I am always asked to speak to a patient or a family member about someone’s medication regimen, often with a clear focus or intention. It could be to explain the indication of a medication, describe some common side effects and explain the rationale for the treatment duration. But almost always, the patient is not interested to talk about the medications or there is something else that needs to be addressed.
One time, I was asked to speak to an elderly lady with recent medication changes. But as soon as I started connecting with her, her medications were the last thing she wanted to talk about. She was depressed, severely depressed. She told me she was unhappy to be living in a retirement home. She was not on good terms with her two sons who lived miles away. She did not want to talk about her medications. Our conversation was filled with many moments of silence. It felt wrong to force her to speak about her medications when she was clearly not interested. I spoke with the charge nurse afterwards who reassured me that a geriatric psychiatry referral has been made but it would take some time for the team to come for a visit.
On another occasion, I was following up with a patient who was recently discharged from the hospital for his complex medication regime. It turned out that he was found with a butcher knife in his hand with an attempted suicide few days before. He was immediately sent to the hospital, only to be discharged quickly with a new prescription for an antidepressant and a plan for outpatient follow up. The retirement home has since removed any potentially dangerous objects from his room and he was placed under close observation. He too was not interested to talk about his medications. He explained to me there was nothing to enjoy anymore. All his close friends were slowly leaving him. His vision and hearing were deteriorating to a point that he couldn’t do anything. He sat there, feeling down and isolated. I wish his antidepressant would start kicking in soon but he would also benefit from psychotherapy which is often not easily accessible in the community.
Clearly, mental health support is desperately needed in our community. The federal budget has promised to allocate more funding for mental health initiatives. But would more funding address our mental health needs in the community?
I think as a community, we need to look after one another more. Perhaps we need to meet more often for coffee, connect with each other more , discuss, share or vent each of our problems, issues or concerns. Ultimately, we may not have a solution to someone else’s problem. But it can be incredibly therapeutic, just knowing someone cares, takes the time to listen and offer empathy and compassion. If we collectively do more of random kindness, reach out to connect with others and perhaps not as many people will develop clinical depression, anxiety or other mental health issues.
Maybe it is a naive way of looking for preventative strategies in mental health we can engage in. Maybe it is not. In the meantime, I find this link helpful when I am looking for ideas to brighten up someone’s else life when visiting an elderly living in a long term care facility. It describes 12 tips for one-on-one visits with seniors. It’s a good read for those who are looking for ideas to better engage seniors in their conversations.