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MIL - Bi polar - wits end - please help?(18 Posts)
My MIL has a long history of mental illness, and has been diagnosed with bipolar for at least 30 years (she is 67 now.) As a family, we are finding it incredibly difficult to provide support and cope with her health in the last 5-6 months, and I was hoping that perhaps someone could offer some advice on where we can go from here.
MIL was widowed some 5 years ago. FIL kept her diagnosis and health concerns completely separate from DH and his siblings, they knew very little of the extent of their mothers mental illness which, unfortunately, has left them quite poorly prepared for her needs when FIL passed away. In the years since FIL has passed there has been a flurry of activity. She attempted suicide with medication, but was luckily found by DH who immediately took her to hospital. She stayed in a psych ward for some months before returning home and eventually was placed in a sheltered accommodation. It took some time for her to settle, and we did have another potential suicide scare when I found a note explaining ‘she would miss us all and needs to go, doesn’t belong here…’ The last 2 years (up until around March this year) have been a merry go round of good times and bad times. For example, on a good run she seems a loveable doddery 67 year old, and bad times include hearing voices, becoming paranoid, seeing things others can’t, people around her and on TV talking about her - and has also developed quite obsessive tendencies like washing her clothes every day at a specific time. We have learnt to cope with these occurrences with very little help or support from her mental health team, and found them to be quite difficult to speak to.
Fast forward to more recent events. In early 2015, she had a mini stroke and her physical health took a downward turn, which has a knock on effect to her mental health/wellness. There have been issues with diabetes control and water infections as she does not eat well (no water - only full fat coke and coffee – typical breakfast is possibly toast, lunch is crisps/snacks and very little for tea, perhaps fish and chips if the residents are all together socialising.) The warden had noticed an increase in her paranoia and she has had quite a few complaints against MIL from other tenants ranging from aggressive outbursts, to blaming neighbours for breaking into her flat and tampering with things/breaking things/stealing from her. We had also noticed that her medication was not necessarily being taken – missed meds in medipack. DH, warden, CPN and I got together to discuss what we could do to help MIL and, no thanks to her mental health team (MHT), we enlisted the help of carers to ensure she was taking her medication correctly and prompt her to eat breakfast/dinner. Home meals were attempted – this was a waste of time as she threw them all in the bin.
We have limped on since March/April with no real improvement, if anything her paranoia and aggression is worse. Approximately 6 weeks ago, she had a verbal altercation with a gentleman in the laundry room (who removed her clean washing as it had finished in the cycle, and he needed to use the facilities) – called him a range of horrific names, accused him of breaking into her flat etc etc. She then called my DH and said she knew he had hired someone in a van to watch her and called him every name under the sun/wanted to die, so I drove around to check on her and managed to calm her down. Her MHT put this down to a water infection, and basically refused to take any further action other than refer her to her GP for antibiotics. The crisis team were involved through my persistence, but apparently they are mostly there for people who do not have family support/MHT support.
Since then there have been further complaints/comments from tenants to the warden, with one lady putting in a request to move citing MIL as the reason. Last week MIL initiated a very nasty verbal attack on the warden, who has known MIL for decades and normally copes fantastically with her less volatile outbursts. I saw the CCT from this and fully support the warden filing some sort of procedure with her manager with regards to MIL’s suitability for the accommodation. I ended up hand delivering the email correspondence between myself and warden over the last few months as well as her request for a behavioural assessment to the Dr’s secretary that same day. I feel like I am hitting my head off a brick wall though, as we are still no further forward in putting together some sort of action. Her anti psychotics have been increased, and she has been referred to the memory clinic. That is apparently all that the MHT will do.
Am I expecting too much from them? Am I missing something? She cannot cope, and doesn’t seem to be in the right place for her care. She doesn’t manage her finances/diet/medication and cannot seem to control her aggression – I personally feel there is a serious breach in safeguarding, not only MIL, but the other tenants. Does anyone have any similar experiences or advice? I just feel like I am treading water right now, and something is going to happen where her residency is revoked (this is already being threatened) or police involvement – and her MHT seem happy to let it get to this stage!
I am so sorry that this is so long and garbled, I am just at my wits end here. I need to take my son to a activity, so will be on later to catch up (not a post and run!)
Oh God, that sounds horrendous.
I have bipolar type two and, if treated properly, it is an illness that is manageable.
Your posts highlights one of the most significant problems that people with bipolar have - they don't always take care of themselves or take their medication properly.
I don't really know what to suggest
fat help I am
It looks like she is no more suited to sheltered accommodation. It will not get better as she is aging. If she is not able to take her medicines then she needs assistance with it. She needs to move somewhere where she is receiving more care. A care home. I am not sure but you could probably involve adult social services to assess her care needs. She is a risk for herself and others. Best of luck, what a responsibility for you!
Is her psychiatrist aware of the issues? If so I can't understand why medication alterations haven't been attempted. Sone drugs can be given on a 2 weekly/monthly basis via injection. The current culture is to treat people in the community sometimes with the help of careers. My 1st port of call if I were you would be to arrange an appointment for her with her consultant psychiatrist to review her medication.
Gosh, what a very difficult and upsetting situation for you all
I really don't have anything to offer - except my support - but I wonder if procedure is that things have to get to an acute stage (to provide solid evidence?) before anything gets done. Absolutely pants for you all - but NHS mh care is not known for acres of funding...
You could post on the mh board to get some more solid pointers?
I think sadly she would better off in home .
Go for one that can handle dementia. Not saying she has it just that she has the behaviour s which will get her thrown of nice places.
Be 100% with the home and what she is likely to do.
Hi all. Rugby was bliddy freezing!
Thank you all, I appreciate the responses. We have already enlisted carers for her medication, they come in the am and pm to witness her taking them.
I honestly believe that the MHT are happy to leave this whole situation until something more serious happens and she is forced out. Whether this is due to funding/facilities or just incompetence or laziness I am unsure.
Thank you for the advice to move this over to MH - I will ask for the post to be moved. Perhaps someone with medical background can give me some pointers xxx
Have you spoken with MIND? Or Carers UK? They might be able to offer some advice.
I agree with pp that your mIL needs to see her consultant psychiatrist. Circumstsnces have changed and her support needs to be reviewed.
Also, speak to your own GP? You are effectively her carer and need support to do this.
This sounds horrendous for all of your Family. It's shocking that the MH team are seemingly allowing it to get to crisis point. I presume they have other very pressing cases, And it's not their fault the 'system' is letting you down. But the system needs to change
pigs might fly
Poor souls, that's a god awful situation to be in for all of your family and her. My first wife developed this awful lilness and ended her suffering herself, and I know it sounds very hard but it seems to me that shes not going to get any better as time goes on. That Stroke you mentioned is a bad event as that's probably added to the damage to what's already there.
Sorry to say also that sometimes with the MHT you really need to kick someone's arse or it does take a serious adverse event to make things happen. I can only suggest that you make your concerns known to the GP concerned and push him/her to get her moved to a more secure place if at all possible. Make a point that its causing you very severe problems and its affecting you and the rest of the family. It i don't think will be easy but that's about all you can reasonably do.
But bless you for taking concern about her i know all too well how difficult it can be!
Thank you Gazelda and Justaboy.
She saw her psychiatric Dr on Friday, and again yesterday. We have been advised that her anti psychotics are being increased, and she is being referred to the memory clinic and that is all.
I hate the thought of her slipping through the net, and I am so on edge that she is going to do something or fly off the handle and be put back in the psych ward. It took us so long to get her back to her old self last time
Rather than moving the thread, perhaps start another one in mh? You could get some good support in relationships from people who have experienced similar but don't frequent the mh board?
Oooh, am I allowed to do that? I thought you had to move it rather than start a new one?
Having gone through similar behavioural challenges with DM I honestly think you need to push, push PUSH for a really thorough dementia assessment.
It's a nightmare, op. Sorry you're having to deal with it.
pm me if you want any pointers. X
God that sounded really arrogant. I'm no expert and am certainly not a psychiatrist, but what I was meaning to say was I have very recent first hand experience.
We started at WTAF is fucking going on here? So I might be able to help.
Lol Trooperslane, we have been at 'WTAF is fucking going on' for a few months now! I can't quite believe the sheer size of the grey area we seem stranded in.
She is being referred to the memory clinic for tests, had one today which showed a decline in certain areas - but the over all score was far from bad.
I just feel so un educated and un prepared for her.
Oh Chebs it's very hard.
Caught between chivvying her up to take some responsibility for herself/trying to work out what was ACTUALLY happening.
Would recommend contented dementia by Oliver James - I realise I'm totally un qualified and possibly projecting, but if it is the case it helped us to get our heads round how to deal with the paranoia.
E.g DM "there's someone living in your sister's bedroom and I'm scared of him. He is ignoring my notes telling him to go away"
Me "Mum, there's no one up there! You're scaring me"
Deeply ashamed of how bloody clueless I was.
What I should have done was acknowledged her fear and asked how I could help and then swiftly on to some serious distraction.
Quite funny in a way.
When I finally managed to get her to agree to go into hospital after she was kicking her handbag around the living room, being really aggressive and telling me to fuck off... Turned into a bad teenager.
Hospital did the memory test. She couldn't remember the name of the hospital but was still on the ball enough to spit out with utter disgust "David Cameron" when asked who the PM was.
Sorry for derailing the thread. I'm reminiscing but hear parallels in your story so do please shout if you think I can help.
Thank you Troopers.
My DGM was diagnosed very early on with Alzheimers - just 58. She went down hill after about 4 years, and then it was many years of almost a completely different person. I know it isn't necessarily the same, but I remember feeling the same way.
We shall see what the Dr's say - I hope this moves relatively quickly, but I get the feeling we are WAY down the priority list.
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