Navigating Care for Aging Parents: Addressing Health and Emotional Challenges

Q: Navigating Care for Aging Parents: Addressing Health and Emotional Challenges

Dear concerned child： Hello. <br>Your mother has experienced a change in personality and a decline in health due to a recent illness, resulting in loss of appetite and sleep disturbances, along with tendencies towards depression. <br>The sudden onset of multiple health issues in

My mother's health is deteriorating, and as her child, I feel anxious but helpless?

Dear Doctor,
My mother was hospitalized for cellulitis in her arm at the end of September, receiving antibiotics for three weeks at a local hospital and Cheng Kung University Hospital.
Since then, her appetite has significantly decreased.
After being discharged, she often cries at home and expresses nihilistic thoughts, such as wanting to stop eating and drinking and sleep indefinitely.
She has been physically weak and unable to walk independently for two months, which raises concerns about her possibly having depression.
I have been trying to avoid mentioning depression or psychiatric care by suggesting we see a doctor for appetite-enhancing medications.
However, the medications prescribed by the psychiatrist (antiemetics, probiotics to stimulate appetite, potassium supplements, and anxiety prevention) have not improved her condition.
Before her illness, my mother was very active; the neighbors loved chatting with her, and she was often chosen to accompany them on outings.
She frequently made delicious snacks, like sticky rice dumplings, to share with the community and was always involved in local activities.
This illness has completely changed her lifestyle, and I wonder if it has significantly affected her mood.
Currently, she has a poor appetite, experiences frequent vomiting, and suffers from severe bone density loss, requiring pain medication to sleep.
During these two months of immobility, I have noticed muscle atrophy and weakness in her limbs, and I fear this situation will worsen.
I am unsure if she could benefit from hospitalization for treatment, possibly starting with a nasogastric tube for feeding to help restore her digestive function.
Adequate nutrition is crucial to prevent further deterioration.
I am genuinely worried that if we do not take action soon, we might miss the critical window for treatment, leading to lifelong regret.
I regret not paying attention to her health, as I have been preoccupied with personal pursuits and have always thought her ailments were minor and could be managed with outpatient medications.
I am truly frightened by the current situation.
I am discussing with my employer the possibility of taking a leave of absence to accompany her for medical care, but I am unsure of the right direction to seek help.
I kindly ask for your valuable advice based on the information provided above.
Thank you.

Wei Ren Zi Xin Ji Ru Fen, 40~49 year old female. Ask Date: 2018/11/23

Dr. Liang Yinpan reply Geriatrics

Dear concerned child: Hello.
Your mother has experienced a change in personality and a decline in health due to a recent illness, resulting in loss of appetite and sleep disturbances, along with tendencies towards depression.
The sudden onset of multiple health issues in the elderly can indeed cause anxiety for children who may feel unsure about how to provide treatment.
I recommend taking your mother to the Geriatrics Department at Cheng Kung University Hospital, which has a comprehensive and professional program.
She should receive a thorough evaluation and assessment, which should lead to significant improvement.
This is from Liang Yin-Pan, Geriatrics Department, Changhua Hospital, who cares about you.

Reply Date: 2018/11/23

More Info

Navigating care for aging parents, especially when they face health and emotional challenges, can be an overwhelming experience. Your mother’s recent hospitalization due to cellulitis and her subsequent decline in appetite and emotional well-being are concerning signs that warrant immediate attention. It’s important to recognize that the changes she is experiencing may not only be physical but also psychological, potentially indicating depression or other mental health issues.

Firstly, it’s crucial to understand that significant health events, such as hospitalization, can lead to a profound impact on an elderly person's mental health. Your mother, who was once active and engaged in her community, may be struggling with feelings of loss, helplessness, and depression due to her sudden change in lifestyle and physical ability. The symptoms you describe—loss of appetite, frequent crying, and expressions of hopelessness—are indeed indicative of depression, which is common in older adults, especially after a significant health crisis.

Given her current condition, it is advisable to seek a comprehensive evaluation from a geriatric specialist or a psychiatrist who specializes in elderly care. They can assess her mental health and determine if she is experiencing depression or another mental health disorder. It’s important to approach this sensitively; you might consider framing the visit as a general health check-up rather than focusing solely on mental health, as this might make her more comfortable.

In terms of her physical health, her poor appetite and the resulting weight loss can lead to further complications, including muscle atrophy and increased frailty. If she continues to refuse food and is unable to maintain adequate nutrition, hospitalization may be necessary. In a hospital setting, she can receive nutritional support, potentially through a nasogastric tube if her condition does not improve with oral intake. This would help ensure she receives the necessary nutrients to regain her strength and improve her overall health.

Additionally, addressing her pain management is crucial. If she is experiencing significant discomfort that prevents her from sleeping or engaging in daily activities, it’s important to communicate this to her healthcare provider. Effective pain management can significantly improve her quality of life and may also positively influence her mood and appetite.

As you navigate this challenging time, consider the following steps:
1. Schedule a Comprehensive Evaluation: Arrange for a visit with a geriatrician or psychiatrist who can evaluate both her physical and mental health. They can provide a tailored treatment plan that addresses her specific needs.

2. Discuss Nutritional Support: If her appetite does not improve, discuss the possibility of hospitalization for nutritional support. This can help prevent further deterioration of her physical condition.

3. Pain Management: Ensure that her pain is adequately managed. Speak with her healthcare provider about adjusting her pain medications if necessary.

4. Emotional Support: Encourage her to engage in activities that she enjoys, even if they are modified to her current abilities. Social interaction, even through phone calls or video chats with friends, can help lift her spirits.

5. Involve Family and Friends: If possible, involve other family members or friends in her care. Having a support system can alleviate some of the emotional burdens on you and provide her with additional companionship.

6. Self-Care: Remember to take care of your own mental and emotional health during this time. Caregiving can be exhausting, and seeking support for yourself is equally important.

In conclusion, your concerns for your mother’s health and well-being are valid and reflect a deep care for her. By taking proactive steps to address her physical and emotional needs, you can help her navigate this challenging period and improve her quality of life. Don’t hesitate to reach out for professional help; it’s a sign of strength and a crucial step in ensuring your mother receives the care she deserves.

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