Family and Caregiver Schizophrenia Discussion Forum

Appeasement: When is it worth doing?

My brother finally wore me and my siblings down with a delusional obsession. My father is diagnosed with Alzheimer’s and takes a myriad of medications including the same AP I take, but at a higher dosage. He’s had increasing mobility issues over the past year, shuffling instead of lifting his feet. It’s to the point that he needs a walking assist device and my mother had a stair lift installed.

My brother, who takes no medication aside from huge amounts of alcohol, (his words not mine) has been running an incoherent and rambling telephone campaign against the stair lift and inevitably his AP medication. I’ve repeatedly asked him what exactly he wanted us to do, and have been met with incoherence for many months, but he’s finally managed to convince another brother to broach the subject of taking my father off AP medication altogether, in hopes that it helps his mobility issues. This brother had spoken to his psychiatrist before and dosages were adjusted.

My sister and I are very dubious that taking him off the medication will be at all beneficial, but frankly we are fed up with my brother drunkenly rambling on and on about this, so we are acquiescing thinking it might get him out of his current downward cycle. My brother has a fanciful notion that with a united front the siblings can overrule my mother’s medical decisions for my father. He thinks she also has dementia and has been brainwashed by the incompetent psychiatrist who has misdiagnosed my father, blah blah blah blah. I’m to this point of playing along realizing from my inside knowledge that even if he manages to get my father off AP medication, AP drugs don’t work like a switch. My father is generally medication compliant and we make sure he takes handfuls of medications each day, so I assume we can resume medication at a later date.

My sister and my take on this is this is sort of a grieving mechanism he and my other brother are going through in their own ways. My brother had years ago latched onto the idea that he, being the eldest son, leads the family after my father had supposedly ‘passed the baton’ to him. He’s also latched onto a comment that my father wanted to live to 100 and that it’s his sole responsibility to realize this goal.

Have any of you had to go through appeasement processes like this, even though your gut tells you they are at best dubious, and at worst wrong? What criteria makes you say “what the hell… I’ll play along.”?

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Yep, but first who’s the medical power of attoney because this can get alot more complicated later when bigger decisions have to be made.
Personally, I would never play along with a MI sick sibling or for that matter any person making a unhealthy decision for my parent if I had the power to do so.

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My “bottom line” with my own son when it came to appeasement for the sake of peace was health and safety. If it doesn’t threaten anyone’s health or safety but it will maybe lead to much needed peace, go for it. Otherwise I would try to have a doctor intervene if at all possible.

Sadly, its usually more complicated than people think it will be when you have to factor in Alzheimer’s, dementia issues, physical body failure, siblings vs siblings and siblings vs parents.

What I have experienced is this - as the elderly parents’ conditions degrade and they are no longer living in safety, yet no one has the power to change the situation, there will be a period of time in which family drama will occur.

Siblings often feel differently about how to move forward, and how badly change is needed. On the local news here years ago during my husband’s family’s conflict, two daughters were being interviewed after their parents had been found two states away. They still had the birthday cake they had been bringing to a grandchild’s birthday party - a party that was located a few miles from their home. One daughter told the reporter “my parents have some dementia issues” the other daughter was indignant and told the reporter “there is nothing wrong with my parents!”

Personally, after dealing with my husband’s family on this subject years ago, I do have a plan for my own parent who has just reached the point where she can’t live alone. I just gave my opinion to my parent and my siblings and I am sitting back to wait it out. I have enough going on with my son, I don’t need to add family drama to my plate. I am happy to take my turn taking care of my parent, I just can’t go first, its an inconvenient time. Luckily I come from a large family.

Eventually the situation gets forced by some sort of incident. Like we do with our family members, you just hope its not a tragic incident.

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I suppose these issues are hard for everyone, but there’s an additional handicap when SMI is involved. I’ll look into the power of attorney situation, thanks @Mojoclay. My sister may have a handle on this, she controls my brother’s trust and is trusted to help with my parents finances and with taxes. My father’s dementia was discovered when he made some mistakes with taxes and became quite anxious, depressed and delusional.

The situation is thorny, because the siblings don’t all get along for various reasons. I’m perceived as the most neutral party, but I’m strongly aligned with my sister. My father’s dementia seems atypical. He has fairly good recall and when he speaks after some effort, he demonstrates an understanding of what’s going on which is remarkable considering he’s profoundly deaf and English isn’t his first language. He was and in some ways still is quite brilliant. My understanding is Alzheimer’s presents differently in men than woman, and my fathers base cognitive load could be a factor.

It’s unlikely my brothers will prevail, it’s laughable that the only geriatric psychiatrist in town would seriously entertain the wishes of an unmedicated person with bipolar disorder and alcohol dependency and an amateur google doctor who cherry-picks studies. I’m hoping this feint will buy some time for my brother to become less anxious about the situation and maybe sober up. My mother is presently my father’s primary caregiver, so she’ll have the most say in the situation for the near future. I feel my brothers have an uphill battle and my sister and I won’t back them up when it counts.

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Hi MB. I have a question. Is your father on the AP because of the dementia or for another psychiatric disorder? I wasn’t clear on that… sorry. In my personal experience through working ten years as a hospice nurse and also from my own family members on my mothers side deteriorating with dementias before they passed, I would never, ever advocate (and I was pretty outspoken when a new doctor took my mother’s mum off all her meds for this reason) ever taking them off meds that may be suspending what’s left of their cognitive functioning to any degree at all. They will never ever gain any level more of functioning back, cognitively speaking, than they have at this very moment. As far as longevity goes, removing any meds that are in fact suspending deterioration and maintaining cognitive functions would, in my opinion and what I see as common sense, could very well land your father in a state where he will be unable to care at all for himself. My rule of thumb was always always always what’s best for quality of life. Loosing some mobility isn’t just a natural part of aging for a lot of people, it’s also not the most detrimental to their long-term and overall health as descending into entire cognitive decline, as that in and of itself will eventually inhibit his ability to execute essential day to day self care functions.
Bluntly, no. I would not pacify a family members’ psychosis to experiment with my other loved one’s well being.

As they say, it’s complicated. He has a history of transient delusional episodes accompanied by anxiety and depression associated with dealing with tax situations. He was hospitalized once and was put on an anti-anxiety medication. This was after one of his brothers died and he received an inheritance. In clearing out his brother’s estate he discovered a sack of various currencies and felt he didn’t report them properly and he would face dire consequences because of it. He’s always been irritable, anxious and angry when tax time came around yet always did his own taxes. But this time he went in a depressive spiral, and ended up in a psych ward. He called me from there and my advice to him to get out was to play along.

Flash forward 10 or 15 years or so, and my father got into a similar spiral along with a physical ailment. My mother had thought my father had continued the antianxiety medication all along, but he quit seeing his psychiatrist somewhere along the way. He was put on an AP and antidepressant at that time. In his recovery he started going off on long unannounced walks and drives to the library unannounced etc. My mother became alarmed at this, thinking it was wandering behavior. Long before this he would go on long ‘interesting’ walks seemingly to purposely get lost and then find his way back home. He would get more disoriented on these and we outfitted him with a tracking watch for a while in an attempt to deal with the problem. Eventually the shuffling walk I noticed years before before and had alerted people to as a precursor to Alzheimer’s became more pronounced. Whether the AP caused the gait change because of Parkinsonism side effects or advancing dementia and whether the AP was prescribed specifically for dementia or an underlying mental condition is anyone’s guess. Sort of an academic chicken and egg problem at the moment from a practical perspective.

Yes, my MIL had schizophrenia, my husband’s brothers have high paranoia issues- but have managed to hold down jobs, their relationships and home lives have been wildly rocky. It was quite the merry run dealing with them when his parents couldn’t live at home anymore.

In my own family situation which is currently underway - I have two siblings with bipolar - my youngest brother struggles the most, his diagnosis finally came after a court commitment when he lost it and threatened the lives of his boss and his boss’ children. My older sister with bipolar keeps herself self medicated with alcohol and we all get the drunken phone calls from her as she insists, repeatedly that she knows what is best for my parent. She wants my parent to move in with her. That’s right, calls us all drunk to say she can take care of our parent.

So lots of drama, since I don’t care for family drama, I play along until they are about to do something stupid.