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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.
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!
What Are Palliative Care and Hospice Care? | National Institute on Aging (nih.gov)
Who can benefit from palliative care?
Palliative care is a resource for anyone living with a serious illness, such as heart failure, chronic obstructive pulmonary disease, cancer, dementia, Parkinson's disease, and many others. Palliative care can be helpful at any stage of illness and is best provided from the point of diagnosis.
In addition to improving quality of life and helping with symptoms, palliative care can help patients understand their choices for medical treatment. The organized services available through palliative care may be helpful to any older person having a lot of general discomfort and disability very late in life. Palliative care can be provided along with curative treatment and does not depend on prognosis.
A palliative care consultation team is a multidisciplinary team that works with the patient, family, and the patient's other doctors to provide medical, social, emotional, and practical support. The team is made of palliative care specialist doctors and nurses, and includes others such as social workers, nutritionists, and chaplains.
You and mom if she’s capable have every right to understand and agree with treatment but don’t go in with an advasrial approach, skeptical sure but start by just making it clear you want to understand the thinking, the choices and why this is the plan rather than refusing the plan right off the bat. Hopefully this will also establish a relationship that will put you in the loop from now on. Good luck!
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?
Wishing you good luck. If your Mom is in distress something should be done. See if you can make an appointment with her psychologist, taking your POA papers with you, and tell her you are very worried, and why.
AS A RETIRED NURSE AND A CAREGIVER, I SAY THAT YOUR MOM, AT 91, DOES NOT NEED AN SSRI TO ADD TO HER BUCKET LIST OF MEDICAL PROBLEMS. IF SHE WAS SUFFERING FROM A UTI, THEN I WOULD SAY, OF COURSE TREAT HER WITH THE APPROPRIATE ANTIBIOTIC AND FLUIDS. SINCE YOU HAVE HER POA YOU DO HAVE THE RIGHT & RESPONSIBILITY TO CONSULT WITH THE PHARMACIST.
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