Family and Caregiver Schizophrenia Discussion Forum

SZ mom being released from hospital - High Stress - How to help?

My mother has been in the state hospital for nearly a year now with sz. In comparison to a lot of the cases I’ve been reading about on these forums, she is a relatively mild case. She doesn’t have violent tendencies or hallucinations, but she typically has delusional beliefs and actions when sick.

Anyway, she’s progressed well enough in treatment that she’s due to be released tomorrow into a halfway house (known as Intensive Residential Treatment, or IRT). At this point, she’s completely lucid and rational, but she’s very nervous for the transition out of the hospital. Her stress levels are high, which can be a precursor to a relapse. (Which, obviously, we do NOT want.) My wife and I have been visiting her weekly in the hospital throughout the duration of her stay. We live about a mile away from the hospital, but we are both working to put ourselves through college and so it would be hard to spend much more time or money to take care of her.

My mom is nearly sixty, and is nervous about finding a job, finding housing, getting her car in good order, and just about everything else imaginable. She has grown somewhat comfortable with the hospital over the last year, since they take really good care of their patients, and the hospital offers a predictable, stable environment (which keeps her stress levels down - she doesn’t handle the unknown very well).

We are concerned she might drive herself to relapse shortly after her discharge. Does anyone have any ideas on how to help her calm down and keep her stress levels low?

Thanks in advance for all your support and ideas.

Maybe you could get her out slowly? Have her spend weekends in her new habitat and then build from there. Give her time to adjust.

Also, is there some sort of “meditative” activity she liked before she got sick? I don’t think taking care of anything, like a plant or a particularly low maintenance cat, would be a good idea. I think that it would just add stress.

Does she have a therapist set up? Even someone who isn’t “top notch” can help as long as they are non judgmental and a good listener in my opinion. My therapist has never dealt with a sz person to the best of my knowledge but my case is very mild too. Part of the appeal for me of a therapist is they legally can’t repeat anything you tell them unless they think that you are a danger to yourself or others. That fact really comforts me and helps me open up. I don’t know your Mom but for me being able to say what is scaring me, bothering me, ect to someone who can’t repeat it is much better than a diary because diaries can be read. I know that sounds incredibly like paranoia, but I only write in my diary when I am furious with someone.

It isn’t that I have some sort of terrible secrets but she is probably annoyed with a whole lot of people that she can’t say anything too because she knows that her annoyance or resentment is unfounded. I have gotten really, really annoyed with friends sometimes because they have some stupid habit or said something that annoyed me that I just can’t let go of. I am NOT saying that your Mother harbors nothing but love for you, what I AM saying is that if she is anything like me she may be very sensitive. Lots of times I get annoyed with or feel distant from those that I love the most because of stress or bad meds. Or both. So if your Mom shows these things just know that it is stress.

If someone from the hospital is staying with her mentally (she may have made some friends that she feels like she will miss or she does miss when she finally gets out) a therapist can help her make new friends or maybe find a way to visit them, call or write.
If I say something about it to someone else the worry or annoyance disappears for me.

For example: I told one of my friends about how my suite mate (I’m in college) never seems to contribute anything to our shared bathroom like the shower curtain or toilet paper. But once I said it, it was gone. Any of that bother was completely erased from me. I am very fond of my suite mate. She over heard me say that and got mad, but other than that we have only spoken about twenty words to each other. I like my alone time. I appoligized and we worked out a better plan but I would have rather her not have heard me because she is upset now and none of it bothers me any more. Something that trivial was not worth bringing up. Sometimes I still worry that she might be upset by what I said even though I apologized profusely (and I really did mean it).

There are also things that you can’t admit even to yourself that you can tell a therapist. For example I was worried that a couple of my professors were hitting on me but I was worried to even think that because that would be narcissistic. I am very full of myself any ways so this is a valid concern. I think that I was right but being able to say it even when I didn’t want to say it to myself gave me a lot of relief. (Note: it wasn’t that they were hitting on me, hitting on me, they just seemed very taken with me and that’s what made me nervous).

I don’t generally have delusions though. So there is that difference between us to take into account.

But finally (and most importantly) take care of yourselves. You can’t help her if you are burnt out and over stressed. It is bad for both of you. You will feel cruddy and she will feel cruddy because she feels like she is forcing you to take care of her (even though you are doing it because you love her and you want too). I feel that way sometimes when my Mom has to come stay with me or has to come get me because I am freaking out.

Thanks for all your input. The hospital does a very good job of transitioning patients out of there slowly - they have IRT, as well as a little job for her that they call “clubhouse,” that will allow her to continue to visit the hospital almost every day. Still though, she is concerned for her transition out. She doesn’t have much to do in the hospital, except worry all the time about… well everything haha.

Thanks for reminding me about burnout. It’s really easy for me to get burnt out - it’s just kind of my nature to want to do everything I can. I know in my head that I need to take it easy but sometimes I forget to actually do it. It’s good to hear it from someone else.

I notice that a lot of what you said about being worried/annoyed is very similar to what happens to my mom - she gets annoyed or stressed out about seemingly inconsequential things. I’ll try to continue to talk with her about them - hopefully it will help her get past them.

She doesn’t have any meditative activity that I know of, but we will certainly talk to her about the possibility when we visit her today. Thanks for the great idea!

Maybe meditation class or yoga class. They have special classes for seniors (get the doctors approval that she is physically up to it though). I always hated going to yoga class but I was always so happy I went afterwards. Exersize is good too. Does she read? My Grandmother reads a lot. If she can figure out how to use (I think it is the kindle) they have a subscription you can get that is sort of like a library. You can read as much of anything you want all month. You don’t get to keep the books but if she isn’t really into re reading them…

If she ever does get out on her own maybe a dog? My Great Aunt Eva had a small show dog named Holly. Because Holly was a show dog she was trained to trot along side her, not pull on the leash, not bark, but my Aunt would joke that all her neighbors knew Holly and she was just Holly’s human. My Aunt didn’t have any of our types of problems but animals are great companions and ways to get to know other people. If she likes cats there are cat shows. I don’t think you have to bring your cat or any cat. I’ve never been but I imagine there are lots of people there who are very eager to talk to each other about their Mr. Whiskers.

I recommend getting an adult cat if you want a cat. I have my own special method for choosing cats. If you have your own place and want a cat or a dog for your Mom that she can come visit that might work. But once more, caregiver burnout. Keeping someone else’s animal is not fun.

Thanks for all the ideas! I will float a couple of these past her. I don’t know how it will go because she has never really done much of any of this (to my knowledge) at least since she developed sz 15+ years ago. I’ll talk with her about it and I’ll let you know how it goes later on today, hopefully! Maybe it won’t make much of a difference, but then again, maybe it will. (One thing this whole experience has taught me is unrelenting optimism.) Thanks again.

It would also good to remind her that she should just take one step at a time, and not try to worry or do too much at first. Sounds like she will have other people with her.**

Treat her like she’s normal. It helps me when my sisters do that to me.