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My Father has extreme anxiety about his health and is afraid of dying. He has COPD, lives alone, still drives, cooks but mostly watches TV. He goes to Dr. frequently because he is always worried. 2 of his friends recently died which made the situation worse. He refuses to go to an independent/assisted living place because he doesn’t want to spend the money. Any suggestions on how to ease anxiety? He doesn’t like his preacher and I’m not sure he would go to counseling.

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There are needs for anxiety and depression. They work. Has he been seen by a geriatric psychiatrist?
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Mds1954 May 2019
Thanks for responding. He currently is on 50 mg of Trazadone which is used off label for sleep aid and anxiety. He used to take Xanax to help him get to sleep but I took him to a Geriatric specialist who said to wean him off Xanax because he had become addicted to it. I’m trying to get his Dr to suggest a Geriatric Psychiatrist. He won’t listen to me.
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Sounds like my 81 year old mother in law, who doesn’t drive. Her Anxiety started when her husband went into hospice. Her anxiety made the COPD flare up & it wasn’t good. AT ALL! What helped her was Xanax, she’s tiny & is on the very lowest dose. It’s been a miracle drug for her. No side effects. Zoloft landed her in the hospital twice for critically low sodium. Numerous other drugs just left her sleepy, it was really a trial & error search! If you do go the medication route, please watch carefully for side effects.
(My mother-in-law’s primary care Dr. is taking her off the Xanax because she doesn’t like the drug at all, period. It had been prescribed by the heart doctor. <sigh>

Best set of luck in a search for something that works!
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anonymous903302 May 2019
Great response.

Xanax is a quick acting med, and lasts maybe 4 hours. At low dosages. And it's the "go-to" anti-anxiety med from many doctors. It's really best for "as needed" when you can feel an anxiety attack coming. Or know that you are walking into a situation that will cause anxiety. It works, short-term. It is not the best treatment for chronic day and night generalized anxiety.

And, also, totally on point comment about the Zoloft. I think I was writing my first comment at the same time you were writing yours.
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Yes, as BarbBrooklyn said, there are meds for anxiety and depression. And a psychiatrist is the right way to go.

I understand. My mother, 91, is off the charts for anxiety. But, she is very low tolerance for meds, and a fall risk, and has COPD. So, there's only so much we can do as far as meds.

Tip: For depression, it's very tricky. There is no great testing to figure out which of the major neurotransmitters need to be treated. So, most likely, the doctor will just assume it's serotonin; maybe prescribe Zoloft.. Which may not be the right neurotransmitter to try to treat. Also, with elderly patients, they prescribe low dosages and the meds take up to 3-4 weeks to have any effect.

For anxiety, there are many meds that can help.

Tip: Important to know your father's usual schedule, day and night, so you can tell the doctor when his anxiety is at its worst, when your father leaves his house, when your father drives, when your father sleeps, etc.

Also, is your father generally a low tolerance or a high tolerance person with respect to meds?

Ideally...and that's hard to accomplish....you can end up finding the right anti-anxiety med, to be taken at the right times of day and night, so that the meds do not add a fall risk or daytime drowsiness or driving risk or depressed respiratory (since your father has COPD).

Please let us know what happens after taking your father to a psychiatrist.

Yes, I am assuming that you will do that!
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Medication along with a geriatric psyc eval or equivalent sounds like a good way to go. The other things you/he could try are first getting more exercise, being sedentary could be contributing to his body not managing anxiety, especially if was an active person his body may not know how to handle physiological surges it has always had without exercise. The other thing to make sure he's doing is hydrating well enough and of course eating right. Scent can also help, there are a variety of scent's either from herbs or essential oils (pure not the perfume or soap versions) diffused into the room or applied to skin or placed on clothing/bedding can have a much greater affect especially on anxiety than you expect. It's even been studied and proven in hospitals. Then there is deep breathing if he can do it or convinced to try, deep slow "cleansing" breaths can help calm a person but if they haven't been exposed to it in their lifetimes that may be hard to introduce and hard to do with COPD. Pick up a good quality Lavender essential oil and wear it around him or put it on his sheets/pillow, on the couch maybe and see if that helps at all. Don't tell him about it at first and then if it seems right tell him about it, the knowledge could help or hurt depending. Anxiety is so difficult to both go through and watch a LO go through I hope you find the thing or things that help.

COPD in itself can be anxiety producing, depending on how difficult his breathing is or how often he has "attacks" air hunger terrifying both to the mind and the body, it can become a vicious cycle pretty quickly if you can't calm down. I'm so sorry you are both going through this.
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I’m sure I will have anxiety when Im 87 (if I’m lucky enough to live that long).

It must be terrifying to lose multiple peers.

Why dont you see if you can find him a resource to meet new friends his age.

Maybe there are programs or activities that would interest him in your community or church.

Do do you have any friends with parents that he could meet occasionally?

Help him develop new social outlets.
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Speak with his physician. When this happened with my DH, I made the decision to allow him to be put on Zoloft and it really helped stop his anxiety.
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Mds1954 May 2019
Thanks for replying. We were hoping the Trazadone would help but I guess we need to revisit that. Maybe Zoloft or another antidepressant would be helpful. He doesn’t like to take meds so compliance may be an issue.
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Get him Life Alert. Also, reassure him about what's waiting for him when he dies - his parents, wife, peace, healing. People are afraid of the unknown! Tell him you will be fine and will take care of the things that are important to him. A bit of anti-anxiety med might be helpful, as well.
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Mds1954 May 2019
He does have a life alert and has used it several times. I have a friend who is a retired Pastor who I will try to have visit him. Unfortunately his pastor is horrible. He even got a letter from his pastor asking him to join the church - my Dad has been a member for 50 years. 😳 I’m going to try to make an appointment with his Dr and travel down to go to the appointment with him. We need to discuss medications and options that will address anxiety and sleep issues without making so druggy that he Falls. Difficult times.
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I found comfort in listening to podcasts or YouTube videos from Near Death Experiencer's. Here is one link from Tricia Barker interviewing Jeff Olsen. https://www.youtube.com/watch?v=OQlKWCQDi_w
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Mds1954 May 2019
Thanks for replying. I wonder if I could get something like that on CD or DVD. I’ll have to check. Good idea!
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Now it is time for YOU to become the parent and the boss. Talk to him gently that every human is afraid of dying and it is normal. Can the doctor prescribe something to calm him down a bit? He is feeling the loss of his friends and does not want to change what he still has. If he has the means for his care, try to get a Power of Attorney and then look into a suitable place for him where he can get care and hopefully make some new friends. It can be done. And if he won't go to counseling, is there anyone "valid" who would come to the home and visit him and talk with him? If he is not willing to cooperate, and there is nothing you can do, then he has to suffer because you can't fix it and it is not your fault and you should have no guilt.
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See if his physician can prescribe some anti-anxiety medication. Assure him that everything will be okay. Elders are more afriad during night time hours.
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Mds1954 May 2019
Thanks for your reply. I’m going to make an appointment with the Dr and go with him to talk about changing his meds. I don’t want to drug him up but I’m hoping to find something that also helps him sleep in addition to easing his anxiety.
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My mother is terrified of dying, always has been. She has dementia and delusions so no sense trying to talk to her now but she wouldn’t even bring up wills with her husband after working at Probate Court for 30 years. I just asked her PCP to give her an anti anxiety med and she agreed. She also takes a small dose of an antidepressant. Many seniors have depression and anxiety. And living alone doesn’t help if they can’t get out much anymore.
No one enjoys seeing their friends passing away one by one. When the last of my mother’s siblings passed away , she was abnormally upset by it since she said her whole family was gone( yeah, just a husband and 3 kids who she saw every week or so vs siblings she hadn’t seen in a decade or more🙄) . I thought it was more thinking of her own demise rather than grieving for them. My mother was never one you could talk to but if he’s willing, maybe see if you can at least tell him you understand, ask how he feels , how you can help etc.
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Mds1954 May 2019
Thanks for your reply. I think my Dad feels the same as your Mom, in terms of his friends death. Not so much grief for their families but reminders of his own mortality. He doesn’t have the skills to verbalize his feelings or even identify them. He doesn’t have dementia but he is not thinking rationally either. He doesn’t want to spend the money on an assisted living facility even though he can afford it. He’s hell bent on trying to leave his kids something. We told him we’d rather him be happy and in a situation where he could enjoy life.
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I am replying about the addiction issue, which presently seems like the big thing with many doctors, and has not helped in managing your mother’s issues. Doctors have spent decades over-prescribing highly addictive drugs (Fentanyl, Valium etc), but now seem terribly concerned about Codeine, which is the least addictive of all the opioides. They prescribe ibuprofen for babies, who can’t tell you if they are part of the 10% for whom it damages the stomach lining, and they prescribe many other common (and profitable) drugs with suspected side effects. Why have total faith in doctors getting it right? Use your own common sense as well.

Addiction is a problem when it leads to health issues, strong desires for ever higher doses, and an entry into the drug abuse business. I take a lot of Codeine when my scoliosis is very painful but have no trouble stopping when the pain incident is over. My husband has found over many years of experiments that regular Codeine with Aspirin is the only thing that controls his chronic migraine and allows him to be a useful productive person. So what if he is addicted – he isn’t robbing banks! Our doctor supervises us regularly to check on possible adverse effects, and he too thinks a lot of the baloney is just the ‘idea of the year’. For very elderly people, mild addiction is possibly the least of their worries – they get unlimited morphine at the end, for Pete's sake.

My own feeling is that if you find a medication that works well, look up the ‘adverse effects’ and see if you can pick them occurring. If it all seems OK, change doctors if you need to find one who isn’t simply following the latest scare tactics.
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Mds1954 May 2019
The reason his Dr wanted him off Xanax was because he was worried about my Dad being so drowsy it could cause a Fall. I’ll look into other options too. I have a very stubborn Father. Thanks for your response.
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When you say "extreme" anxiety... he does have things to be anxious about. He's 87, he has chronic lung disease, he's on his own, you're two hours away, and his friends keep dropping off the twig. In what way is his anxiety extreme, would you say? What does he do that expresses it?

When you say he goes to his doctor "frequently" - how often is that, and are you able to go with him?

I'm sorry for your father's situation, and I'm sorry that you're in the difficult position of worrying about him without there being an obvious answer. What I'm trying to dig into a little bit is what you would expect of him, and what is the best you could hope for?

Looking at the option you put to him of moving into an independent or assisted living community: so, you felt, when you suggested this, that if he were less isolated and had more help at hand and more people to talk to, he would feel better? And he dismissed the idea because he doesn't want to spend the money. Was that, would you say, a rational argument? Is he short of money? Does he have other plans for it? Or are there other reasons why he might not like the idea of change?
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Mds1954 May 2019
Thank you for responding. I agree , being 87, losing your friends, etc. would certainly be all reasons for anxiety. I think his Dr could prescribe better meds to address the issue, which is my first step to accomplish when I can arrange an appointment and go with my Dad. He has enough money to afford an assisted living facility- but he has always been frugal and is hoping to have money to leave to his 4 kids. We tell him to use it for him- he’s worked hard his whole life. He is by nature a social person so I felt that he would be happier in a place that had activities, food he didn’t have to cook etc. as far as frequency of Drs visits- sometimes every week. The problem is if gets worried about something he just barged into an office and demands to be seen - since he doesn’t have an appointment. He does this with his Pulmonologist, gastroenterologist, urologist, and family Dr. I have tried to explain to him that Drs are very busy with scheduled patients and that he should call first to see if they can work him in. He has a life alert button for emergencies. The senior service center has a “ buddy” program that pairs them up with someone to come take them places, out for lunch etc,. He vehemently opposes any of my suggestions. I’m just trying to help in the best way I know how. But he just doesn’t seem to want any help. I’m just very frustrated and feel badly that he refuses to agree to things that might make his life more enjoyable.
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I am no expert in this field and I am anti medication, but I found that certain meds like Seroquil and trazadone can do together. Worth looking into. It’s done wonders for my mom and she isn’t doped up.
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How many medical appointments - or barges, if more applicable - would you say your father has had over the last three months?

I have a ? mark over his seeming not to grasp the appointments concept, and wonder if scheduling and planning might be becoming difficult for him, which I would want to investigate gently if he were my dad. Other than that. If I'm going to be really honest. I wonder if the anxiety is felt more by you than by him? Would that be unfair?
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Mds1954 May 2019
His “barging” in can be as much as once a week. He is aware that appointments need to be made but when he is worried about something , that fear supercedes everything.
I don’t know that I would say I’m anxious about his situation. I am concerned and I want to make sure that I do right by him. I’m the oldest of 4 and the main decision maker for his care. My brothers live far away and my sister is only available to help sometimes. I live 2 hours away so I do a lot long distance.
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Meds I just picked up on your comment that "his pastor is horrible." And then that your father received a mailshot inviting him to join the church he's been a member of for 50 years.

If that is the only problem, make sure your father is not cutting his nose off to spite his face. So he was included in a mass mailing that shouldn't have gone to him - so what? Ignore it! Don't take it as a personal affront when there was no such intention.
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At 87--and we're worried about addiction?!!

Love of heaven, what a joke this 'war on drugs' has become!!

I had a friend who had to take codeine daily for chronic pain, She didn't know it was an opioid and when she found out it was, she called me, crying, 'I have to stop taking this! I am an addict!"

Seriously. Had to talk her off the wall. I also take it daily and while I am not proud of it, it allows my arthritis to settle down and for me to be functional. Am I addicted? Probably. Dr sees me every 3 months, we're just trying to keep me MOVING.

Xanax is fairly 'harsh' and when it stops working--wow, you really feel it. Klonipin (Clonazepam) has been, in my life, a godsend. It works longer and as it leaves your system, you don't even notice.
Yes, it is addictive. But it works for me every single time I take it. W/O it I would have ended my own life many years ago. Chronic anxiety is horrible.

Trazadone is OK for sleep, but not a good drug for men.

The fear of death is real. The fear of getting old and 'useless' is very real. Sounds like your dad needs some friends. And some hobbies. And some positive outlets. Everybody needs to be needed.
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Mds1954 May 2019
The worry about the Xanax by his Dr was that it could increase the chance of him falling and breaking a hip etc.
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An old hippy lady I met at the beach, suggested Marijuana. She said have my hubby smoke some and he will mellow right out. :-)
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Mds1954 May 2019
My daughter actually suggested that! Or CBD oil. Who knows? Maybe?
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My dad is a world class worrier, filled with fear all the time. Last year his primary care doctor added Zoloft to his meds, giving my dad little explanation, which was good in his case. My dad calls it his “attitude medicine” and while it hasn’t been a cure, it’s most definitely helped his anxiety.
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I think being alone allows his fears to escalate.  How about calling council on aging in his area and see what's available such as get-togethers with people his own age or a day time senior center?  

In my area (and we live in the boondocks) we have such an agency and they have many resources that may help your Dad.  We have a senior center where a bus will come and pick up my Mom (that stopped) but it was great when it lasted (my Mom met many people her age, played bingo, listened to music, etc.).

Get your Dad involved even if he grumbles about it so he won't have to be alone so much.   Being alone can be a person's worst enemy as the mind overthinks everything.

Best of luck,
Jenna
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