Helping my mom who has severe anosognosia

I’ve read and received a lot of advice on how to listen to and support those with schizophrenia who are unaware and unwilling to acknowledge their condition. However, my mom’s situation has long ago reached a point where she cannot be helped unless she recognizes at least some of her delusions.

Background: She’s lived in assisted living for about 15 years, since I was 11. My father kept us separated (he was very emotionally abusive to her when they were married) as much as possible. When I had the autonomy to reach out to her, I didn’t for a while, or I only did at arms’ length, because my mom enabled my CSA by helping my father avoid criminal charges + giving legal permission for him to move me away and have more control over me. She had reassurance from her delusions that what she did was okay, and would even help her in the long run. Even in that context, I can’t forgive her, because while she was unaware that her plans to “fix” things weren’t possible, they still involved endangering my sister and I. And beyond that, she is very dismissive of what happened to me and how my trauma has taken so many opportunities away from me. I’m only just now in a more stable position where I’m not suicidal at all.

However, my mom’s quality of life is in jeopardy more than ever. She was diagnosed with stage four breast cancer two months ago. Luckily, it’s surprisingly treatable, but she’ll have to take medication for the rest of her life. However, it got to this point because she opted not to follow up on a mammogram years ago. And she hasn’t come to terms with it- she thinks it will be cured soon by a person who doesn’t exist, and she’s holding off on her other physical health problems until the “cancer is done”.

On top of that, her mobility is way worse than I or even her care coordinators were aware of. She’s been using a walker for years due to osteoporosis, and has refused to go do physical therapy beyond occasional at-home stretches, because she also thinks that will get cured soon. When I see her, she hides how much trouble she has walking- I think she prepares and saves more energy, but she also allows me to help her more and so doesn’t have to get up as much. But then I heard that she called 911 for help getting up, because she couldn’t move at all. Her care coordinator has tried arranging a home health aide for her, but my mom is offended and gets angry at the idea. The new plan that her team proposed is to find a nursing home for her, because both her physical and mental health needs are beyond what they can provide.

Right after we decided this, my mom had two separate trips to the hospital. One was to a psychiatric ward, because she thought an enemy of hers was using her magical powers to poison her. She actually imagined the doctors agreeing with her about the poison, and showing her proof. The second time was for shortness of breath, caused by the cancer being in her lungs + East Coast air quality issues. She believes that was also for poison.

I’ve tried talking to her to reassure her that no, it wasn’t poison, it’s the cancer, which is serious but much more controllable and predictable. I’ve told her there are cameras and staff watching out for her, and that everyone I’ve spoken to- over a dozen people just in the last two weeks, from doctors to nurses to her care team- have confirmed that it’s not poison.

As usual, she got vehemently angry with me. While she didn’t threaten me or call me a stupid b*, she did scream at the top of her lungs that she’s not schizophrenic and she’s tired of this bullsh*t. I was honestly, seriously going to stop trying to convince her, and instead follow advice on just listening and validating emotions. I still tried primarily doing that- staying calm, telling her I believe that she believes this and how much it hurts, that it’s not her fault and it’s just a medical condition. I’ve thought of bringing printed articles next time I see her (she forgets/insists what schizophrenia is), specifically about her common delusions, though that feels like a bad idea.

This is not even the worst of it. She’s denied herself the opportunity to visit her home country and family for over 2 decades, because of delusions saying it’s not possible when it is, or it is when it isn’t (ex. she refuses for me to plan a trip there with her, but then imagines her “friend” telling her they’re going to the airport tomorrow, and getting confused when no one shows up). But now it’s every aspect of her health and life. If I could get her to fold on anything, it could make an enormous difference. For example, I’ve tried talking to her about using a wheelchair, because she’s against physical therapy, and she doesn’t go outside often due to mobility issues. But she got very angry and expressed a lot of internalized ableism at the idea. Like everything else, she just said “you’ll see, you’ll see”…like she’s been saying for years.

I’m sorry for giving our life stories…I had to cut a lot of details out, actually. Point is: I think I’m trying my best, but my head is only just above water. My mom is drowning, and even if I could disregard every boundary I’ve struggled to establish with her and help her, I have no idea what would work. Before I had a clue how severe her schizophrenia is, I thought she may become aware and accepting. But now, I just hope for a break in the loop she’s in. Any thoughtful input would be immensely appreciated.


Hello @axolotl and welcome to this site. I am so sorry that your mother is doing so poorly and that she has never recognized her schizophrenia. It is a common condition unfortunately for those who have schizophrenia and makes it much harder for caregivers. I can’t imagine the emotions you are feeling with her current cancer diagnosis and other physical troubles on top of the severe mental illness she has struggled with for her lifetime. I went through my own battle with breast cancer (Stage One at the time is was treated) and my daughter’s schizophrenia, so have some personal understanding. I hope that a nursing home for her can be found, if the assisted living can no longer take care of her. In my personal experience, nothing handled my daughter’s anosognosia except for being on a monthly shot for over 2 years, at which point she could finally look back and see her prior years of troubling voices. She still does NOT believe she had hallucinations and delusions however.

My only real advice is to do what you can to help your mother. But to also be kind to yourself, care for your own stress levels, and to accept what you cannot change.