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Hi everyone,


I have been reading on here for some time and see so many stories with similarities to mine but here it goes. I could really use some help sorting out what to do.


Now that I understand depression a little better, I’ve come to the realization that my mother (now 77) has been suffering from depression (perhaps manic depression) for most of my life. She would never even think about mentioning anything like that to a doctor for fear of being “locked up.” My Dad and I just learned to live with it and her mood swings. I live quite far as an adult - couple hour plane ride. My Dad has had to bear the brunt of her mental illness alone all these years, even worse that almost all of the hatred coming out of her has been directed at him. But he stays by her side anyway...


A couple years ago, she got shingles and started to act quite off - paranoia, hallucinations, hearing voices. Over time, that passed and she went back to normal (still depressed). Then last summer, it was incredibly hot and they don’t have air conditioning so she got dehydrated and stopped eating and drinking water. In connection with this, she started hearing voices telling her terrible things about my Dad - stealing, plotting to kill her, affairs, many other conspiracies. The voices also told her my wife and MIL had attacked me and one of my sons and beat us to a pulp. Horrifying stuff to hear over the phone for me. My Dad has always sheltered me from the trouble but this time asked me to come help. Long story short, we called an ambulance and had her treated for dehydration. While there, we got a full psych eval and dementia testing. The psychiatrist recommend something for the paranoia but she thought we were trying to kill her and refused to take it. Since coming home from the hospital, she now refuses to take any meds (worst ailment being high blood pressure) and won’t even see a doctor. She eats minimally - bread and milk. She cries all the time and finds no joy in any part of life, including young grandchildren that she once cherished. Her life is all misery right now and her goal in life seems to be to ruin my Dad’s life as much as she can. Yet he’s a loyal, good man and sticks by her (mostly to spare my own family the misery of taking care of her). There’s more of course but this is it in a nutshell.


As much as I want to help her, I want to save my Dad from this jail more than anything. I don’t know how.


Are there psychiatrists that will come to our house? Can I force one on her? Even if I find some way to get her into the hospital, we will likely get released and she won’t take any meds again so it will be a vicious cycle. She’s showing some signs of dementia but can gather herself with adrenaline to get through any verbal tests. I just don’t think she’s at the point where I can force anything on her. And unfortunately, no POAs in place. Getting her to do it now (or to even leave the house) seems impossible.


I’ll stop here. Any ideas are welcome. And thank you so much to this community. I see how you have supported others and now need you too.

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psychiatrists are not magicians. they cannot make an accurate diagnosis when someone is guarded and not being forthcoming. if she refuses to be forthcoming with him, he will be unable to make an accurate assessment. if you can get her to sign a release of information, and he can talk to you he is likely to get a much better idea of what's going on. But you really don't need that. You might have much better luck getting a psychiatric nurse practitioner to come to the house. If you have POA, that makes things a lot easier with regard to the sharing of information. For depression she will likely try a common antidepressant in a low dosage or perhaps just a mood stabilizer. If she has anxiety he will likely prescribe an antidepressant that relaxes people or a very mild sedative, depending on comorbid health conditions. Go for the nurse practitioner through medicare. I think that would be your best bet, you can get one to come to the house easily.
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Have her checked out all blood work, UTI's rule those out first.

ALZ is just not a fun road, but some of us must travel down it...

Geriatric doctors will help. Try getting primary doctor to file in for palliative/hospice evaluation first. Go from there.

Your dad is amazing. So are you. Hang in there. don't do anything too drastic.
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Try to get POA on health. Try to talk to doctor and ask for palliative care and/or hospice evaluation so they can come to her in her home. Do ask about UTI's. They mess up the brain, and if the urinary tract infections gets bad, the kidneys can go bad too. Usually with my MIL once she gets A uti, her brain will get scrambled.
I'm sorry your are going through this, your dad is very special.. He still loves her.
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my mom is currently in post rehab (related to a pelvic fracture after a fall) at home care where different nurses, therapists, social workers come to her home now and then. The nurse in charge had a psych nurse come as it was very evident my mom is nuts. The psych nurse came and recommended to my moms primary physician a more robust medication regiment (mom is on 20 mg of Prozac now) and referral to a geriatric psych. My moms doctor seemed to take offense that a nurse (albeit a psych nurse who works with this all the time) was telling her what to do and dismissed it, saying changing meds right now would add to much chaos. The psych nurse said GPs don't like to get involved in anything other than very basic anxiety meds, and that is fine, but then refer her to a geri psych. She seems reluctant to do that. Would be great to have one come to my moms home, but I would just like to get her to one period.
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I accidentally ran across a medical school that has a department of psychiatry that has geriatric specialists who make house calls to the seniors. I could hardly believe it. It's such a great service, but, unfortunately, this particular facility is not near enough to my family. PM me for the name of the place, if you are near Winston Salem, NC. Oh, their website says that cost is something that they do not prevent one from receiving care. So, they'll figure that out. All I could say was awesome!
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The hallucinations my mom had resulted in us taking her to ER. They thought it was dementia. Not having any knowledge of it as didn't think so however she ended up with Alzheimer's. All the symptoms you described all played a part. Certain medicines especially tramadol made her mean and combative. Mom wouldn't take meds either so I got a pill crushed and would mix them with her food. Of course if she refuses to eat that s an issue. If she drinks tea I found mother earth anti-anxiety tea on amazon that seemed to help calm mom down. First since your father is mentally fine it's up to him if he's on board with whatever you do. I agree with others that your first choice should be APS or elder services. If she has Alzheimer's it's only going to get worse. Tell your dad he needs help to make sure he's not accused of elder abuse. All the best to you.
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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!
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atl: Let APS do their job if and when you call them.
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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?
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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.
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my2cents Jun 2019
If you call an ambulance you can tell them all of those things if they have happened. You might add that you did not want to put her in your own car because of fear of her opening door while driving. (Houston ambulance service tries to find any reason at all not to transport) -The thing is if you say she is acting crazy, they will probably ask her some questions like does she know what day it is, the year, where she is, president's name, etc. If she's having a good day, the odds are she will answer them correctly even though she has not been acting right around you. At least, if you got her to the hospital and explained behavior, you would get an evaluation done and meds started.
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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.
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atl1977 May 2019
Good idea on conservatorship. I’ll start working on it. Not exactly sure where to start but I think others have provided websites for elder law specialists.

I wish I could get my Dad some help but there’s no way she’s letting anyone in the house, definitely not more than once.
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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!
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atl1977 May 2019
Thank you. How do I find a geriatric LCSW? I think I only have one shot to get someone into our house so I’m not sure whether to take a chance on a social worker or someone that will take their time to think about things and issue a recommendation later.
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Think Urinary Track Infection. Especially elderly women. Treat ASAP. Delirium sets in rapidly.
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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.
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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.
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atl1977 May 2019
What does letting them handle it mean? They would show up at their home and start questioning her? Agreed that something voluntary is just not happening unfortunately.
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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.
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atl1977 May 2019
Thanks, JohnnyJ. How would this work exactly? The person from APS comes in and evaluates the situation and then what? My concern is that if we don’t deal with immediately in that instant, she will never let anyone enter their house.
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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.
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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.
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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.
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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
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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.
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KiminAL May 2019
You will have to force her to see a psychiatrist who can then have her committed to a treatment facility as needed. Best for all involved. It sounds harsh but is actually a good way to get her real help. My family did this for me after a suicide attempt years ago. At first I was so angry but later realized that’s what started my life turning around.
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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!
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atl1977 May 2019
Thank you. My Dad is in very good shape and capable of a very full life if he weren’t stuck inside with her. If he tries to go anywhere, she goes ballistic. I don’t know how he has the strength to suffer so. I can’t even stand a few hours there anymore.

I have tried CBD candy. I have no idea if she eats it. I’ve just left it for her when I visit. My Dad says after I visit, she has a few peaceful days and so it may be the candy but who knows?
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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. ,
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Your doctor can Recommend Someone, hun, To come and Evaluate her for Possibly a Facility...
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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.
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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.
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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
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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.
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Yes. Call her physician to arrange it.
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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.....
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