Great depression; Are there psychiatrists that will come to our house? Can I force one on Mom?

My dear my heart breaks for you and your sweet Dad. Overall I think Mom has some major emotional issues that could stem from her dementia/alz symptoms, if I am reading all of this correctly. I am surprised the doctors are not admitting her for full review of her mental health and get official diagnosis.. Her level of paranoia is a sure sign of dementia or other ailments. Not sure how your sweet Dad is handling all of this emotionally. VERY hard on him I am sure. Check with your Dad's local senior facility to see if they have adult day care where he can drop Mom off so he has some breaks for himself. In addition call insurance to see what medical options she has. I have my Mom live with us and she is pretty frail in walking/moving and they have an in-home care Dr coming to check on her, hope they have something like that for your Dad in his area. There are many options. A Place for Mom is another good website to check for senior assistance in your Dad's area since you live far away, do some checking for him. Prayers to all of you in this life changing journey.

I don't know if this will help, but you can't make mom seek Tx. However, can you and dad find her a psychiatrist and make her appt, then lie to her? I know this sounds horrible, but sometimes we have to do what we have too. Tell her that you are taking her out for ice cream or to her favorite store, restaurant whatever you think will get her out. Of course afterwards you should take her where ever you said you would. Explain to the psychiatrist what is going on. In your case I would not push the meds because she may see that as threating. Tell her that you love her and worried about her, and you just want her to feel better.

I wish I had more to offer. I am sure someone else will come along with better advice.

I wish you the best.
Hugs!!!

Hi 1977. So sorry your family is going through difficult times. A few things you mentioned about your Mom are familiar to my Mom. Has your Mom ever been treated for her depression? That would be the first thing I would focus on. See if you could get the psychiatrist to prescribe something. Is It new behavior, her not taking bp meds? If so, this is unusual behavior for her and life threatening so you might get some help due to that. The paranoia could be something in addition, such as dementia. I would get in touch with a Social worker at the local hospital or referral through her primary care doctor to see what you can do as concerned family when mental state is not healthy for your Mom. My Mom was in such a bad depression once I had to be pretty forceful to get her to see a dr. When depression sets in people cannot help themselves. They get hopeless and need others to be their advocate. Best of luck. Golden Year’s. Sure, so Golden. Hang in there and I hope you can find some help. Your Mom AND Dad are lucky to have you.

Thank you, Helen. This is very helpful and I will check with the insurance company and A Place for Mom. This feels so overwhelming but I feel the need to act on this soon. The time is now. Appreciate the kind thoughts.

A place for mom is a placement agency and probably won't be able to help in this situation.

Is it possible to have her committed to a psychiatric hospital because she has become a danger to herself and your dad?

Where I live a spouse can initiate a committal. I know she is fearful of that, that tells me she knows her behavior is wrong. Bi-polar is so tragic and most people I know don't want to treat it because they like the manic times more then they hate the depression times.

Do some research on psychiatric hospitals in their area and call to find out how to get her committed. You may need to go be with your dad as it could be traumatic if she fights the police or whomever takes her to get treatment. Sometimes people change their minds about their loved ones because of the battle to force them to go. It is scary and chaotic, keeping your eyes on the end goal is pretty hard at that time.

I know this sounds harsh, but she really does need drastic intervention. She is having delusions that could turn her violent and end tragically for your dad.

As her spouse he is automatically her POA when she can't make decisions for herself and she is there.

As hard as it will be for everyone, this really is the necessary steps to get her help.

While she is in the hospital, find a facility that will take her. Talk to a certified elder law attorney, you can find one at www.nelf.org, and find out how to ensure that dad is still able to survive financially and how to get complete control over your mom.

Your dad is a pretty amazing man for loving her through this. It is time that he gets some peace instead of daily escalation.

Hugs for all you do and have done for your parents.

I wonder if the NAMI group might have some advice for getting help? There are chapters all over and while it tends to be parents in re to children with mental illness, as far as knowing how to handle emergencies, they may know or know of resources, including legal. Holding good thoughts for you...and as in my response somewhere below, also suggested adult protective services for guidance and resources

Call an ambulance....they know how to deal with this...she will be evaluated at the hospital....they will decide what the next step should be...just went through the same thing.....

Yes. Call her physician to arrange it.

In my state, you can only commit someone if they have been declared a danger to themselves and others. If she is threatening suicide or physically abusive to your father that could work.
That’s one of the biggest reason those with mental illness aren’t helped. It’s hard to force someone to take medication to begin with or continue after they start to feel better so the illness continues .
If there is a brain health department in a hospital system near them , they could do a better job of evaluation for dementia that a PCP or hospitalist. My mom was great at hiding her dementia until I took her into a neurologist who kept her talking until she eventually got into one of her delusional states, then we were off and running lol. With my mother, the madder she gets the more she loses control , the more she shows her true mental incapacity. But that takes time, a couple of questions won’t do it. I would think from your mother’s reaction to physical stress/ illness , she sure sounds like my mother’s dementia ( my mother saw horses and boats floating in the air outside her hospital room after she broke her hip) .
I hope you can get it straighten out. Mental illness is devastating for all involved, add dementia to the mix and it’s like living a nightmare.

Just a side thought, most mental facilities are NOTHING like you see in the movies. A lot of mental health programs use IOP programs where you aren’t committed, you daily go for intensive outpatient therapy with group support for 6-8 weeks , get meds balanced etc. BUT you have to be willing to get help. It doesn’t really seem like that’s her situation.
But even though a mental health facility may have locked outer doors but it’s like a rehab facility, public rooms, cheery atmosphere, support groups not straight jackets and locked up screaming people. They can hopefully make her get on medication that would help her. Don’t be afraid of her going to one, it’s not he** , it’s help.

Call the police and have them Baker acted if you feel they are a danger to themselves. But be aware psychotropics have side effects including increased risk of falling, hip fractures, and even linked to Alzheimer's disease itself. https://www.nejm.org/doi/full/10.1056/NEJM198702123160702

Lot’s of great information already and I will only add that my uncle who has major mental health issues and dementia was taken to a mental health facility after being escorted by ambulance to a local ER due to his acting out at his AL facility. After several weeks in a mental health facility, where he refused to take pills, etc., they ended up giving him a twice monthly shot that is supposed to help him with his paranoia, delusions, etc.

So if your mom isn’t willing to take pills, the alternative may be a shot. There may also be other meds in liquid form, since many medications are available for those who have difficulty swallowing (I’m not a pharmacist, so I don’t know for sure), so it might be worthwhile to see what works for her and in what form it can be administered. Perhaps so she won’t fight it or refuse it, they can just say it’s something else.

Start with a trained Social Worker and work from there. However, I will tell you now that this is sounding like a problem that is going to require placement in care. So sorry for all you are going through.

Your doctor can Recommend Someone, hun, To come and Evaluate her for Possibly a Facility...

Talk to her Dr. - tell him she won't take meds, etc. In CA Baker Act aka 5150 gets police involved. Easiest to take to emergency - sign papers and then refuse to take her home. They will do mental and put in rehab if warranted (Which it sounds like she may need). Also, look at "Laura's Law" - allows parent, spouse etc. to request help for her . Dad means well, but what if something happens to him? Then who will handle her? All too often caregiver wrecks own health and goes before patient. Then you would be forced to "in-patient" her. Better to see if she is "help-able" now than have a really bad melt down. ,

Dear Atl1977,

My heart breaks for you and your dad because so much of your situation and the life you have had is relatable to mine. My advice may be considered a little -or a lot unethical-, but extreme situations call for extreme actions. There are some natural medicines that are safe to take, such as hemp oil which is meant to calm anxiety. I haven’t tried it myself but have heard so much about it, very good things. I bought a bottle for my mom and she actually tried a little-too little to see any changes- because she was afraid.
But for some people it has been a life saver. There are many other natural remedies that you could even give to her without her noticing (this is the potentially unethical part, but as a daughter that is desperate to help, I really don’t care about ethics as long as I’m responsible and careful) she may take a good calming tea, plus like I said all natural meds in the right amounts are really harmless, yet should be consulted with a doctor ahead of time.

What I am thinking is that you could go see a doctor yourself and tell the doctor all your mom’s symptoms, bring with you all support as far as her physical state and mental state as well, all you have, and see what the doctor says. I did that, I went to see a doctor without my mom, the doctor even gave me medication that I could give to her, yet she never wanted to take it, but I think talking to a doctor will help you a great deal; a psychiatrist of course, as they will be able to understand a lot about the situation. During your visit also mention the natural meds possibility, the point is to try to get her calmed enough to hopefully reason a little with her and get her to see a doctor. The paranoia and deep depression are your worst enemies right now, so if you can get those under control a little, temporarily, just enough to get her to allow you to do anything, something, that is a key step. And I think once you talk to the doctor he or she could be willing to go see her, or at least give you helpful ideas.

People don’t understand me at all when I have to talk to my mom about something she should do and I wait, and wait, and wait sometimes weeks! so I can get her in a “good” day, meaning a day when her mood is a half inch above drowning line, so she doesn’t shut the idea down before I finish saying it. So you could also try to wait until she has a non so terrible day and talk to her. I think it is necessary for you if at all able to take some time to go be with them so you can really assess the current situation.

As far as your dad, could you possibly take him out of the situation temporarily? He needs a break badly, even if he doesn’t recognize it. He will likely tell you no, if he is anything like my dad was, but you still should try to give him a break, even if the break means him not leaving the house but you or someone else coming and interacting with her instead of him. Is he able to drive or go places on his own, even if to the supermarket? Or to seat somewhere to read the paper? Talk to him, from your heart. Look at him in the eye and ask him to please accept the break, to do it for you.

it is time for their unhealthy routine to be stopped for both of their sakes. I know too well that you cannot force anyone to do anything but you can and should try your best, being creative and inventive, and patient.

Hope you manage to help them, for them and for you because I know very well that as their child this is very important for you. May God bless you and give you the strength you need for all you have ahead!

I don’t see how this will get better without professional intervention. She’s abusive and cruel to Dad because she can. I’ve read many instances where the unruly become more passive, cooperative & polite in the presence of others, once they are placed in a facility where they are trained to deal with her issues. It sounds like she has the ability to “fake” normalcy, which I doubt she could do with Alzheimer’s or dementia. I don’t see how she can be diagnosed without 24 hour observation to provide proper nutrition & medication. I feel so bad for Dad. He is a saint but his own mental health is in jeopardy. While guilt and obligation frequently guide us, it’s not always in the best interest of anyone. Best wishes for you all.

No, i don't think you'll find a psychiatrist who will come to the house. You will likely need to take her to one. Medication can be very tricky, a matter of trial and error. Not at all easy

First look up all of the medicines she takes. Some of the problem may be found right there. Gabapentin (sp?) caused my mother to have hallucinations - bad, terrible dream like issues. Tramadol also caused depressed state, crying, major mood changes.

Do not depend on your doctor to tell you about issues caused by meds - you tell them about a problem and they add a med and usually without regard to issues it may create. Do you own research. With info in hand, discuss with your family doctor first. Do not just let him add another med.

While some of the meds may have helped with certain pain issues my mother has with severe osteoarthritis, the side effects were not worth it.

Forgot to mention, dementia (not necessarily Alzheimers) creates beliefs in her mind like you have described - people harming her, thinking husband having an affair, someone else wanting to have affair with him, believing people from the past have paid a visit. Also, that meds you give her are to harm her. Those may be part of the disease. Arguing will not convince her otherwise because they are very real in her mind. Sadly, it is what it is.

If dr has given you something that is supposed to help with the paranoia, is there a way to give it with other meds and perhaps she won't notice? Worth a tray for a while just to see if it offers relief.

You can suggest phone appointments. I learned from my mothers’s therapist that earlier generations are not usually open to talk therapy and it took a while for my mom to accept that her adult children are not counselors and for her to build a trusting connection with a stranger. Initially I encouraged my mom/WW2 survivor to go to-in person appts after the death of her youngest child. She reluctantly managed a few appts, yet there is so much unpacking of trauma to even get to the underlying causes of her lifelong depression which grows worse with age. At least now at 87 she’s started journaling and makes phone appointments when she feels like it. I set up the initial therapy through her medical care. It’s been now six years, and the two appear to have a trusting relationship, not regular, but safe. I wish you much luck and patience. You are a good child who cares.

When my friends kept driving after their licenses were revoked, I called Adult Protective Services for advice. When someone calls, they have to have an agent visit with them to assess the situation and make recommendations. I got there first so they would let her in. She did a good job of assessing their abilities and made recommendations for me. Best of all, she got the husband to give me the keys to the car so I could get it out of their possession, so my immediate problem was solved. Perhaps they could help you with this process since they would come to your parents' house to evaluate things and say what should happen next.

Okay - so a couple problems here - She won't take any medications for her depression (could be life long clinical depression) so getting her to a psychiatrist isn't going to solve the problem since the psychiatrist is going to want to give her an RX depression med. I think if you call APS and let THEM handle it, it may be a Godsend for you. I don't know. Worth a call. You have to do something, else a medical emergency happens.

Have had a very similar problem with my crazy mom. Perhaps a blessing in disguise, but she broke her pelvis, went to rehab, then came home and has in home care (visits from OTs, PTs, nurses, bath aids, etc) The nurse who both noticed her craziness and heard about it from me is going to have a mental health nurse come over as part of the service, sort of disguised as treating stress related to the pelvis problem. This may lead to diagnoses which will require better psych meds.

Think Urinary Track Infection. Especially elderly women. Treat ASAP. Delirium sets in rapidly.

In my experience with my mom who suffered from vascular dementia, it was better to start with a geriatric social worker (some of whom may be contacted through Hospice agencies, rehabs, or through Dementia websites and list serves. Another option we found as a last extreme was to call in adult protective services (when my sister started sabotaging the caregivers and doctors by removing mom’s meds and essential daily routine treatments).

We routinely used a geratric psychiatrist who was wonderful with mom, managed her medications (especially those involving issues with anxiety, paranoia, lack of sleep and obsessive agitation), and saw her for therapy sessions. She took insurance but we needed to meet with her in an office at a rehab/senior citizen community. Thankfully, she accepted insurance!

I would encourage you you to start with a geriatric LCSW as they will typically come to your parents’ home. Deep breaths!

God I just wanna hug everybody who shares on this website because we are dealing with so much hurt and pain trying to continue to love others!

I think maybe work on getting a conservatorship done that way she legally has no say over her own life and you can take care of her.

That’s the short blunt version of a long conversation. God bless you. I hope you find someone who is helpful & reasonable.

Actually if you can’t afford it, I don’t know how savvy you are with the paperwork but I was told by the courts that I could actually do the conservatorship paperwork myself. If i filled out anything incorrectly they would tell me what I did wrong and what I needed to do to correct it and re-file. It does cost money, but it cost a lot less if you do it yourself instead of going through a lawyer. Anyway good luck.

what a sad situation for your father. Maybe you can get him some support him. Hire a caregiver to work WITH him. The simple help they give him, & their companionship and understanding can work miracles for a person mentally and emotionally.

Thank you so much to everyone that has responded. Your support and ideas are invaluable to me. Even reading all this causes me to tear up as I realize things will never be the same. She may even end up hating me forever.

Some more questions:

Will primary or insurance co speak with me?

What exactly will social worker do if I get one into her home?

If I have her committed, is that the end of her living outside a facility?

My Dad isn’t ready to do something drastic. I need to save him though.
If I call an ambulance, what do I say?

That she’s not taking meds, acting crazy, suicidal? Is there a chance they show up and do nothing? That would be a nightmare

Thanks again. My heart is pounding just thinking about what is going to happen when I show up with someone to help.

ATL, I think your dad holds the cards here.

Is he willing to go talk to a psychiatrist about what is going on with your mom? His mental health must be in tatters. I think he could certainly use the support of a geriatric psychiatrist right now. Getting HIM to see somebody may open doors for getting mon into treatment.

If you were able to get your mom committed to a psychiatric facility and she was able to get stabilized on meds, she would be able to return home. However, she would need to remain compliant with meds and many psychiatric patients do not.

If mom starts acting out and threatening dad, you call 911 and tell them that your mother has become irrational , is off her meds and is threatening your dad with bodily harm. And that you want her transported for an involuntary psychiatric hold. This is called Baker Act in some places.

Why are you so afraid of her anger? You're trying to help her, yes?

atl: Let APS do their job if and when you call them.

It may be possible for a video visit by a psychiatrist. Many providers have adapted video visits in their practice. You can set up a laptop to Skype the provider and their psychiatrist can see each other (like FaceTime).

Just a suggestion as a last resort.

It appears that the number of psychiatrists have diminished. Access to mental health providers is getting harder and harder.

The clinician who treats someone via Video Visits is usually provided with the person’s medical history, & medications in advance. You’d be surprised what behaviors are picked up during a video visit.

Video visits are fairly new and thus come with another bunch of concerns but that argument is for another day.

Good luck!