Psychiatric Nurse Practitioner Follow-Up

I spoke with mom’s psychiatric nurse practitioner this morning. The first words out of his mouth were: “She’s presenting well.” I laughed because she sure can present well when she needs to! We had a really good conversation. As my daughter mentioned might be the case, the doc thinks mom’s behavior is episodically driven at this point, and doesn’t think mom needs additional big-gun meds. What’s available in that arsenal is contra-indicated for the dementia patient. He did prescribe a dementia specific drug that ‘helps with mild delusions, irritability, and anger episodes.  It can help with dementia related mood and behavior symptoms.’ This sounds like the additional boost we need. Mom exhibits all of these symptoms, though it’s been six-ish months since I’ve seen any delusional symptoms.

Having this doctor’s perspective, from his specific specialty’s perspective, was very helpful and reassuring. For instance, while the holidaze are stressful for us, he helped me understand what they must be like through mom’s eyes now. She’s stressed and agitated anyways because she can’t remember things. Add new events, additional people, unusual decoration (lots of that), different routines at the community to celebrate the holidays (dinners for Thanksgiving, Hanukkah, Christmas, Tree lighting, New Years), seeing more of her own family (which triggers her), and it’s just not a joyful situation for deeply routine driven mom. 

I’ve been struggling, outloud with my DH, about whether we should attend the Christmas dinner at the community. After our chat this morning, I think we won’t. Spending 5-6 hours on Christmas Day together will be enough. The doctor said, “Sometimes you just need permission… Be guilt free.” Mom, 20 years ago, would have resonated deeply with that advice. 

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