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Tuesday, July 06, 2010 michelesr89, Community Member, asks

Q: My mother- is severely sick. I need some advice as to what to do. please help me answer this.

my mother has paranoia schizophernia disorder- manic depression, bipolar and has had these disorders for about 15 - 16 years now. It has recently ( past two months) gotten much worse. Ever since her first nervouse break down she has been in and out of the hospital 2-5 times a year. She went a whole year without going once 8 years ago. The last two months she has been hospitalized 5 or 6 times. It is getting hard to keep count and this is only in the time frame of 2 months. She is Needing to go back very badly right now. It is so hard to make the call for her to go because everytime she refuses and cops have to get involved. She was actually arrested before for trespassing at her bank. Yelling and screaming at a clerk, as she was asked to leave she refused and continued to yell. The cops came and she gave them a hard time and they charged her with tresspassing. She was arrested and taken in. My oldest sibling went down to get her, as she was just to sign a piece of paper and would be able to leave, she would not sign the paper. she thought if she signed it that the sheriff was evil and she would be signing paper saying she would be hurt. she believed the sheriff was a bad person out to get her. as she thinks about many people. She ended up choosing not to sign and stayed in jail over night. She has done some very outrageous things and cops have been involved countless numbers of time. that was the first time she was in custody and sent to a holding cell, and charged with something. Unfortunatly the whole police department knows her. My Father couldn't take it and about 4 years into it, as her disorder started, he had to leave her. She was to leave the house and was sent to a homeless shelter where she stayed for 2 months until she was able to move into an apartment paid for by the government. She was living with people with disorders as well and gone through many different apartments with many different roomates because of her not being able to get along with her roomates. She now lives alone, and stays in her apartment all day everyday. she leaves to grocery shop, and takes a walk here and there. these days she doesnt leave at all. People bring her medicine every morning and watch her take it. as she has had a problem taking her medicine on her own since i can remember and that causes her to have to be hospitalized. This is just a few things that go on. I have been dealing with this problem all my life, and It gets better, and than it gets worse. its very hard to deal with because this is my mother and i care about her and love her more than anything.I just want some answers. It seems as though her case manager and the Pact team as they call themselves really don't care, nor do much about it. she gets hospitalized and is released in a few days, a week, maybe 2 weeks at a time, when she is most certainly not ready to go home. the voices she hears all day everyday and says she cannot sleep because they won't stop. They threaten to kill her and she changes the locks on her door about twice a month because she believes somebody has her key all the time. especially when she is hospitalized, not a home for a period of time, when she gets back she always believes somebody has been in the house. I don't know what to do. I try to be there for her and go see her a few times a week but theres only so much i can sit and listen to her. Its extremely difficult because the things she says are absolutley unreal. its hard on me, because when she tells me something like i have been talking to them to and i say no she calls me a liar and gets angry. she thinks i am in on whatever they are trying to do. that i hear the voices and talk to them to. she believes me and my two brothers all have twins as well. and my father is a twin and has always been a twin since they met in Korea a very long time ago. They had a rough marriage, money was tight, my dad was going from job to job, they had 3 kids to take care of, and when my mom got to the states she barely knew any english and my father was always working. she worked for a few years until she was diagnosed with the Schizophrenia Paranoia Disorder. She had to be let go because she was hospitalized to much and missed to much work. she worked one other job after that and then had to stop all together, and hasnt worked since. So i guess my question is, as i said before the last few months shes been hospitalized about5 or 6 times and is in need to go back but it seems she gets out is a little better and then gets way worse as she is right now. I dont know what to do. i feel helpless and i want to know if there is something i could do to help in some way. Should i make the call for them to come take her back to the physch ward? Please help me. I am so scared for her life. I can't be there everyday all day and i need to do something.

And like i said she has always had a problem taking her medicine. our guess is that she isn't taking it everytime she goes crazy. They come and watch her take it in the morning, but in the evening she is suppose to take it before bed on her own. We assume she doesn't take it at night. She has is stuck in her head that God heals all and there is no need to take medicine- about 14- 15 years ago a church she attended told her that. She will get very defensive and angry when me and my siblings ask her is she is taking her medicine and says she is every time we ask. She complains about the side effects all time- make her gain weight. eat all the time. sleep all day. so when she is now telling me she hasnt slept in days and isnt eating ( which is very noticeable is why we assume she stops taking the meds because of the side effects) She thinks the world is out to get her and is telling me the voices won't stop, it saddens me and i really need to know what to do so please help me even if it is advice that could help. i would do anything for her and dont want to lose her so please help me! thank you.

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Answers (2)
Christina Bruni, Health Guide
7/12/10 9:56pm

Hello michelesr89,

 

I'm sorry to hear of the unbearable distress you are in and have been in for most of your life living with a mother who has schizophrenia and lacks the awareness that she has a medical condition.

 

I believe you are a good daughter and I believe you have been doing the best you can over the years to cope with this situation so I want you to know I doubt there is more you could've been doing without help and a unified front if there was none.

 

Going forward I know you will also make the decisions you feel you need to make to help make your mother's life more comfortable.

 

Like I said I would hate for you to be hard on yourself in light of this challenging, seemingly intractable problem.  You love your mother dearly and do not want to see her this way.

 

Now:

 

You are no stranger to the "revolving door" syndrome where a patient is released as soon as possible even if they haven't gotten well enough to leave and when they promise to take the meds when they get out and then don't when they're in the community.

 

Hence the revolving door and your mother is not getting the help she needs.

 

I want to tell you something about a symptom of schizophrenia that affects a hemiphere of the brain and affects up to 50 percent of the people who have this illness.

 

It is called anosognosia and that is the term for the symptom where the patient lacks the awareness that she has an illness.  So her reasoning will go: "I'm not sick so why do I need to take the medication?"

 

Xavier Amador, PhD wrote the book I Am Not Sick, I Don't Need Help (you can buy the 2007 updated edition if you want) exactly about this syndrome and how to persuade a loved one to get in treatment and take the meds.

 

I feel I need to do the necessary by referring you to the interviews I conducted with Xavier here at the Connection.  You can read my Xavier Amador Interview One and Xavier Amador Interview Two to get an overview of the techniques he talks about in his book.

 

His own brother Henry he convinced to take meds even though Henry did not believe he was sick.  Your main concern is not to try to convince your mother she is sick, the thing to do is to help get her treatment.

 

If she has advanced in years she might need to live in mental health housing specifically for senior citizens where the staff give her her meds and assist her in her daily living.

 

A woman I know who had to have her son hospitalized when he was having a relapse did this: called her son's psychiatrist and told the doctor to call the psych ER and tell the staff: "David is coming in and he's to be admitted, he's not to be released."

 

Hopefully your mother has the kind of psychiatrist who could call ahead and tell the staff to admit her long-term and not release her in three days or even three weeks.

 

What also comes to mind is that a short-term hospital might not be geared to admit patients for longer than two months and she might need some kind of residential inpatient hospital where she lives on the grounds permanently or at least for a longer duration than a month.

 

Screwing up the courage to make that kind of decision for your mother will not be easy of course.  Yet it doesn't seem like she's capable of living on her own at this point.

 

Your mother is most likely one of the more challenging PACT or ACT clients.

 

However it might be a start to have a dialogue with her PACT team and to ask about a move to a permanent facility.

 

With some people who suffer from anosognosia it is possible they will never come to the realization on their own that they need help.  Xavier recommends building a relationship of trust with your loved one and linking their goals in life with how taking the medication will enable them to achieve their goals.

 

From the length and depth of your question however I wonder even if rational conversations are possible.  However this problem didn't happen overnight and any solution will not occur quickly either.  So I feel your option is to read the interviews I did with Amador and read his book, see if anything he says makes sense and also consider the strongest approach you need to take if you need to take that approach right now.

 

It is possible your mother is "cheeking" the medication when the staff come to give it to her however I don't know this, they might be checking inside her mouth.  Only if they are not checking she might be "cheeking" the medication and really not taking it even with supervision.

 

This of course is of no comfort to you.

 

Let me know if any of this is helpful to you.

 

A last thing: I hope you siblings can come on board and help you with this so that you don't have to make the decisions on your own although of course you might have to do that.

 

Whatever you do it's not going to be easy and I can understand this.

 

For added support I recommend you contact your local NAMI chapter.  Call (800) 950-NAMI (6264) to get the name and number of the local affiliate in your city or town that hold family support meetings.  Their members might have even more ideas for you based on their own experiences living with a loved one with schizophrenia.

 

Feel free to ask amother question, to respond to my answer, or even write a SharePost to get support two.

 

Regards,

Christina

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celia, Community Member
2/ 3/11 11:44pm

did you tried holistic/natural healing... herbs etc?? can help a little. Or may be she is allergic to something, medications or...??? I read a nurse that saw changes in her mother and after observation, one of the medications was really bad for her mother once the dr. modify and change the medication the mother improved. Some drugs are Not good for old people. good luck

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By michelesr89, Community Member— Last Modified: 10/26/11, First Published: 07/06/10