Ask Dr. Keith Roach M.D

Ask Dr. Keith Roach M.D

DEAR DR. ROACH: I would like your advice concerning my 75-year-old boyfriend, whom I have known for eight years. He had what I suppose would be called a nervous breakdown two years ago. He was admitted to a mental hospital for seven days.

He came out on olanzapine, lorazepam and Wellbutrin, and now has been prescribed mirtazapine and was told by the doctor – an MD specializing in geriatric medicine — that it is a 'sleeping pill.'

This was a man who was a lot of fun to be with and who had a keen sense of humor. He now shows only one emotion, irritation — at traffic, long lines or at me if I try to talk to him about his medication or how his personality has changed.

His daughter makes the doctor appointments and lays out all his medications for the week. She claims her only concern is for what is best for her father and that I am not to interfere. She criticizes any decisions he makes, leading him to feel he is incapable of making any decisions on his own, which is eventually going to be the case, as I see his brain function deteriorating from all this medication. He now makes few decisions on his own but calls her for everything. She then gets irritated with him and yells at him like he is a child. I suppose because he is bothering her. I am able to get him to walk with me every day. We live in the same condo complex; I make sure he has lunch, and we always eat dinner together.

I am watching him become more and more a zombie, with no interest in doing anything and unable to follow even the story line of a movie. He never laughs at a joke or funny incident. A smile is rare, and he used to have such a warm smile and a twinkle in his eyes. Now there is only a dull stare.

Is this a form of elder abuse? If it is, what steps should or could I take? -P.B.

ANSWER: Yours is a heartbreaking letter, and I hope I can be of some help. Let me begin by admitting that I don't know why your friend's personality is changing. You blame the medicines, and you might well be right, but it certainly is possible that it is an underlying neurologic or psychiatric disorder. Were I taking care of him, I would be tempted to stop all his medicines and watch him very carefully to see how he does and whether he needs all of them.

You ask whether this is elder abuse. Elder abuse is common and can be much more overt, with physical, sexual and financial abuse. Based on what you are telling me, it sounds like verbal abuse, which is a type of mistreatment.

If you have witnessed or suspect mistreatment, you can and should report it. You can find out more information on elder abuse from the U.S. Administration on Aging's National Center on Elder Abuse by calling 800677-1116 or visiting www.ncea.aoa.gov.

*** Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.c ornell.edu or request an order form of available health newsletters at 628 Virginia Dr., Orlando, FL 32803. Health newsletters may be ordered from www.rbmamall.com.