to look into some natural methods.

Some essential oils, like lavender scent has a calming effect.

Rosemary has an amazing amount of flavonoids, which interact with nervous system receptors in such a way that they it also helps greatly reduce anxiety.

Just a few alternative ideas. There are more things you could try without having to worry about the dangerous side effects of the drugs they push on you.
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LoopyLoo Apr 23, 2024
Oh good grief. Sniffing rosemary won’t help brain damage.

Guess she should have just bitten down on a stick during the surgery and not had that terrible anesthesia with side effects.

Maybe doctors “push drugs on you” because they are trained professionals and want to help their patients?

DRUGS ARE NOT THE ENEMY.

ALL-NATURAL MEANS NOTHING. There are no industry standards for ‘natural’ or ‘clean’. None of these so-called remedies are tested. A medication has to go through years of trials to get FDA approval to be prescribed. Herbs may smell nice but are not any sort of solution. Every herbal item you buy will say on the label that it is not intended to treat any medical condition. The government made them have the disclaimer because they do not treat anything.

I’m baffled as to what your problem is with medication. It’s as ludicrous as not vaccinating.
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No experience with it, but I would definitely try it. The anxiety could lead to accidents or falls, because she may be so over anxious she could forget her walker, or whatever she uses, and over do things.
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My mother has dementia and is taking Lexipro for anxiety. It helps her tremendously to where she is basically content so yes, I would recommend it.
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When my mother started developing dementia she started getting anxious - like a deer in the headlights - when anything out of the norm happened. We opted to try anxiety meds just to see if they would help her relax. Started with a low dose of Sertraline and we immediately saw a difference. As the years passed, we have increased her dosage to keep her leveled out. The medication hasn't had any other affect on her behavior other than to help her cope and stay calm. I can't speak for anyone else, but for us, the medication has been a Godsend. If it will help her find peace of mind, I would think it's worth a try. You can always take her off if there are adverse effects. Blessings.
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Your mom probably still suffers from the fall and the hospital stay issues which are lingering and bother her. The memory care probably is new and any change in the patient's environment can have adverse effect on their anxiety.

I am an advocate of care-based interventions. Drugs can be useful if all fails, but not as a first choice.

She may also suffer from sundowning issues. Here is a copy paste from an article in my book "Dementia Care Companion" related to sundowning:

Sundowning and Nighttime Issues
Many of the symptoms of dementia tend to get worse late in the day and toward the evening. During the day the patient might be able to go about their life without too much difficulty, while in late afternoon or evening they may experience increased confusion, restlessness, and anxiety. This is known as sundowning because the confusion tends to intensify during the dusk hours.
Sundowning occurs mostly in the middle and late stages of dementia. The compounding loss of brain cells over time makes it harder for the brain to process complex visual stimuli, such as the dimming ambient light and the lengthening shadows at dusk. Destruction of neurons in the brain also disrupts the body’s internal clock, which regulates night and day cycles (circadian rhythms) and related physiological processes. The result is a variety of sleep disorders that reach well past dusk and into the night.
Most elderly people do not enjoy a continuous eight hours of sleep and may wake up several times during the night. For those suffering from dementia, these sleep breaks can be accompanied with confusion of time and place, restlessness, and other behavior disorders. For example, the patient may wake up in the middle of the night, get dressed, and leave home, believing that it is time to go to work.
Improve the Living Environment
·        Provide adequate lighting in the patient’s living environment. Dim light makes it harder to see things, leading to confusion and anxiety.
·        At the end of the day before it gets dark outside, draw the curtains and turn on the lights to make it easier for the patient to transition from day to night.
·        Ensure a safe sleeping environment. Equip the patient’s room for comfort and safety, including comfortable temperature, nightlight, and closed and locked windows.
·        Install safety features to alert you if the patient leaves their room. You can use motion detectors, baby monitors, or similar devices.
·        Pay attention to nighttime dangers. The patient may leave home in the middle of the night and not be able to find their way back. Or they may go into the kitchen, turn on the stove, and leave.
Refine Daily Routines
·        Organize daily routines with a natural progression from morning to noon, through the dusk hours, and into the night. By the time you help the patient to bed, they should be primed and ready for a good night’s sleep.
·        Schedule adequate physical activity during the day and prevent long naps. Long naps during the day translate to difficulty sleeping at night.
·        Keep dinners light, while lunches can be more filling.
·        Avoid coffee, tea, soda, sweets, and alcohol in the evening.
·        Limit sensory stimuli during nighttime. Watch out for loud TV, noisy children, and lengthy visits from friends and relatives.
Reduce Physical and Mental Distress
·        Watch for signs of physical and mental distress. Hunger or thirst, uncomfortable ambient temperature, fever, constipation, itching, and infection can disrupt the patient’s sleep.
·        Do not resort to force to put the patient to bed. Restraining the patient in any way and using force will make the situation worse and lead to more anxiety and even aggression.
·        Speak gently and make the patient feel safe. Say things like: “Everything is fine,” or “Don’t worry, I will stay with you.”
·        If the patient suffers from sleep apnea (a sleep disorder in which breathing stops repeatedly during sleep
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There are plenty of each, if you are asking about good and bad results.
Some seniors do very well with a very low dose antidepressant. Some do not.
I would start with that rather than anti-anxiety drugs as with these there can be further falls. They are hard on the already extant issues of poor balance due to an aging brain.
Take the best advice of the doc. I wish you good luck. Our own experience is really not useful to you as each individual is as unique as his or her own thumbprint.
If you want a few individual examples?
My friends mom who went from not recognizing anyone to completely non verbal is doing VERY well on a few edibles, recommended by her Austin, Tx. care home. She is happier and talkative and eating well, many more smiles.
My brother was given ativan and nearly climbed the wall and hung from the ceiling. But a move to ALF helped him enormously as did my taking on Trustee and POA. Once his worries left he did so much better with so many fewer hallucinations from his Lewy's.

As a nurse I know it takes some experimentation for each patient often enough, but I also know that anxiety is very dreadful, and it's worth the try.
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My mom was helped a lot by meds when she needed them. They only gave her them when she would get real agitated and anxious and they couldn’t re direct her.
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At the nursing home my moms at that put her on Zoloft and she has stopped crying and is more happier . She’s been in there almost 2 years now and they keep them busy with activities so that helps with her Anexity and depression and the Zoloft has really helped her. You will need to talk to her Dr to see what’s best for her to be on.
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Ativan .5 mgs helped my mother a lot with her Sundowning agitation in Memory Care Assisted Living. Hospice administered it as needed.
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Don’t be afraid of meds! The goal is to take the edge off anxiety/agitation, not make people into drooling zombies. Her anxiety is no fun for her either. She needs help.

As others said, it may take some trial and error to pinpoint the med and exact dose that will work best.
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Anxiety meds helped my dad when he was 91 and had dementia as well as cancer. It was a tiny pill that we slipped under his tongue when he became agitated. He never even knew we put it in his mouth because it dissolved right away. It calmed him within minutes.
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Anxiousness in the afternoon is called Sundowning, a feature of dementia. Dementia robs people of their ability to bring themselves to a calm or accepting mental state due to loss of reason and logic and memory functions. The right med or meds in the right combo and dosage can make a helpful difference. My 94- yr old Mom just started the lowest dose of Lexapro with no side effects and it has helped her depression and negativity. She lives semi-independently next door to me.

It may take a while to find the right meds so be patient with the process.
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