Family and Caregiver Schizophrenia Discussion Forum

Trying to help sister-in-law


#1

My sister-in-law was diagnosed with schizophrenia almost 25 years ago. For years she lived with my mother-in-law, or on the streets and in homeless shelters, as was her choice. Then, when my mother-in-law moved to another state, my sister-in-law followed, and kept her own apartment for about seven years. In 2013, my mother-in-law was diagnosed with lung cancer, which had already traveled to her brain. I stayed with her for five weeks and took care of her until the end, with the help of the wonderful people at Hospice, of course. My sister-in’law was there too. At that time she was still functional. I’m not sure what effect the death of her mother had on her. I wonder if she is depressed. Since then, my husband and I were able to purchase a property with two houses, so my sister-in-law could live in one. A year ago,when we all first moved to the new location, my sister-in’law was still functional, but has been seriously decompensating for the past several months. She is not on her proper medication, and refuses to take the prescribed amount anyway. I am doing her laundry and her grocery shopping. Her life revolves around her strange diet and the food she eats. She is becoming increasingly more helpless. She is becoming like a hypochondriac, and germaphobic (?). I’m not name calling, I’m just trying to explain. She called 911 a couple of weeks ago because I didn’t get her oatmeal to her by 5pm. She sits in a chair, the only chair on the planet she is “able” to sit in, literally all day long now, insisting she can do nothing and needs to have a private room in a hospital somewhere. She keeps saying she wants to go to Hospice, which we keep explaining to her is for people who are terminally ill. She said she is not suicidal, but tells me if she can’t go have a private room and lie in a bed somewhere, she will “just die off here.”. She thinks she has a head injury (although she was checked out and nothing was found )and every little thing under the sun (including private functions) triggers it. I have taken her to a general practitioner, who so far, has found nothing physically wrong with her. But she thinks there is something wrong with her arms, she is too weak to do anything. I have to put away her groceries, opening containers for her. She says she cannot even hold a bottle of water. She keeps thinking she needs other medications, such as penicillin. She is obsessively brushing her teeth and washing her hands.She says the voices here are mean and evil. She is making no sense, of course, and has SO MANY delusions now. I have not yet gone to classes at NAMI, although I think I should. Does anyone recommend it? She has an appointment with a psychiatrist in a couple of weeks, but already insists she will not change her meds, and is already talking about not being honest with the doctor. Just getting her in the car is a chore. Hopefully the visit will be of some help, in the meantime, I thought I might find some support here. I apologize if I have vented too much, we are at our wits end. Anyone else experiencing anything like this? we need HELP!


#2

This is a sad story. It certainly seems that her mother’s death has been a serious trigger. It sounds like you and your brother are making great efforts to help his sister transition to a new living arrangement at this time, but she may need some additional help. Hospitalization might be very helpful at this point to re-stabilize her. Case management from the area mental health service provider could also be helpful.

If your sister-in-law is unwilling to be med compliant and it can be shown that she is not able to function independently or perform self care, you all might benefit from investigating getting guardianship. This will help with enforcing med compliance and necessary care. Guardianship can always be relinquished if your sister-in-law is able to again manage her life successfully.

I have not done the NAMI classes, but have heard good things about them.


#3

As Vallpen said, the hospital is the best place for her right now. There they make her take medication. Also you can talk with them about her getting a shot once a month of medication. The time she spends in the hospital will give you time to regroup. I hope you can get her through this. Time is of the essence here.


#4

Thank you Vallpen and metime for your responses - It is actually my husband’s sister, and we have always agreed to take this on. We don’t have any kind of legal guardianship, as far as we know, she is considered to be an adult, supposedly capable of making her own decisions. I agree, and apparently my sister-in-law does too, that hospitalization will be helpful to her. My husband might be sad, but I know he wants to do what is best for his sister. We have told her

that if she goes into a hospital, they will make her take meds, she seems okay with the idea. Our next question is, are there reliable, caring facilities, (especially near us) that take medicare? I imagine we would find out, further down the line - what will happen- will they stabilize her and release her, and then will we start over again? First things first. How do we go about finding proper care? Wait to talk to the psychiatrist on the 31st of this month? I really appreciate your input. It is a sad story.


#5

P.S. - the office where she is prescribed her meds- I was not able to talk to the doctor, but the office manager seemed to have the attitude of “tough love”. It is difficult to agree with, in a situation such as this, as it is not her choice to be mentally ill.


#6

Lastly, you mentioned time is of the essence - do you think it unwise to wait for the doctor’s appointment on the 31st? What do you think will happen?


#7

Oh, investigate guardianship - thank you! Yes!


#8

Can’t thank you enough …


#9

Yes, and it is not the office manager’s choice what happens to her. But if I were you I would just pay as little attention as possible to the OM as long as you SIL has a good enough relationship with the actual doctor.

The other thing I’d suggest is that once the hospital has her a bit more stable, maybe a bit of good old-fashioned grief counseling might help her.


#10

Grief counseling is a great idea.

Once your SIL is in the hospital, social services can help you learn about community services begin looking for alternative living situations for her, if that is what is necessary. I think your original plan of neighboring houses sounds wonderful if she can restabilize and work with you and your husband. It sounds like she had a lengthy time of being relatively stable, so she may well be able to get back to that once she has worked thru the sadness of losing her mother, and becomes comfortable with you and your husband as her new support system.

Time IS of the essence here, in that the more she decompensates, the more difficult it will be to restabilize. The office manager needs to be got around somehow - it is so frustrating to deal with people who wrongfully think they get to make the decisions!

It sounds like your sister-in-law has a very strong case for being admitted as a hospital inpatient. If she is amenable, it would probably be the thing to do.


#11

I am sorry for not responding to your concerns. I drop in for the occasional visit nowadays.

You should be okay if she wants help. I have to agree with the tough love stance. Sz makes people want to do weird stuff that doesn’t help them at all. It is like parenting, kids need boundaries and so do people with Schizophrenia.

For future reference, when in doubt hospitalize. Psychosis eats the brain. You want to do everything in your power to keep it at bay.