She sounds to me seriously depressed. First of all she needs to change primary care doctors. In my experience Physician Assistants or Nurse Practitioners do a much better job. How long ago did she have hip surgery? Having gone through very similar situations myself, I would advice that she change meds first of all. For me CYMBALTA did the trick. If Lexapro is not working she needs to try something different. If you can afford it, vitamin supplements are a must. Has she had a blood test? They should test for deficiencies, primarily Iron. A good counselor would help also. Talk therapy works, though hard to find someone who will take Medicare, they DO exists.
Write to me at rochanah2000@yahoo.com. I have several more suggestions.

She sounds to me seriously depressed. First of all she needs to change primary care doctors. In my experience Physician Assistants or Nurse Practitioners do a much better job. How long ago did she have hip surgery? Having gone through very similar situations myself, I would advice that she change meds first of all. For me CYMBALTA did the trick. If Lexapro is not working she needs to try something different. If you can afford it, vitamin supplements are a must. Has she had a blood test? They should test for deficiencies, primarily Iron. A good counselor would help also. Talk therapy works, though hard to find someone who will take Medicare, they DO exists.
Write to me at rochanah2000@yahoo.com. I have several more suggestions.

Since your mother in on Medicaid, she can get free mental health counseling at your community mental health center. This could include seeing a psychiatrist for a new prescription as well as getting a therapist and/or a case manager who could provide additional support.

The worker probably won't call you back because of the HIP PA confidentiality rules, but you could support your mother to make the call while you are there with her. If your mother gives permission to her worker over the phone, then you could continue the call yourself with the worker. Good luck! Sally

Since your mother in on Medicaid, she can get free mental health counseling at your community mental health center. This could include seeing a psychiatrist for a new prescription as well as getting a therapist and/or a case manager who could provide additional support.

The worker probably won't call you back because of the HIP PA confidentiality rules, but you could support your mother to make the call while you are there with her. If your mother gives permission to her worker over the phone, then you could continue the call yourself with the worker. Good luck! Sally

My husband has had brain cancer for over 3 years. We have spend a lot of time consulting many specialists: neuro-oncologist; neuro-psychiatrist; and palliative care oncologist. They all work hard to try to get the right balance of meds for his depression, fatigue, and other symptoms and side effects. For us, the fatigue/depression has been the most challenging. One feeds the other. We've had only limited success, but they haven't given up trying to find meds/treatments that help. He also sees a psychotherapist regularly who communicates with the neuro-psychiatrist. His behaviors sound very similar to your mother's: not answering the phone or calling people back - he has great difficulty relating to people over the phone, gets confused about who they are, and has trouble maintaining a conversation, and forgets who called or what they said. He never calls anyone back. The docs say that, due to his brain trauma from the cancer/radiation/chemo etc. he is unable to initiate social interactions and is very passive.
His fatigue is very real although not physically induced. Walking any distance or even standing for more than a few moments is exhausting to him. If he gets up for a meal, he has to lie down and rest for a few hours. If we go out to a doctor's appt. or to visit our grandkids, he takes 2 or 3 days to recover. We got him a power scooter to get around but he hates to use it in public. (He's only 52 and it hurts his pride.) He's very sensitive to noise and lights and a lot of a going on around him exhausts him. He is happiest in bed in a darkened room, or sleeping in his recliner. He says it's easier to hide away and not have to try to be normal. I try to be as supportive as possible. I used to nag and pressure him to be more active, but it only made him feel worse. Now I try gentle encouragement and try to accept his limitations. It's been very hard for both of us. I hope you can find supportive doctors. We've been fortunate. By the way, my husband is on Medicare due to disability. It helps but we have a lot of out-of-pocket costs, especially meds. (He hit the "donut hole" last year. That was expensive!!) Good luck to you!

My husband has had brain cancer for over 3 years. We have spend a lot of time consulting many specialists: neuro-oncologist; neuro-psychiatrist; and palliative care oncologist. They all work hard to try to get the right balance of meds for his depression, fatigue, and other symptoms and side effects. For us, the fatigue/depression has been the most challenging. One feeds the other. We've had only limited success, but they haven't given up trying to find meds/treatments that help. He also sees a psychotherapist regularly who communicates with the neuro-psychiatrist. His behaviors sound very similar to your mother's: not answering the phone or calling people back - he has great difficulty relating to people over the phone, gets confused about who they are, and has trouble maintaining a conversation, and forgets who called or what they said. He never calls anyone back. The docs say that, due to his brain trauma from the cancer/radiation/chemo etc. he is unable to initiate social interactions and is very passive.
His fatigue is very real although not physically induced. Walking any distance or even standing for more than a few moments is exhausting to him. If he gets up for a meal, he has to lie down and rest for a few hours. If we go out to a doctor's appt. or to visit our grandkids, he takes 2 or 3 days to recover. We got him a power scooter to get around but he hates to use it in public. (He's only 52 and it hurts his pride.) He's very sensitive to noise and lights and a lot of a going on around him exhausts him. He is happiest in bed in a darkened room, or sleeping in his recliner. He says it's easier to hide away and not have to try to be normal. I try to be as supportive as possible. I used to nag and pressure him to be more active, but it only made him feel worse. Now I try gentle encouragement and try to accept his limitations. It's been very hard for both of us. I hope you can find supportive doctors. We've been fortunate. By the way, my husband is on Medicare due to disability. It helps but we have a lot of out-of-pocket costs, especially meds. (He hit the "donut hole" last year. That was expensive!!) Good luck to you!

Thank you all for your responses. To clarify a few points, her hip replacement was in August 09, brain cancer and treatment in July 2002. She is on Medi Cal not Medicare (because of her age), and they are reviewing her case for Medi-Cal for disability. I don't live in the same town or county, even, so I really appreciate all your advice for who can help her. I will look into getting her services at the county mental health office and try to find her a new doctor. This one she has now was the only one I found who would take an uninsured patient, but now that she has Medi Cal I can try again. Dundonian- good luck with you and your husband. Thank you for sharing information about his condition..

Thank you all for your responses. To clarify a few points, her hip replacement was in August 09, brain cancer and treatment in July 2002. She is on Medi Cal not Medicare (because of her age), and they are reviewing her case for Medi-Cal for disability. I don't live in the same town or county, even, so I really appreciate all your advice for who can help her. I will look into getting her services at the county mental health office and try to find her a new doctor. This one she has now was the only one I found who would take an uninsured patient, but now that she has Medi Cal I can try again. Dundonian- good luck with you and your husband. Thank you for sharing information about his condition..