Geriatric Depression
Q.I finally convinced my mother that Grandma should be evaluated by a psychiatrist. My mother met with Grandma's doctor, who agreed that he had felt for some time that she was depressed. Grandma's doctor, however, won't take any action or make a referral until all five of Grandma's children agree. That's the problem. The children range in age from 60-70+. One of Grandma's children fears that Grandma will be sedated rather than having her depression relieved. Two others believe that Grandma will react by thinking that her children think she is crazy (ironically and tragically, both of these people lost teenage children to suicide). One (who was hospitalized many years ago for severe depression) has not replied. Money is not the problem, although they voice concerns; I think it's just another excuse. Grandma has quite a lot of money (at least I think so - my mom thinks so, too), and her children do not need the inheritance.
A.One word: Euthanasia. If she wants to die, let her. Don't force her to live a useless and miserable life. I expect the AMA and most sci.med readers are against this idea, due to the legal penalties Dr. Kevorkian faces as well as the fact that sick old people are a doctor's best customers. Clearly, your grandmother is not a minor. If she is also lucid, and capable of making decisions, then why the "committee" to determine whether she needs medication for depression? It seems to me that it is time to consult with another psychiatrist. If she were suffering from arthritis, would the MD require a family consensus to treat her? Somebody should ask Grandma what her wishes are. If she is herself dead set against a consultation the odds of its being helpful are much reduced. On the other hand, if she's open to seeing or wishes to see a psychiatrist, her primary care doc really oughta refer her. The failure of Grandma's doctor to make the referral without everyone's approval seems really strange to me...why not calll him/her and ask for an explanation. Certainly he would not wait for everyone's approval if she needed a podiatrist or a surgeon. A referral from grandma's doctor is not really necessary to arrange for a psychiatric evaluation; there may a psychiatrist or psychiatric nurse who could see grandma at the nursing home. The Psychiatry Dept at Univ Colo (in Denver) has a very good reputation; you might call there and see if they have a division of geriatric psychiatry or could recommend a service or practitioner closer by. As for convincing the aunts and uncles - forget it. Go around the primary care doctor if necessary. Don't worry about hurting his or her feelings. Grandma's feelings are more important.
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