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My mother is mentally ill. She has been diagnosed as paranoid schizophrenic since back in her 40's. She is 76 now and my Father is 78 and he is her caregiver at this time. He is getting too old and showing signs of dementia. She is very abusive to him at times and relies on him for everything. He is spent and exhausted but doesn't want to be the one to place her in AL because he's too afraid of not looking out for her yet he can't deal with the verbal abuse anymore. My siblings and I know it's a matter of time that she will need to go into AL. Nobody wants this to be their job, but I've been elected since for some reason they say I've always been her "favorite". I'm having all kinds of emotions, and I'm not ready for this. I've lived in a different state from them since I was 21 and they recently moved 7 miles from my house, so it's difficult to adjust and I find myself somewhat avoiding the situation because it's overwhelming and I feel it's going to adversely effect my life; in my career, my marriage and my own mental/physical health.

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Basically, you DON'T. My mother had something like schizoaffective disorder, so I get where you are coming from.

The situation is becoming unsafe for both of them. Please get her placed into some type of assisted living facility - if one will take her. (Some won't.) Alternatively, she could go live in a group home.
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You're been "elected" to make this decision, but I do not see where you are POA. It is too much on you. Speak with your siblings.
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This is a very difficult situation. I understand your concern & your father was raised to always care for his wife, but they didn't understand Mental Health back then, and she would have been institutionalized..as in locked up, restraints, windows barred.

Get MPOA & FPOA or Guardianship papers in order now! You need an Attorney for Elderly/Disabled!

Next, she is NOT candidate for AL. She needs a NH Specialized in Schizophrenia & Delusional Disorders.

Second- take advantage of this unique time to contact facilities. Get references, from MH Professionals. A few places have IL or AL for your Dad in the same building or complex.
You can't or should not move her until about 2-3 months after the COVID-19 crisis has cleared IMHO. But be first on the list. Also how facilities handle this crisis will tell you a lot. Drive by and talk to families visiting from the outside! That is best information.

Third- Does your area have Emergency Response Team for MH Crisis. Get that #, Give it to your Dad. Then trained Professionals can help de-escalate the issue.

Fourth: Do use mask or scarf & other precautions when you shop for you parents. Leave it on the porch, if they have one, & stay till they confirm perishables are put away. Maintain 6-12 distance for their protection.

Fifth: Anything that needs to be closer than that needs to be people trained to do so. Make sure they are trained for severe MH issues.

I have worked in hospitals & MH. I hope this helps.
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The task appears to be anxiety-inducing for you. I find when I have to do something convoluted and unpleasant that it helps to write it out so I can look at it one piece at a time:

1 - What are each of your parent's needs that are not being met or threatened with not being met?

2 - What are the resources available to take care of these needs? Spends lots of time researching and finding all options available.

3 - Why am I finding this difficult or distasteful? Feel overwhelmed? Fear mom's wrath? Difficult to communicate? Difficult for your parents to understand? Past history?

4 - Who has responsibility for taking care of these issues? Are there POAs or guardianship legally in place? If not, can you get them done now (talk to doctor about mental competence and then a lawyer)? Give over pieces to the person responsible for deciding. If it is you, communicate with others who are "stakeholders" in the decisions: your parents, family members, doctors...

Praying for you to make decisions that not only provide care for your parents but peace of mind for the entire family, especially you.
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To Truwoman. Gather ALL his medical records bc obviously sounds like your loved one can't travel. See if a medical school Dr will review ALL his medical records & meds & make recommendations. My sister was able to be correctly diagnosed AFTER she went to Tucson to the University of Arizona Medical School. Good luck!
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Hello,
My mom has the same diagnosis for the last 20 years. It stared when I was heading to high school. She lives in an assisted living facility because I have a family and need to work. It was too difficult with her staying in my home. Now I have the peace of mind that she is taking her medications regularly and being fed,etc. When she lived on her own in another state; she was afraid to go to the grocery store and things like that. Also nervous that someone was poisoning her. I know it’s a progressive illness; Its very difficult to take care of someone who is also low income. However, I was able to find some additional benefits to get her into an assisted living. My prayers are with you; it’s definitely not an easy job to oversee her care. She complains about everything, but I know it’s because she is not satisfied with her life and decisions that she made previously. Also being low income bothers her because she always talks about going back to nursing although she lost her license years ago. She is 61! I also made sure she was set up for a counseling group where a outside psychiatrist could manage her psych medications and make sure the assisted living facility had her psych meds and her primary care managed her other medications. It’s important for people with this mental illness to have a schedule and routine to create a structured environment, and have their medication managed! She attends 2-3 times per week.
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Until your mother is properly medicated and her illness is manageable, an assisted living facility will not accept her as a resident. She will need to be admitted and treated in a psychiatric facility first. She may even be able to stay at home when properly medicated. Your father cannot be the person to administer her medications; however, you can contract with an agency to do this. Most agencies only permit RN’s to administer psychotropic meds. If necessary, call 911 and state that she is a threat to herself and others. They will transport her to a psychiatric facility.
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If you can, try to convince them both to go to an AL facility that can handle mental disease and dementia. Even if you could handle it now, will you be able to do it when their situation deteriorates? Better to do it now, and it's best if they are OK with the decision. Make sure all paperwork is in order: POA, medical directives, will, etc., while they are still functioning mentally. It may be impossible to visit places in person and/or move them during the coronavirus emergency. But you can start looking for a place and can contact them. It's best to find a place near you, if you can, so that you can check in often. All the best to you.
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Oh, sweet girl, what a challenge. My brother had schizophrenia and his life was challenging for him as well as for my sisters who lived nearest him and cared for him. He was able to live in an apartment alone for many years, years and do much for himself, though. He spoke to may parents and us siblings as often as he could. that gave my parents a break. I lived just far enough away to not be able to help tons, but close enough that I could come and help
in circumstances where they needed a break. I feel for you, I know their challenges. And I had my own anxiety and depression to deal with as well. Make sure you have a good counselor that can help you get the self care you need. I think we all need a good counselor! I think you have some good suggestions from people here, and getting as much info as you can to begin with will be helpful in the long run. We just had my husbands mom move in with us. That situation is very easy compared to yours. Keep a prayer in your heart for yourself and for her. I just watched to some really good videos on You Tube by a gal who is a specialist on dementia. The information she gave was helpful and reinforced my commitment to help Mominlaw be comfortable. But she’s really easy to take care of and she and I have always had a wonderful relationship. Teepa Snow - Dementia 101. I know that dementia is NOT the same as schizophrenia. Nowhere near the same. My brothers medications made it so he was relatively calm. He had his times, and when he got UTIs, everything was exacerbated. And he was delusional and unreasonable. He spent his last few years of life in and out of the hospital because of UTIs and other health problems. He passed away this last September. I hope you are able to find resources for your Mom and Dad as well as yourself. You are in my prayers.
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Mipollito Mar 2020
BETSY, in response to "we all need counselors" so true.....I just read something that said some of us need therapy to deal with the ones that won't go to therapy.
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You have a lot on your plate. I am so sorry that you are struggling with this situation. I think your dad has done more than his share and deserves a break from it all. He deserves a permanent break from his caregiving days. He needs caring for and deserves a nice facility of his own to live in.

Obviously, your mom needs psychiatric help and the appropriate treatment. I sincerely hope that you are able to find a suitable place for her to be placed.

Let us know how you are doing. Vent anytime to voice any concerns that you have or just to blow off some steam.
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Doing nothing is going to adversely affect your life, your career, your marriage and your own mental and physical health. Please do not allow your mentally ill mother to continue to abuse your vulnerable father.

Given the pandemic, most doctors are not seeing patients unless it's an emergency. If your mother's behavior reaches emergency, you may call 911 and have your mother Baker Acted, which is an involuntary hold for up to 72 hours during which time she will be medicated. That will also enable you to talk with the hospital case manager about placing your mother into an appropriate level of care upon discharge. I urge you to not allow discharge to home given that your father has dementia and cannot be charged with giving your mother medication.

Your father needs help at home. Start working with your local social service agency to learn about options and getting your father the help he needs.
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NeedHelpWithMom Mar 2020
Great advice. Her dad deserves a break! A permanent break so he can breathe again and live his own life. He has paid his dues. Her dad is an angel.
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Right now, as you read this, consider that there’s AT LEAST a 50/50 chance that her life will become BETTER when she’s in a semi structured regimen that is predictable and relatively peaceful, and possibly MUCH better.

Adjustment will likely be difficult, but truth is, most are, and ultimately, it’s often the POA that suffers more than the newly placed resident.

You are Blessed with siblings who are observing the signs that potentially BOTH of your parents may be needing residential care, so don’t allow yourself to feel as though you’ve been chosen for an assignment you can't handle, because the odds are also in your favor that you can.

If your father wants to continue to oversee your mother’s care he may be able to enter a continuing care facility where he can have some space for himself while continuing to monitor her life style.

Start today doing an online search of the residential facilities within a 25 mile range of where they’re living now. Because of Covid-19, you’ll be doing cyber visits for now, but you’ll have a fund of knowledge for when the stay-in-place bans are lifted.

The actual placement may be somewhat simpler for your mom, or for both of them, based on how easily they’ve tolerated their recent move.

Most have us here have made decisions similar to yours. Trust yourself. If you are looking to make you mom (and/or dad) SAFE, PHYSICALLY COMFORTABLE, and RESPECTED AS A HUMAN BEING, you’re on the right track.
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SicilianLady1 Mar 2020
You are very kind to say to NRFT2020 that she is "blessed" to have siblings who are observing the signs that potentially both of your parents may be needing residential care, etc.  Nobody wants this job and it has been "dumped" on this nice lady because she has always been the "favorite"?  I'm old enough and have seen enough to know that this is the way the siblings are dumping this very large problem on her. But if she is made to believe that her siblings are trying to somehow honor this very nice daughter, perhaps it will make her feel better to be the scapegoat.  If this nice daughter has no POA, I believe that there will be problems anyway.  An elder lawyer is always the best person to consult first.
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How about moving DAD to a nice AL?

Adult Protective Services should be notified that she is a vulnerable adult. She needs to be in in-patient psychiatric care so that a proper medication regimen can be found. THEN you can figure out what her need for care is.

"Dad, in order to get mom the care she needs, we need to leave her on her own."
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It sounds like for your dads well being mom needs to be in Memory Care or AL.
The first thing is she needs to be seen by a doctor that can prescribe medication so that she is not abusive. This will make it easier on dad as well as easier to find a facility that will accept her.
Since your dad is also showing signs of dementia AND he does not want to place her would he also be willing to move to AL? He would then have help when he needs it. He could get a break with different activities. When and if mom gets to the point where she needs Memory Care the transition for both of them would be easier.
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truwoman Mar 2020
We have the same situation with my son-in-law. They don't seem to be able to get a med that works. Right now he is on an IV in the hospital and restrained. No one seems to be able to help. He needs placement and can afford it, but WHERE? How can we find out. They keep giving us lists of places, but none of them wants him unless he is medicated...again...the doctors cant find a med that works. I would be grateful for any helpful suggestions.
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