Family and Caregiver Schizophrenia Discussion Forum

How much is too much?

My 24 year old son was diagnosed with schizoaffective disorder when he was 18. He collects SSI, is on Medicaid, lives alone in an apartment, has a case worker and a nurse deliver his meds twice a day. He continually goes off his meds. His apartment is filthy. His Dad and I go in occasionally to clean it up. If he wasn’t ill I would completely be on board with a tough love approach and not do it for him. Does tough love ever work with this illness or is it an inappropriate approach? He refuses assisted leaving or group living. His Dad and I take him grocery shopping and on outings because all his friends abandoned him.

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They will live in deplorable conditions regardless how many times or who cleans up after them, My wife and daughter are not allowed to enter my room under any circumstances (solid wood doors, locked, dead bolt, and padlocked when I’m gone), they are forbidden to enter my bathroom and strictly forbidden from eating and smoking in my TV room… They are nasty people and that will never change.

About once a month I bring in a crew to clean their end of the house or we would be infested with bugs…

A sufferer who spoke to our Family to Family class said that tough love had worked for her. Her family threw her out to live on the streets. She was beaten and raped before she decided living at home on meds was better.

I have to agree with GSSP, I think its rare that tough love works. Some people have success with bullying/forcing/cajoling their kids onto meds until they find a med that works. These methods seem to work when scz is more severe at a younger age. For others, no amount of such efforts will get them to take meds. We each have to do what will work for our relatives and realize the answers aren’t the same for everyone.

About once a year my son is gone long enough that I can thoroughly clean his place. Jeb is not allowed in our house. He is always very grateful. I do it more for me than him.

The “throw them out on the streets” approach is sometimes all you have left when you just don’t have anymore to give to this terrible illness.

They are so helpless, its like throwing a puppy into traffic. But sometimes, its save yourself to try to reduce the amount of damage scz does to you and your family.

My husband would really envy your situation Warrior 1.

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It’s really hard to spend the time to find out what is the illness and what isn’t. The way I think about it is: just see what my family member can do. I learned the very hard way that my family member is disabled in many ways by the illness. Not in all ways, but definitely in the realm of activities of daily living and lots of vocational stuff.

Everyone is different. And the illness changes, so someday our family members may be able to do more for themselves.

We always have to be able to have our own boundaries and see whether or not our family members can do for themselves. I guess there is the above anecdote of tough love working, but I don’t think it’s common for that strategy to be effective. I wouldn’t call it tough love if you just stop cleaning his apartment and stlll take him to the store and outings.


My son lives with us. His room made the people on hoarders look neat.
When he was younger, I would clean it now & then - then, I kind of just gave up.

When he went to the hospital for the first time about a year ago, I must have spent 10 hours a day for about a week cleaning his room. I threw away a pickup truck full of nothing but trash. I literally scraped stuff off the floor. I washed the walls, the inside of the closets, you name it.

When he came out, he wasn’t well, but the room never got back in quite as bad a condition.

He went back to the hospital 4 more times in the past year until we got his meds somewhat straight.

Now, I take 10 minutes every other day to pick up anything in his room he didn’t pick up.
He’s still very messy in the kitchen, but does attempt to clean up a little. As long as he’s showing some kind of effort, I’ll do the rest. Now & then, I’ll point out that he could have put something in the trash.

We’ve talked about it, and he honestly does not see the mess & disorder in the same way I see it. He’ll say he doesn’t know how to clean, but he can do it if we do it together - and he will sometimes clean something on his own outside his room. Like mop the floor or wipe off handprints on the door - just depends on what catches his attention.

It kind of sounds like he didn’t improve much, but it’s like day & night compared to what it was before.
I don’t think most people with SZ will ever be neat freaks, but they can improve with the right treatment.

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My ex is like that with the cleaning, to a point. He now lives with his mom, so he can’t get away with leaving dirty dishes about. When we were together, I’d often come home work to a sink full of dirty dishes that we’d argue over who would wash… But I wonder, if he lived alone, how often the dishes would be done.
Right now, he tells me that he can’t get going on cleaning his room. Mostly it’s papers all over the floor. I suggested starting with old bills-- throw them out, it’s mostly computerized anyway! But he did not like that idea. So he’s done nothing.
He also kept EVERY empty pill bottle . Over the years, there have been dozens. I found out when once we were moving that there were trash bags full of them stashed in the attic.

My son went thru several apartment leases, leaving each one on the verge of eviction due to complaints from other tenants, as well as the condition he allowed the place to get into.

But he has slowly improved. I have had him live in both group homes and assisted living - because, quite simply, I would have lost my mind myself if I hadn’t at those points. Now he lives in a house I purchased and he pays rent to me out of his SSI. He doesn’t clean, but he also doesn’t mess it up. He puts his laundry in the basket, and will wash it if it piles up. He puts trash in the trash, and recycling in the recycling bin. I put out the trash and recycling myself. He has his books arranged according to his own mysterious system, as well as his CDs.

Part of the arrangement was that he would let me come into the house regularly. I put dishes in the dishwasher, and wash up dishes I use to prepare his dinner. I occasionally clean the bathroom or vacuum.

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It is interesting reading this. I can see that my parents treated me very harshly and used the tough love approach all the way through with me. They rarely offered me the carrot, but I sure got a lot of the stick all the way through. Part of it might have been that they had both been in the military (that’s where they met). Not keeping my room clean was not an option for me, ever. They used both verbal and corporal punishment on me, when I needed it. And they took away privileges at times also. If I mouthed off to my mom or dad, my dad would make me wish I hadn’t. One time I even got locked out of the house and had to spend some time living outside.

Anyways, they didn’t let me sit around all day doing nothing. I was kept busy cleaning the house, sweeping the floor, mopping the floor, dusting furniture, cleaning the windows, doing the laundry then folding the clothes and putting them away, cleaning the bathrooms, taking care of the lawn, sweeping the porch and sidewalk, etc. And they never paid me for any of it. It was a huge incentive for me to go out and find a part-time job. Because I realized that I was going to be busy all day anyways, but I wasn’t going to get paid for it. And now I pay them rent.

And they wouldn’t allow me to socially withdraw and isolate myself. Relatives came over (and still do) all the time to see me, and my mom and dad took me (and still do) everywhere they went unless they were working. I also had to attend a group therapy class for schizophrenics on a weekly basis. That helped me immensely because I got to talk to people who were going through the same or similar experiences. I still keep in touch with two of the friends I made in that class. This is one thing you can do for your sons or daughters. Make them go to a group therapy class for schizophrenics. It will give them a chance to socialize with people who might be able to understand them and get them. The rest of it is probably not practical for you to do. I was raised that way, and so I was used to it. To suddenly impose a military style parenting regime on people who had never been treated that way would be traumatic.

But the alternative, of letting them socially withdraw, isolate themselves, and turn almost vegetative might have some long term consequences for them.


Thank you for your insight. By tough love I did not mean to imply I would yell at or hit him. I just wonder sometimes if I’m doing too much for him.

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While our situations are more complicated, I guess the same rule for using them when they were young and before they became ill might apply. That we shouldn’t do anything for them that they can do themselves?