Struggling to support somebody with OCD

[Greenfingers12]

Don't want to give too much detail, but it's a family member living nearby who's quite unwell and declining. I am helping them as are external care staff, but their OCD is making visits very difficult.
When I go there once or twice a week, I will end up staying much longer than anticipated because if I accidentally touch anything they will shout at me to wash my hands.
They will make me clean the same items again, and again, and again. I will help them to have a shower but they will literally spend up to an hour scrubbing themselves raw.
They want me to wipe down any shopping I bring them several times.
If I try to leave they can become nasty.
Short of just walking out I'm not sure what to do, as it's my family member but this is making my life a misery atm. I know it's mental illness but it's very hard to support. I know they are also very unwell and I feel guilty.

I can be easily washing my hands 10 times whilst I'm there.

Stop going. You are not obligated to help someone just because they are family.

What are they doing to overcome their OCD?

Carers are having the same issue and I believe some have complained to the agency.
They aren't doing anything, she's in her late 60s, I don't think there's any mental health support.
She is terminally ill and I feel I can't just abandon her.

She will stand over me to make sure I'm washing my hands in the exact manner she prefers, the visits are very suffocating. I need to speak to other family members I think.

Are they on medication? It does need reviewed if it isn’t working.
I have a very close family member with OCD, but it doesn’t manifest in cleaning which I feel like is all people associate it with these days.
There are majorly ups and downs, I think dealing with any mental illness that has manic tendencies is extremely difficult.

She's on pain relief medication but nothing for the OCD it seems. I need to speak to someone about this.
Yes I totally understand, I suffer with OCD in the form of obsessive thoughts and I know it can be very stressful.
I will definitely speak to someone about Medication for it.

That must be exhausting. I have a friend who developed serious hygiene OCD during covid and frankly our relationship has suffered badly.

She won't eat anywhere but her home, won't socialise indoors, constantly goes on and on about how selfish and dirty other people are. It's wearing and frankly a bit insulting.

She is trying to get better though and is in therapy.

TBH I have taken to telling white lies so smooth things - last time we went out she refused to use the venue toilets even though she was bursting as she was worried they might not be clean. I went in, picked a cubicle that looked fine and then came back saying I had just seen member of staff to cleaning it.

I’ve answered YABU. Because you cannot keep indulging this. It is unacceptable and you are running the risk of making yourself ill.

Just do not go. You can be a support at the end of the phone. You can send supermarket deliveries but do not enter the house. Be very clear why you won’t.

Does she recognise that she has ocd

She has no children and I am one of her few local family members. She has also been racist to certain staff of colour which is unacceptable, by not allowing them to touch her.
Unfortunately I may have to even though I feel terrible. She still has the carers' support.

It sounds like she’s spiralling into more and more severe ocd, and if she’s alienating carers her MH will now be impacting her physical care. She needs focused help to get out of this situation. Can you help her access that?

I have had OCD for a long time, including cleaning and germs related obsessions/compulsions. I am so sorry you are having to manage all of this. I know that when I was ill I could be incredibly controlling to people around me because my brain was telling me it was life or death - but it wasn’t and I was being completely unfair to people.

I think the medication situation definitely needs reviewing - a high dose of Sertraline worked well to initially bring the level of obsessive thoughts down and increase my ability to resist the compulsive behaviour.

Has your relative got a GP you could mention the issues to? I know they won’t be able to say anything to you, but they could try and discuss with your relative.

I would stop visiting. Sorted. She has help. Stop indulging it. Yes she is mentally ill but you matter as well.

what's the situation with her illness? You said it was terminal. Is it cancer? If it's possible she's only got months left, it's unlikely that tackling her OCD is a priority for her. Often OCD sufferers are performing rituals/washing hands as a coping mechanism for underlying anxiety/trauma so now more than ever the OCD will be a hard thing to break and probably offering comfort and predictability in her very uncertain world.

If I were you I'd visit but wouldn't perform any of the tasks she expects you to do. If she wants to wash her own hands ten times, fine. She can. But don't do this yourself. Tell her you're not prepared to do this anymore.

Every time you or they do a compulsion you they give in to their OCD which makes it stronger.
the correct thing to do is refuse. I know this is hard and yiu or they will loose many of the battles but it’s the only way to deafest OCD. ERP exposure response therapy is the gold standard.

there is a useful book called something like “helping a family member living with OCD” where you can learn many more things.

“When a family member has OCD” it’s called . I have OCD myself (not cleanliness related but it’s all the same).

If she is at the end of her life with a terminal illness, she will be feeling completely out of control and powerless. This, and the fear of contamination, controlling you will bring some (short term, momentary) relief.

It’s amazing that you are helping her. Is there a way that you can still help but make it more sustainable for you?

Professional help will be important I think. May be an honest but empathic conversation with her?

Has she had treatment for her OCD before?
Stress is a huge trigger and if she's also terminally ill she must be pretty scared right now.

It's not 'indulging' ffs, it's referred to as accommodating and the default for most family and friends is to do the rituals because of the high levels of stress and behaviours of distress that the person with OCD can experience.
It doesn't help, but without any skills or support for the person just stopping is impossible for them and very difficult for them to manage.
I would start to step back - 'I am washing my hands once because you want me to, but there is no need and I'm doing it because of your OCD' don't repeat it, do it 'properly' once and then continue the thing they need help with. Or don't, but you have given a warning. Always refer to the OCD and don't support the idea that something is dirty or scary if it objectively isn't.

Thank you. I'm unsure how long she has left exactly, she is still able to walk around a little bit etc. But has lost a lot of weight. Her treatment has been withdrawn and she's just on medication to manage the pain.
She's always been a volatile person, if I don't wash my hands she'll shriek at me to do so.
I completely understand the situation she's in and I know a lot of this is likely down to anxiety/control.
I will see if I can speak to anybody about this and about GP referrals.

From what you've said about her having 'always been a volatile person' and also the fact that she's been dishing out racist abuse to her carers, it sounds her personality is actually more of a problem for those around her than the OCD.

It absolutely is draining being around someone with that level of anxiety and obsessiveness, always. But it's being made a lot worse in your case by the personality of the OCD sufferer. It's hard to be asked to wash your hands a dozen times in an hour, but it's even harder when you're being screamed at to do it or the person doesn't recognise that they have a problem.

As others have said, I would guess that being terminally ill and relying on carers etc has meant a huge escalation of your relative's anxieties, associated with the loss of control and fears of germs etc while her health is fragile. But at the same time, that doesn't mean you have to take abuse and screaming from her and it certainly doesn't excuse her being racist to care workers.

Your relative needs to seek appropriate treatment. OCD rarely goes away on it own. I had it as a teenager (had therapy) and my 11yo DS now has it. Our entire lives revolve around our son's OCD. He is having CBT but it is a long, gruelling process. He has a fear of germs, but the initial trigger was not germs. It was a specific fear which led to counting rituals to allay this fear, which eventually became centred on germs. It is very complex and debilitating. I find it helps if I separate the OCD from my son and think of it as something living inside him. It stops my frustration from turning to anger.