Q: A psychiatrist has diagnosed my elderly mother with bipolar disorder or bipolar depression. Can you explain what that is?
Q: My mother and I live together, and I am her caretaker. I never married. Throughout my life, I can recall my mother feeling sad and other times when she was unusually happy. My mother is having difficulty caring for herself, and her primary care physician suggested she meet with a psychiatrist. I took her for the appointment and provided the psychiatrist with some additional information. The psychiatrist has diagnosed my elderly mother with bipolar disorder or bipolar depression. Can you explain what that is?
A: Bipolar describes someone who can feel depression at times and, at other times, a high elevation outside the norm, irritable mood, more talkative than usual, unable to focus, racing thoughts and a belief of feeling very important and sometimes doing risky behaviors.
Depression can be exhibited by sadness, tearful, loss of interest in activities, difficulty sleeping, weight loss (or weight gain), lack of energy, feeling worthless, slower movements or signs of agitation.
Some seniors can feel depressed for a period of time and then begin to feel a high feeling, which is called mania. Bipolar describes people who have the low feelings of depression and the high feelings of mania. For some people, the highs and the lows have always been their norm, and family accepted it. As the aging process takes place, sometimes what was accepted escalates to a new level. Some psychiatrists will recommend medications to help the wide mood swings.
Q: I am in charge of my aunt, and I find it difficult to make medical decisions on her behalf. We were never that close when I was younger, and it was my mother who volunteered my services. My aunt is in an assisted living facility and, as her health care agent, I am asked questions about her. How do I answer these questions?
A: Speak with your aunt’s siblings (if they are still living) and ask them questions about your aunt, and then ask them questions about their beliefs. You can also ask them what they think their sister would want in certain situations, such as resuscitator measures and treatment options. If that is not available, then you could hire a geriatric care manager to assist you in being an advocate for your aunt. The geriatric care manager can meet with your aunt to discuss topics such as a “Do Not Resuscitate” order and other related topics. The manger can also be a sounding board to you and help with decision-making. Your aunt is the client, which will allow the geriatric care manager to provide you with additional information on all subjects, including diagnoses, testing, etc.
Q: My mother is moving out of a rehabilitation facility soon, and I am worried that my mother will not be safe at home. I work full time and have a husband and young children at home. I have so many questions about my mother’s safety and about resources. Who can I contact at the rehab facility to discuss my concerns?
A: Contact the social worker or case manager at the facility. Ask for a meeting with the team that has provided your mother’s care. This must include a nurse, social worker and physical and occupational therapist.
Bring along a list of questions, and describe to the staff your mother’s day and what she could and could not do for herself prior to her admission. Bring up your concerns, and let the staff know how much you can or cannot help at home. Prior to discharge, you must know what services will be provided in the home, how often they will visit, what is a back-up system if someone does not show at the house, and what is covered by insurance and what must be paid privately.
It is important to ask if the city or town your mother lives in provides any free services to seniors. If you do not feel that the plan provides enough help for your mother, you must speak with the staff at the facility and meet again to discuss additional services in the home.
Debbie Gitner, a licensed certified social worker and certified social worker care manager, and Linda Sullivan, a registered nurse and case manager certified, are geriatric care managers and owners of ElderCare Resource Services helping families investigate, assess and choose medical and non-medical care and resources for seniors.
Send questions to firstname.lastname@example.org or ElderCare Resources, Inc., 29 Gano Road, Marlborough, MA 01752, or call them at 508-879-7008.