Depression and ALS

[degem25]

Hello,

My grandmother is in late stages of ALS. She has been on Zoloft for some time. The Zoloft has stopped working and she is having terrible problems with depression and they crying associated with ALS.

We contacted her Hospice nurse and we were told that she is on the highest dose of Zoloft. The nurse told us that there are no other options for anti depressants for her to take and that she will just have to deal with the depression. We were told the reason there are no other options available is that the other anti depressants would have withdrawal symptoms when she is no longer able to swallow pills. I find this answer ridiculous. We can crush pills for her when it becomes necessary. Surely there is something else they can suggest?

Has anyone else faced this? I don't want to see her sad and crying uncontrollably for the time she has left.

 

[sanderson]

HI degem25. First let me say how sorry I am that your grandmother is going through this and thank you for looking for a way to help her. There are other antidepressants that can be tried , safely with seniors. She would need to be weaned off the Zoloft and slowly ramped up on the new medication but it would certainly be doable. May I suggest that you discuss this with your grandmother's physican, or better yet a geriatric psychiatrist is there is one available in your area , as they would be the best ones to make suggestions for a new medication. Some medications are also available in liquid form that may be delivered via a feeding tube( or meds can also be crushed and given through a tube). As well some are available as injectables . I am not sure if there are any, other than lorazepam( which is something more useful in short term anxiety relief and not recommned long term especially for seniors) that are available sublingual( where they are just placed under the tongue and disolve), again your Dr should be able to assist with this. There should not be any reason someone should just have deal with depression, there are ways , plus medications that can help and to suggest otherwise is not acceptable in my mind. If there arent any geraitric physchiatrists in your area, please check with yor local mental health centres and ask to speak to a nurse who specializes in seniors mental health. This disease is enoughj to be coping with, and depression is a real illness and can signioficantly limit a persons quality of life if not treated, as I know you realize so please forgive me my little rant
Susan

 

[Katie C]

I totally agree with Susan's post. Glen took Celexa even after we had to puree all his food.. it's very teensy and we were able to put it into a bit of pudding for him to swallow it. The only other thing I would add is that you need to contact that nurse's supervisor and tell her/him what happened. Your grandma deserves better than that... the purpose of hospice is to make the patient as comfortable as possible.. not to say "oh, too bad." There are always alternatives. Lazy is not one of them!

 

[degem25]

Thank you to both of you for your suggestions. I was very unsatisfied with the answers I was getting from the hospice nurse. The answers seemed absurd so I began my research. I found the suggestions of liquid antidepressants as well. Thank you for verifying this. I have been frustrated with the RN Hospice assigned us for some time but have been hesitant to complain. Her most recent visit changed everything. MY grandmother was crying and telling her how much she felt like she needed help. She told the RN that she was feeling hopeless. The RN told her well there are no other options because there would be withdrawal symptoms with another drug. As she was leaving she told my Grandmother who is completely deteriorated to "Chin up." I was furious! I called the Nursing Director for our local Hospice and made her aware of my concerns. She promised to meet with our RN but she too was insisting there were no other options. I felt like she was just patronizing me. I'm still flabbergasted at this attitude. I feel strongly that most Hospices are just not prepared or aware of the specifics of ALS. After a week with no change I called again and spoke to another Director of Nursing. This one was much better however I was frustrated to hear that the first Director had made NO notes regarding my call. After spelling out my specific concerns she told me it sounded like the RN had been negligent. She assigned a new RN and has a MD coming to make a house call to examine my Grandmother! Yea! Progress! The new RN is wonderful. She is calling in a prescription for a new antidepressant today! Thank you for your support. I hope others who may feel disappointed with Hospice will read this thread and see that speaking up can make a huge difference.

 

[Alyoop]

Well done! What a wonderful person you are. Your Grandmother is so fortunate to have you around as her advocate. I am so glad you sorted the antidepressant problem out. I hope your grandmother will be feeling a little better once she is settled on her new drug.
Aly

 

[sanderson]

This is good news. Thank you for being there for your Grandmother and being her advocate. I hope that the new medication will help, it usually takes 2-4 weeks before the medication is fully at capacity but some folks do start to feel better much sooner. Again, thank you for being there for her and supporting her.

 

[Katie C]

Nicely done! You are a good advocate for your grandmother!

 

[Bad Balance]

Good work Susan!