Parents have completely fallen apart. What should we do?

[midge1969]

My parents, who were previously well-adjusted and quite happy, have completely fallen apart during this lockdown. My mum has always struggled with anxiety. She's never had to fend for herself as my dad takes care of everything, so banking, shopping online etc are all a mystery to her. During lockdown my dad's had a number of health problems and suddenly the notion that he might not be around forever to take care of things has hit my mum like a ton of bricks. She has had a complete mental breakdown. She follows my dad around the house wherever he goes, even to the toilet, and if he isn't paying her his full attention she pinches and kicks him. She has major health anxiety, is convinced she has diabetes and refuses to eat even though she's had a negative test, and is convinced that my dad's current health issue, which the doctors say is an inner ear issue, is motor neurone disease, which she tells him repeated. She refuses to sit and constantly walks round and round the living room clapping.

       The obvious thing is to seek help, but she refuses to do so, as she's convinced they'll put her away. By some miracle my dad and sister managed to get her to see a GP, but she put on a front so I'm not convinced the doctor got the full picture. She was prescribed Setraline which she's been taking for two weeks, but so far nothing has changed and I'm not convinced this is enough. But she's adamant that she doesn't want help, as if she gets better 'the problems will still be there'. She won't see a therapist or talk to anyone. My dad is in despair as he just doesn't know how to cope. My mum is a gibbering wreck and all day just repeats the same phrases, imploring my dad to help her but refusing all suggestions. I'm 100 miles away and my dad has COPD so they are shielding which makes visiting hard. 

          Is there any way out from this? Does anyone have experience of such a thing, and is there more we could/should be doing? Any suggestion of doctors or therapists sends my mum into a frenzy. At the moment we are clinging on to the hope that the Setraline will kick in but so far she's exactly the same, if not worse.

Your poor mum doesn't sound able to make decisions about her healthcare atm. I think your dad/sister/you need to speak to her GP urgently.

Your poor father is being abused. I would focus on protecting him if your mother doesn't want to help herself.

How old are your parents OP? To be honest, a lot of your mum's behaviour sounds like dementia to me - it sounds very much like a family member who was diagnosed with dementia. Can you seek an assessment for her?

I know how difficult it is if the person involved does not want to co- operate and how they can manage to perform while being tested. You might not get results straight away but it is a pathway and you need to get on it and keep pushing for input from the doctor and social services.

TBH the best thing at this point might be for your father to go to the doctors in his own right and say that he can no longer cope. In my (sad) experience nothing much seems to happen unless there is a crisis.

Agree about speaking to the GP again. Maybe pointing out there is a safeguarding issue. Do you think she should be assessed for dementia? Her behaviour is making me wonder if something other than anxiety is going on.

Cross posted with TooManyDogs

Is it possible for your dad to discretely record her, or you do it on the phone?

How old are your parents?

DF is a victim of abuse.

DM has dementia, as you doubtless know. Mood stabiiisers should help. But sadly that's the beginning of the problem, really - she'll kick off about anything you do so you might as well do what works. How old is she? Can you afford a nursing home? Her feelings at this stage are controlled by dementia and in any case, turning violent won't help her - she needs to be treated as any abuser is.

Call emergency SS who will sort you out. They are really, really good in cases like this.

Thanks for the replies. Actually quite shocked by the suggestions of dementia as I'd always thought of it as a gradual onset thing, not sudden like this has been. DM is 71, DF is 75.

I agree we should speak to the GP again, despite her protestations. That was my feeling and I'd said it to my sister but we were unsure because it went against DM's wishes. But the more I think about it the more I'm convinced.

Don’t be so quick to jump to the assumption of dementia.

While her symptoms overlap in many ways, if she’s an anxious person normally then lockdown will have massively escalated her anxiety. It’s entirely possibly that social isolation combined with a pandemic and constant anxiety provoking television news reports have just tipped her anxiety into massive overdrive. Sertraline will take 4-6 weeks to work properly so be patients and gentle with her and make sure she takes the pills. If she doesn’t improve get the GP back.

You dad isn’t a domestic abuse victim. She I’ll very unwell and she isn’t in control of what she’s doing right now but he needs to try and minimise the risk of injury to himself until she gets better.

GPs are dealing with many many cases of deteriorating anxiety related mental health right now. You’re right that Alzheimer’s doesn’t have an acute onset. Support your dad and keep in close contact with the GP until she shows signs of improvement. And keep reassuring her.

Some forms of dementia can have a rapid onset. That said, the important issue is to somehow find a way to get a GP to assess her. Sending you OP.

Gosh i could have written your post OP!

My grandparents had exactly the same a few years ago... turned out that after my nans massive heart attack it left her with dimentia.

Please go and seek help and if you dont agree with the dr's get a second opinion and please make sure your dad has the support he needs (too late for my grandad unfortunately as he is of the generation 'put up and shut up')

Absolutely - it could be very very bad anxiety but the repetition, the pacing and the clapping as well as the hurting DF are also dementia-like, which also includes anxiety. Vascular dementia can cause this rather more sudden change. You can have both anxiety and dementia, a lot of people do.

She won't see a therapist or talk to anyone. DM's in no fit state to talk to a therapist, don't bother with that.

OP, this might not cheer you up, but the person I know IRL who showed all these behaviours had a stroke after she deteriorated. Well, another stroke - she'd had lots of small ones, vascular dementia, undiagnosed. See a psychiatrist, not a GP or a talking therapist - DM needs specialist treatment.

. She has major health anxiety, is convinced she has diabetes and refuses to eat even though she's had a negative test,

The more unusual behaviours may be caused by or exacerbated by malnutrition and dehydration:

'Nutritional deficiencies. Not drinking enough liquids (dehydration); not getting enough thiamin (vitamin B-1), which is common in people with chronic alcoholism; and not getting enough vitamins B-6 and B-12 in your diet can cause dementia-like symptoms. Copper and vitamin E deficiencies also can cause dementia symptoms.'

www.mayoclinic.org/diseases-conditions/dementia/symptoms-causes/syc-20352013

You're right that she needs to see the GP - don't feel that you're acting against her wishes, she is clearly very ill and needs help.

Yes vascular incidents can cause acute confusion and dementia but generally there would be other signs too. This lady has a history of worsening anxiety so the GP is taking a sensible approach. If there is no improvement in a few weeks then investigating vascular causes would be worthwhile. But there is no easy fix for vascular causes so it’s not critical to investigate that yet. See if the most obvious cause responds to treatment.

And pacing/clapping/stimming and other signs of psychomotor agitation can occur just as readily in extreme anxiety as they can in dementia. So yes many people will recognise what is described in people they know with dementia and also in people with autism. But it also occurs in anxiety disorders.

It would help if you dad can keep a diary of her behaviour or video her so that he has good evidence to show the doctors of what things are like at home.

Just to touch on the sertraline. It can take weeks to reach a therapeutic level in the body. Two weeks isn't enough to really know the benefit, you need at least a month to six weeks.

Another person saying don’t jump to dementia. My mum has had GAD for a while but it got significantly worse very quickly during lockdown, and some of the ways it manifested itself sound similar albeit not as severe. It took about 6 weeks of the GP fiddling with medication dosages to start to see any gradual improvements. I’m so worried about what a second lockdown is going to do to her.

Hi,
This sounds identical to my 73 year old mother in law.

The increased anxiety, the aimless walking around, refusing to eat (as all food is out of date 😟), etc etc.

The onset was rapid and I thought she must have a form of dementia or tumour. She has always been an anxious person but lockdown has exacerbated 100 times over.

To cut a long story short, she was admitted and had all blood tests, CT scans etc which were all clear.

She was diagnosed with acute psychosis and is now under the (amazing) Community Mental Health team. After 5 days on Mirtazapine and an anti-psychotic she is starting to improve.

Feel free to DM me, it has been a really frightening and stressful time and I would hate for anyone else to be going through it x

Are you certain she's actually taking the sertraline? Not flushing it down the toilet or throwing it in the bin?

Since she doesn't understand technology can you video her discretely on your phone during a visit? Or even just record her repetitive speech with the phone in your pocket?

It's not fair on your dad, she's being abusive towards him demanding his full attention constantly and becoming violent if she doesn't get it.

How old is she? I would ask for a GP referral to either adult mental health services or elderly social services, as appropriate. Then something might get done because if your dad left her, to protect himself, then she'd definitely need a lot of help so the authorities will be keen to avoid that. I know he probably doesn't want to leave her, but the authorities don't know that.

If it was a woman being followed, kicked and pinched by her mentally ill partner who refused to get help, unless she did what he wanted at all times, nobody would think leaving was unreasonable.

If you can't get anywhere with the GP, if your mum is behaving like this in public you can call the police who will arrest her, if necessary, and take her to hospital for assessment. She's allowed to be weird in her own home though.

Oh darn it, didn't notice the date.

@matina12 reported. Fuck off with your spam.