Expert: Joyce A. Anthony - 5/25/2007

Question
Hi there,
My mom who will be 65 this year has been living with bipolar for many years.(I am 39 years old and have a husband and a small child at home.)  Her first major episode that required hospitalization was in 1986 and it seems as she gets older her hospitalizations have been more frequent.  She never volunteers to go to the hospital and also never admits when she is manic.  She becomes extremely paranoid, thinks she can tell the future, scream and yells at people, and typically destroys her home.  This last significant event happened over several months (2005-2006), she was blue-papered 3 times until finally before the third time she truly destroyed her home,I had to call the police to force her to the hospital and eventually she ended up in a very good psychiatric facility for a few weeks and eventually was back on track. However because of this episode she was evicted from 2 apartments, had to declare bankruptcy, stopped paying her bills, shut off her power, and destroyed all her belongings in her apartment.  I, again, was there to pick up the pieces and get her back on track. I had to miss time from work, and just the trauma of what I saw in her house and had to clean up haunts me to this day.   She now is in another episode, and has cut off her ties to me. (We always would talk at least once a day and touch base.)  This has not happened in a few days.  She lives in a secured apartment building that I have no access to.  She lives alone.  And frankly I can't get myself to go to her house to see what she is doing for fear of what I will walk into.   I have one sister who is more fed up than I am.  We have one other relative who wants nothing to do with my mother and two of her brothers live out of state. They will call her but that's the most they will do.    Frankly I'm tired.  I worry to the point that it effects my home and family life. I have contacted her psychiatrist twice this week (left a message) letting him know  that I felt she was decompensating and when she shut off her cell phone and home answering machine, it's just the typical scenario that the worst is yet to come.  I guess my question is, when is it ok to say I've done what I can do. I can't control the outcome and whatever happens, happens.  She has never been suicidal so I don't worry about that.  What I worry about is the embarrassment I face when she becomes a public nescience.  When I start getting calls from family members giving me the blow by blow account of their interactions with my mother and her very crazy talk and behavior my nerves just take over.    I can't go through this again.  I really want her to find her own way this time.  Please help.
Thank you.  

Answer
Tina:

What you are asking is more a moral issue in that you have to search within yourself to know when you are ready to walk away or even if you can do so without remorse. Many of the homeless come from situations such as this.  Bipolar disorder is hard on everyone involved with the person suffering the disorder.

I do have a couple of suggestions that might help with the situation - although they also are hard choices.

You could talk with your relatives and see if there is a way you can have a visiting nurse check with your mother on a regular basis.  They have medical and housekeeping help in many home health care agencies and it is possible your mother may even qualify for help paying.

Another option would be to try and have your mother legally declared incompetent.  If you could do that and be appointed guardian, it would be possible to have her either admitted to a long-term mental care facility or a nursing home.

A final option would be to contact local mental health facilities and see if they have any "halfway" type housing for such patients.  These usually consist of five or six people with emotional problems and a staff of one or two counselors to help with things like shopping and outbursts.

I wish the answers were cut and dried, but situations like this are never easy.  Search within your heart and see if the answer is there.  
                    Joyce A. Anthony