Dr. Moore, psychiatrist at Halifax, came to visit Mom around 1pm yesterday. When I asked him what he thought, he said he thinks she has a combination of some dementia/confusion/paranoia with possible severe depression. She was sleeping at the time, and he asked if she had been sedated. I said no, but explained that when she is awake she seems to be suffering, and it is only when she is asleep that she seems to have any peace, but that we don’t want to just have her knocked out all the time. He suggested Haldol again, and I told him no. I explained to him my concerns for her depression override my concerns about dementia. He said that he was going to take her off the Celexia (Citalopram) and start her on Cymbalta. He says that it is somewhat related to Citalopram, but that it can also help with any pains. She started Cymbalta last night.
Dr. Hatten, an Orthopedic physician, came in to see Mom around 5:30pm. The CT-Scan she received Saturday night showed that she has 2 fractures in her pelvis that occurred within the last couple of weeks. Dr. Hatten said the position of the bones is good and should be fully healed within 2-3 months. He said her treatment would be conservative, needing to do some walking with a Physical Therapist and using a walker for a bit.
A PT came to assess Mom this afternoon, did some range of motion with her, and got her to sit upright and then stand briefly a couple of times. Mom was stiff from being in bed for so many days and was in pain, but she did manage to stand.
Janis, do you have any reports of Mom having fallen the week of Easter? To the best of my recollection, it was that previous Sunday that Mom was walking as good as I can recall. I was also wondering when she began sitting on the floor.
Mom was then moved from the Bill France Tower to the old building and is now in room 711. (They needed the rooms in the other building for some post-ops.)
Dr. Buck came to see her around 7:30pm. He agreed with putting Mom on the Cymbalta, saying that it is an antidepressant without the sedation and should help with any discomfort. He thinks that the physical therapy will also help because it will stimulate her mind and get her off of the monotonous humdrum thinking she has been doing.
He says he cannot make a full commitment to it, but does feel that much of her condition can be explained by a severe major depression with some kind of breakdown. He is not 100% sure a full-fledge dementia has been proven but recognizes that he did not see her for that time when she was at Act and Halifax through the winter. He feels that Namenda does do some people some good, but he does not necessarily feel that it has to be on board. We can try her off of it if we want. He is not seeing any side effects from it.
Dr. Buck says Mom is on the 3 blood pressure medicines because it tends to be better to balance things out by adding another one than increasing what she has. He said that when you increase a BP med, you tend to see more of the side effects. His only concern was the HCTZ because of its effect on her potassium level.
Dr. Buck’s next concern is how long she will be in Halifax and will she be able to return to Grace Manor or will she need to go someplace else for rehabilitation. He says we will need to see how the next couple of days go.
She will continue to need physical therapy for awhile, and he said it can be done as an outpatient. Janis and Jan, maybe you could give us an idea of what you think regarding how much care she can get or what it would look like to have a pt go to Grace Manor.
Her mood has been better overall, but she has seemed a little “stoned” at times. I am optimistic to see her watching tv as if she is focusing on it, and also, to see her left eye open more. She is a little slow to respond to questions but when you get her attention she does respond, albeit quietly.
Thank you all for your support.
Please let me know what other questions I need to be asking or if I missed anything.