Immediately after lunch finished, it began.
“Who’s looking after me tonight?”
I told her the name of her full-time, regular care partner who would arrive at 3:00 p.m.
“What’s she going to do?”
The same things she does every night. Get you ready for bed.
“What if she won’t look after me?”
It’s her job to look after you, but she also loves you and wants to see you comfortable.
“What if she doesn’t come?”
She will be here. She arrives at 3:00.
“Do I have a shower tonight?”
No, no shower tonight.
“Who’s looking after me tonight?”
At other times, the conversation would be:
“I need to wash my hands.”
We just washed them a few minutes ago.
“But I touched something.”
You aren’t eating, so they are fine. We will wash them just before you eat.
“I need to wash my hands.”
If we washed them again, a few minutes later, the conversation would start again.
Another version is:
“I need to see the doctor.”
The doctor isn’t here right now, but he sees you every time he’s in. Why do you need to see him?
“I’m sick.”
How are you sick?
“Just look at me. I’m sick.”
What do you think is wrong?
“I can’t look after myself.”
It’s been that way for a long time. You’re not sick, you’re 93. Often when you get older, you need some help. That’s normal.
“I need to see the doctor and go to the hospital.”
My friend had the unfortunate combination of dementia, depression and an anxiety disorder. Dementia and depression fueled the anxiety and sometimes sent it spiralling out of control.
Depression and anxiety in the elderly can often be seen as they deal with accumulating losses. Loss of abilities, health, friends and changes in their living situations all can lead to feelings of sadness. These normal emotions can be coped with and overcome with proper supports. But if anxiety escalates to beyond normal, extra help must be offered.
The Problem With Diagnosis
Anxiety hides behind many other labels, making it difficult to diagnose. Often related to a severe life change like the death of a spouse, it can be mistaken for grieving. Someone with obsessive-compulsive disorder may have dealt with it to some degree all their lives and changes just passed off as “that’s Grandma.” Many people deal with phobias of some kind, so seeing new ones emerge or present ones escalate may not be immediately evident. People with social phobias may be seen as shy or socially awkward, but it’s seldom understood as more than a peculiarity. Some of the symptoms which accompany anxiety, such as panic attacks, poor sleep, headaches and breathlessness can be part of many diseases. Or, some could be a natural part of ageing. Can you understand how diagnosis and treatment can be elusive?
The Problem With Assumptions
People dealing with anxiety are often convinced of two truths.
This is normal, or at least my normal.
There’s no way to make it better.
The problem with these “truths” is that they aren’t true. If you assume what you’re going through is normal and not fix-able, you accept it as your lot in life. What a sad, defeated way to live when resources are available.
The Problem With Anxiety
Do you suspect your elder may be coping with more than normal anxiety or depression?
The first step is to observe. Spend some time with them on several occasions. Symptoms or behaviours can be hidden in brief encounters, but not with repeated exposure. Talk to friends (carefully and discretely) sharing your concerns. Write down what you are seeing and look for patterns.
If your suspicions are confirmed, have a conversation with your elder. Although there may be denial and resistance, come at it from a position of love. “Mom, I’ve seen you struggling in these ways and I know there are ways to help with that.” It may take several conversations and the need for reinforcements, such as other family members or friends, but persist.
The next step should be a visit to the doctor. Even if they regularly see a physician and take medication for anxiety or depression, this is an important step. The doctor may not be aware of recent changes, and medications are tricky. Different medications, dosages and timing can all change the outcome. He/she may need to refer to a specialist or do tests to rule out other medical conditions.
Sometimes pinning down the cause and finding help for anxiety can feel like pinning jello to the wall. This can be the case for doctors as well because the number of variables remains vast. The outcome, a better quality of life, is worth the journey.
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Care Partner Wednesday–Unlock the Mystery of Anxiety and Find Hope