Mom With Schizophrenia Refuses Treatment

By Kristina Randle, Ph.D., LCSW

Me and my 20yr old sis take care of her and everything else. So, It all Started about 8 years ago when i was 14 and my sister was 12. My mother had a drug induced schizophrenic break – Crystal Meth was her drug of choice, though she didn’t limit herself to that, also drinking HEAVILY and smoking pot and cigarettes. over a series of months, and many crazy jumbled stories that came from her mouth, we came to realize it was more than just the drug use making her act like that. Then something happened, i cant remember the exact catalyst anymore that set her off but, She went into a full on ranting fit screaming and running through our whole neighborhood – which led to her being taken on her first 51/50. They held her for a couple hours (til she was sober and comprehendible i presume, i was young) and then after having a conversation with her decided she was fine and released her. This has been the biggest downfall to my story, my mothers intelligence. She is a Graduate of USC, majored in English, and generally can talk her way out of ANYTHING – and i don’t say this with any sort light sense. My mother is far from stupid, and in that regard still very much in touch with the world, she knows the date, she knows Obama is the president, she knew very well she didn’t like Sara Palin, and she knows Brian is her favorite character on Family Guy. Like I said, this has been my biggest down fall, my mother has no problem putting on the show for everyone else. Everyone except me and my sister.

This same pattern went on for a few months, big loud screaming ranting fits followed by brief 51/50 holds, only to have her return home in the same condition…if not worse. Eventually something finally happened, my mother deluded herself into thinking she was having a heart attack, which she definitely was not – even me and my sister were aware of this and we had barely hit our teens.

Anyway, she made us call 911 – leading to another 51/50 – this time someone caught on to her. they saw she wasn’t quit right even if she could answer all there questions. At last we had an answer: Paranoid Schizophrenia. She was diagnosed and put on meds (again cant remember which type, i was only about 15 at this point) she took it for a while, and i have a vague memory of thinking my mom might be back. Oh how wrong i was! About 6 months later she stopped taking the medication claiming she felt all better and didnt need it anymore. which was true…for about 2 days.

This how now gone on for years. The same repeated pattern, shell be ok for a little – maybe a couple weeks, then shell start going down hill, then we hit a point where she gets really crazy, constantly talking to herself, then she will through a huge fit, which often involves the police, then once she is calmed there is usually a brief period of guilt, and then it starts all over – not that the voices ever go away – she talks to them all day all night 24/7.

2 Years ago me and my sister moved into our own apartment trying to escape the Madness, we have an older sister – but she only contributes to the problem, she is no help. My mother was basically left on our doorstep and we had no choice but to take her in. We still cant get her on meds, and i feel while we have taken some steps forward in the past 2 years i also know we havent gotten anywhere. She is Sober now, generally speaking, She hasnt been anywhere near meth or any hard drugs as i wont let it within 20 miles of my apartment, where as my older sister had no problem supplying her with it for the 3 years before she moved into my place. She isnt allowed any hard alcohol. i will let her have a beer every now and then, but i avidly regulate only pouring her a small glass at a time and having her drink it over a long period with food and such. Its more of a fixation thing with her, so i try to kinda trick her with little things like that. and she can have her cigs, but that’s it. occasionally she will get her hands on some pot from my lovely father – but i try to avoid this at all costs.

However, even though we have removed the substances from her life she isnt getting any better – more like she is getting worse. She literally cant function as a normal person – i am in firm belief she will never be able to hold down a job again. and she still has rage filled violent outbursts – she would never touch me or my sister and has never hurt us in anyway – but she has punched my neighbors window through, and broken my sisters radio with her fist in bits of rage. Most recently was the window incident which landed her on another 51/50 and in the hospital. Between all the nurses, doctors, security guards and cops, they couldn’t even get her calmed down enough to take her blood, let alone give her a shot of something to calm her down. Eventually they came and asked me and my sister to come back and see if we could get her to sit still.

Now here is the weird part. we walked in, she took one look at us, and was instantly calm. she asked us what happened, why she was there, and what everyone wanted from her. like she didn’t even remember it. Me and my sister refer to this as Mom 1 and Mom 2. her 2 personalities don’t correspond and she has no recollection when one of her personalities does something. we actually have it down to a kind of math – we know immediatly which one she is at any given time.

Anyways, they actually held her this time, for 2 whole nights! this is truly a vacation to me as awful as that sounds to say! but after many meetings with therapists they decided again with the paranoid schizophrenic diagnosis. they did prescribe her a medicine – something that started with an R, i cant remember exactly, and then released her to me and my sister. she was very very normal for the next few days, she seemed extremely happy to be back to our little apartment, and was acting what is now Strangely Normal to me. We tried to go get the prescription filled but whatever they prescribed cost some $200 for a 2 weeks supply!! Obviously we could NOT afford this! so after the few days of this new nice mom, the medicine wore off and she went back to her regular crazy self.

In the last 6 months since this incidence it has been a total roller coaster with her. some days she is fine and she will get up and shower and pick up the apartment and do her laundry, other days she lays in bed and cries literally ALL DAY. She is always saying she doesn’t feel good, but wont go to the doctor. and is up almost every night mumbling to the voices in her head. we try to get her up get her do things but at this point i have lost hope. I tried to apply for disability and got declined – something to do with age and SS credits.

At this point i just need some advice, some options i might have. I have no idea what to do or how to move forward. my sister and i cant take care of her forever like this. we are broke, work 5 jobs between the 2 of us, and barely make enough to cover the rent and necessary bills. We need a break. but we cant leave her alone. we cant give her $5 for food without her trying to go to the liquor store and buy some vodka. we don’t even know where we can take her to get some help. is there like day care for someone like her…again i know how awful this sounds, but i am just so lost with this. Me and my sister have figured it all out on our own since i was 14 and she was 12, we are 22 and 20 now respectively. we are at a lose of ideas.

So what do i do with my schizophrenic mom? How can i help her and help my situation at the same time? Please, any advice would help!

Thank You for your time!! Jenna

A. Dear Jenna, you may only have a few options in this situation. Your mother has schizophrenia, she’s clearly out of control, she’s constantly interacting with the police and hospital, she needs to be watched 24/7 and she refuses to take her medication. This essentially leaves her to remain psychotic and probably you and your sister feeling helpless. You and your sister work five jobs between the both of you and it’s barely enough to pay the bills. The two options I see for you in the situation are 1) that you and your sister work together to create a plan in which you coerce your mother into taking her medication; or 2) move her into a group home or residential living facility in which she could be constantly monitored and given her medication by medical and psychiatric staff.

Let’s examine the first option which is that you and your sister create a plan that focuses on your mother taking her medication. I’m essentially suggesting you create rules for her based on the premise that if she wants to remain in your home she must take her medication. To make certain she does take the medicine you and your sister could take turns administering the medication each day. For instance, you would be responsible for Monday, Wednesday and Friday and she would be responsible for Tuesday, Thursday, Saturday and Sunday or vice versa. You can choose whatever days or times work best for you and your sister based on your work schedules.

Each time you or your sister gives her the medicine do a “mouth check” (i.e. ask that she open her mouth to prove she swallowed it). This may be difficult to enforce because she could “cheek” the pill. “Cheeking” the pill means she hides it underneath her cheek or tongue and pretends as though she swallowed it. You want to check for this. If she believes that she doesn’t need the medicine because she “feels better,” then she may be trying to act as though she took it.

If you choose this method I would also advise you to keep the medication in your possession. That way, she cannot say that she has already taken it for the day. If it’s in your possession, you’ll know if and when you gave it to her.

It also might be a challenge to keep a consistent medication administration schedule between you and your sister if the both of you are working odd or late hours. If coordinated correctly, and if you and your sister make a commitment to administering the medication every single day, this may be a way that she could continue to live with you and not constantly be in and out of the hospital.

You may also want to offer her rewards for taking the medication. For instance, if she complies with taking the medication for a month perhaps you and your sister could take her out for dinner or to a movie. This may create a positive association in her mind between taking medication and the getting to spend time with her daughters.

This method also ensures that she doesn’t have to continually experience psychotic episodes. There is some evidence that with each psychotic episode it takes longer for an individual to “come out” of that episode. There is also evidence that with each psychotic episode it is difficult for the individual to fully return to their previous state of psychological functioning. This is called stepwise decompensation. For these reasons, it is important to prevent reoccurring psychotic episodes with medication. Medication is the best method to prevent these episodes.

Also anticipate the possibility that your mother may not be open to the idea of her daughters administering her medication. She may feel that she is being treated like a child. She may feel this way at first but that feeling may fade with time. I can understand why she may feel that way but the problem is she is not willing to stay on her medication even though each time she stops taking it she has another psychotic episode that lands her in the hospital or involvement with the police.

Unfortunately, she needs help and she’s not able to care for herself at this time. There may come a time in the future when she is able to consistently take her medication on her own and remain symptom-free but at this time, she has a track record of not being able to do so.

A variation of this option would be to stipulate that in order for her to continue living with you and your sister she must accept an injectable form of medication. Currently, there are several antipsychotic medications that can be administered as an injection. Risperdal Consta, for instance, is an injection that can be given in the arm, upper thigh, or buttocks. It’s typically given twice a month. The injection is administered by a psychiatric nurse or a doctor. In many communities, there are services that come to the home to give the injection. If your mother took an injectable form of medication this might give you peace of mind. It could prevent her from having a relapse and it would keep her out of the hospital.

There’s also the added issue of her substance abuse. You could also stipulate that in order for her to remain in your home she must abstain from alcohol or drugs (unless she has a beer in your presence as you allow her to occasionally). If she does not refrain from these substances then there should be some type of consequence for this behavior. She needs to know that she cannot live in your home and engage in behavior that is unacceptable to you.

I would also advise you to check with the social worker or someone from the hospital to see what services are available to your family. I mentioned the service in which a nurse or a doctor could come to the home and give her an injection. There may be other services that can assist you and your sister to more effectively care for your mother.

The second option is the possibility of having to move your mother to a personal care home or a residential living facility. This, of course, would be extremely difficult for her and I’m sure for you and your sister. Nobody wants to place their family member in a personal care home or other care facility. But in some situations, such as when individuals cannot care for themselves or put themselves or others in danger, this difficult step may be necessary. Your mother is a danger to herself if she is not supervised.

I recognize that both of these options are difficult and challenging. You are dealing with a very complicated situation. I’ve worked with many families dealing with similar situations. They’re often faced with many of the same issues you’ve written about. Basically, the options with regard to dealing with these issues come down to the two I’ve presented to you.

With regard to Social Security Disability benefits, it is very common to be rejected the first time you apply. I would encourage you to hire an attorney to appeal the decision. In some states, it could take up to three years to receive a decision on an appeal. An attorney can expedite this process and increase the odds that the appeal will be granted. Generally, an attorney will not charge a fee if they don’t win the case. If your mother won the appeal the attorney would most likely only take a small portion of the Social Security Disability back benefits. I would strongly recommend you consider an attorney.

It’s clear you care about your mother and that you and your sister want do what is best for her. To the best of your ability you want to prevent this uncontrolled illness from majorly disrupting her life and yours. To accomplish this sometimes means you have to make difficult choices. It’s important to do what is best for your mother but also what is best for you and your sister. You can’t let this problem interrupt your life to the point where you can no longer hold a job or function normally because you’re constantly dealing with your mother’s problems. I am under no illusion that this is a difficult challenge but your quality of life has to matter and be a priority.

Your current living situation is unsustainable. Something needs to change. I understand the challenge of your situation and I hope that these suggestions will help you. If you have further questions please do not hesitate to contact me. I will be glad to help.

Photo

 

 

Last reviewed: By John M. Grohol, Psy.D. on 15 Jun 2009

APA Reference
Randle, K. (2009). Mom With Schizophrenia Refuses Treatment. Psych Central. Retrieved on November 23, 2014, from http://psychcentral.com/ask-the-therapist/2009/06/15/mom-with-schizophrenia-refuses-treatment/

Want a more immediate answer from others like you?
Use your Psych Central account in our self-help support community.

Subscribe to Our Weekly Newsletter


Find a Therapist
Enter ZIP or postal code



Users Online: 8322
Join Us Now!