My mother suffers from schizophrenia and has suffered most...

A fellow caregiver asked...

My mother suffers from schizophrenia and has suffered most of her adult life. She has been hospitalized at least two to three times that I know of... She is very secretive about her illness so I don't have all the information. My mother has moments of clarity where is appears normal and able to function relatively well but these moments are getting less and less apparent.

I am concerned about the following:

-she gives away food, money, housewares which she desperately needs even to the point where she has nothing left to eat. When asked if she ate she always says yes but when you check the refrigerator or cupboards they are bare. She has thrown away grocery that has been given to her.

-she lives in Florida and even during the summer time will not turn on air conditioner or use a fan. she claims that the air hurts her arthritis.

-keeps the door unlocked and open all day & will let anyone enter the home. I'm really afraid for her safety

-she lives alone and won't allow any of her children to stay in the home with her even though it would help with housekeeping and help with the rent payment.

-She lives on a disability check and most of it goes to rent she has less than $50.00 left over for the entire month to eat, and pay utilities. She could apply for food stamps, or rent reduction from the government or move in to a senior facility but she refused to do so.

-has conversations with herself - I thought she was talking with another person but when I saw that she was alone I was shocked

-She is not violent and never has been - wouldn't hurt a fly

I want to meet with her doctors but she gets very upset if I mention it. I'm certain she is not telling the doctors anything so they don't know how sick she really is. I feel so helpless, angry, sad, miserable, frustrated, - how do I help my mother? Can I have her declared incompetent so that I can take over financial and medical affairs?

Expert Answer

Maria Basso Lipani writes a popular website on geriatric care topics, where she puts her expertise as a Licensed Clinical Social Worker to good use answering care planning questions. Maria is a graduate of Columbia University School of Social Work and is licensed in California and New York.

Being a caregiver for a parent with schizophrenia is especially challenging for all the reasons you shared. It can be considerably harder when that parent isn't taking medications and, based on your description of your mom, it doesn't sound to me like she is doing so.

I am in agreement with you and think that it's time to explore whether your mom would meet the criteria for having a guardian/conservator (i.e. someone to manage her financial and medical affairs). However, this usually requires a psychiatrist's evaluation and I am assuming she would be opposed. If that is correct, I would suggest the following two steps:

1)Put everything that you've shared in your question here about your mom's behavior and your concerns in writing and send it via fax to each of her doctors and keep a record. This is valuable information and they should act on it.

Many times family members feel powerless because their loved one doesn't want the communication to take place and there is much to be said for respecting those boundaries in situations where there is no risk to a person's health and/or well-being. However, in your mom's case just the opposite is true and I think that it's necessary for you to intervene. Remember that the doctor(s) may not feel comfortable sharing information with you about your mom because of the HIPAA law, but there is nothing to stop you from sharing information with them.

I would do this soon and indicate your interest in having her competency evaluated, then see what response you get. He or she may be willing to make a referral to a psychiatrist and if you're lucky, maybe even work with you on how to roll this out to your mom (i.e. perhaps the doctor would be willing to leave you out of it entirely and say that it is his/her idea for X reason). If your mom trusts this person, this may work. If you don't get a response from her doctor(s)or the response is not sufficient, I would suggest proceeding to step #2.

2) Call Adult Protective Services [APS] in your mother's home town. This can be an anonymous call if you'd like, but most important is again that you share your concerns and the behaviors you're seeing as well as her diagnosis. In some states, APS is able to send a psychiatrist to the home to evaluate competency and if she were to be declared incompetent, the agency would start the process of guardianship/conservatorship then. My fingers will be crossed that your mom's state is one of those, but you won't know until you ask.

Beyond these suggestions for your mom, I think a support group for you may be a very helpful thing to find. One thing I can promise you is that you're not the only daughter caring for a mentally ill mother; support does exist. The National Alliance on Mental Illness is a great resource for this. Their web address is: www.nami.org.

All the best.