Family member not improving after initial treatment

Family
1

I could use some advice on how to help a family member with
her treatment of schizophrenia. This will be a long post so that I can provide a
lot of detail.

Back in the October my mother had severe auditory
hallucinations to the point she was putting herself in danger. We tried to
convince her to see a doctor and counselor but she wouldn’t agree, and she
ended up needing to be committed after another incident.

She spent a couple weeks in a hospital where I think she was
being given plenty of attention and improving pretty quickly. The hospital then
determined she should be moved to a longer term treatment center. Apparently
the patient gets the choice of where they will be treated. My mother did not
want to be far from her home, so rather than choosing one of the recommended
mental health treatment centers farther from home, she chose an assisted living
facility that wasn’t as high up on the hospital’s list of recommendations.

For a couple weeks, she sounded a lot better. She hasn’t
mentioned hearing voices in a long time. She sounded positive and sharp.
However, she’s been in the facility for over 3 months now and doesn’t sound so
good any more. I know she’s been more tired than usual, has problems with
blurry vision, and her memory isn’t as good as prior to treatment. She sounds
depressed, which is understandable since she doesn’t have much freedom where
she is and she really wants to be back in her house.

Her medications are Haldol and Cogentin. She sees a
counselor once every 2 weeks. She sees a psychiatrist near her home once a
month, and another psychiatrist that visits the facility’s residents once a
month.

She hasn’t come to terms with her diagnosis and is stubborn
with sharing her medical information and signing the necessary forms. I don’t
think she is open to moving to a different facility as she thinks she should be
back in her home.

Nobody that I know has experience with schizophrenia, but my
other family members and I feel she should be seeing a counselor or
psychiatrist more than every two weeks. We’re concerned that since the facility
she’s in doesn’t specialize in mental health treatment, that they’re not doing
as much as could be done.

Ideally, we’d like to see her get to a point where she’s
accepting of her diagnosis and understands why she’ll need to continue taking
medication and having regular psych/counselor visits. We’d love for her to be
able to return home since she’s a lot more comfortable there. I don’t want to
see her in an assisted living facility for the rest of her life as she’s just
over 60 years old – she has a lot of years left to find enjoyment.

What do you think we can do to help her improve? I
understand that for some people it just takes time, but it’s been a total of 4
months now, 3 of which she’s seemed worse rather than better.

It’s tough to know what’s best to do without knowing anyone
with experience. The social worker at her facility has been helpful with
answering my questions, but hasn’t given a lot of insight. She basically
suggests having her psychiatrist continue to make medication changes and wait
to see if she improves. I’d welcome any suggestions. If there are any more details I can provide I’d
be happy to. Thank you for taking the time to read this.

2

Yes, the treatment did come after her first psychotic episode. For a number of years prior she had become mistrusting of others and became delusional, but the voices came on very suddenly. When I initially asked the director of the facility if she anticipated my mother improving enough to return home after a few months, she seemed to think she would.

What kind of time frame do you think we might expect? She does have a house and a pet that family members take care of (I live across the country) and I handle her finances, but if we’re looking at several more months, or even years, we’ll need to plan accordingly.

3

Prior to being hospitalized, she was hearing voices constantly and could barely function. I’ve spoken with her about it as well as the case worker at her facility, and she says she no longer hears voices. However, she does have a lot of delusional thoughts, which has been the case for years. For instance, when she sees certain combinations of numbers it can arise suspicions, and she’s skeptical of signing any kind of paperwork.

Thank you for your input on medications. Do you think I should try to get in contact with the psychiatrist directly to express my concerns and ask about switching her to a newer class of drug?

4

Thank you for all of your input, it’s much appreciated. I guess expectations were a little high from myself and family members in regard to how soon she’d be well enough to be on her own. We certainly don’t want her to be home if she’s not truly ready. I will keep checking in with her case worker and see what I can do about having her medication changed.

5

Thanks for the suggestions. I’ve had her sign a release for the assisted living facility, but not with her doctor. I’ll see if I can do that as well and give the doctor my input.

From what I’m gathering, to reach a point where my mother is accepting and understanding of her illness will mainly require finding the right medication. If that is the case perhaps the facility she’s in wouldn’t have a big impact. She does see two different psychiatrists once a month each and they speak with the staff at the facility, who have all been very friendly and helpful, and don’t doubt they have her best interest in mind.

Anyone have experience with both mental health treatment centers and assisted living facilities at this stage, or have an opinion on whether this would have an impact on her improvement?