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How do I deal with her anger and the horrible things she says to me when she is in a psychotic moment? It is taking a toll on me emotionally. Any coping tips?

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I would consult with her doctors about this. Tell them what you’ve told us, that Mom’s mental issues are stressing you to the limit and it’s becoming impossible for you to deal. It worries me that Mom may become physical and injure you or herself. They may suggest she go somewhere that she can be cared for. I know that my doctor recommended a therapist for me, but like your mom’s doctor, she said it would take months to get an appointment. I was able, on my own, to find a therapist who takes my insurance and could get me in the following week.

If that’s not possible, see if you can get home health care to give you a break during the day. But, I’d start with her doctor and tell them their recommendation is not working out for you and you need another option.
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What is your mother's doctor's plan for immediate and short-term treatment?

It is, obviously, not acceptable for psychosis to go untreated for two months. If he really thinks she is having a psychotic episode he needs to act.
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I don't think that leaving psychosis untreated is a good plan.

Do any of your close by University Hospitals have a psychiatric ER? Or a Senior Behavioral Unit? I would get her into one for inpatient treatment the next time she loses contact with reality.
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When the mental health portion of my insurance told me that (after the first visit), the therapist I just saw wasn't available....for more than 5 months, I was amazed! Then why did you book me with her? One visit is barely getting started. She recommended a psychiatrist, who put me on mind altering meds that I stopped after 3 days. It was their way of "taking care" of me without actually having talk therapy. It didn't work for me, I questioned further. They recommend an "outside the plan" group that they subcontract with.
Is there a way your mom could be referred to another "out of group" psychiatrist? It would be worthwhile to ask, especially since the wait is so long.

Surely, the primary doctor can call a geriatric psychiatrist for a medication recommendation while she's waiting.

This is a last resort. When a psychotic episode is starting, take your Mom to ER. You can say she threatened to hurt you. They will have to deal with it and probably medicate her and order a referral. Refuse to take her home because she has threatened to hurt you and you are scared of her. Get the hospital social worker involved. She'll be the one to find temporary placement in a psych facility. Agree to the facility being in the next town, if you're ok with that.

I'm so sorry. I remember when my Mom would hit, spit, scream and fight during her stay with us. She's on a bunch of meds now and is much more calm. If nothing else, the primary MD can at least prescribe some anti-anxiety meds to level her out.

I'm sorry for your situation. Many of us can relate.
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Take her to the ER. They will have someone to do a basic evaluation. If she is having a psychotic episode they will refer to a provider who can see her quickly. If it is a severe episode they may admit her further evaluation and medication management.
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Thank your for all of your advice, it has been very helpful. I am in contact with her sister who is a nurse and we are making arrangements. I'm not afraid of her hurting me (she's way too frail) it just the emotional toll from the things she says. She has a rather sharp tongue, always has.

Unfortunately we live in a rather remote area and choices in doctors are limited, especially for Medicare recipients. There just isn't enough money to attract the best and brightest. Looks like we are going to have to wait for the referral unless my Aunt can pull some strings.

I just can't believe that the doctor isn't being more proactive about all of this. Although to be fair, my Mom can put on a pretty good show of being "normal" when she has to.
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How far are you from a larger or major metropolitan area where there are more doctors to choose from? Two months' wait is to me unacceptable, and irresponsible. I think the referring doctor could be much more proactive and find someone. That's what the greatest doctors we've had would do.
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We are about 35 miles from a bigger city but the doctors here don't (won't) refer to those doctors as they are in a different state. The hospital in our area has a lock on the medical care here and she would have to change doctors. If she did that and had to be transported, she would go to a hospital where her doctor has no privileges. Its a catch 22........

One thing we did learn yesterday is that she has a UTI. Hopefully clearing that will help some of this.......She is on day one of treatment for that.
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We went to the ER yesterday. The final straw was Mom letting her beloved dog out a door to the yard with no fence and the dog getting lost at 5 in the morning. My lab and I found her and brought her back. Mom was totally disoriented and confused about the house we've lived in for 13 years.

After an evaluation, she was admitted to psych. As of this morning in not sure where we are at. I called her and she was distraught and crying saying she was in prison. I reassures her that we are just trying to get her well. I can't visit her until this evening. I hope she can be helped. This is so hard.
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Issy, if you have to change doctors and get away from the one who can't refer to a psychiatrist who can see your mother in less than 2 months, perhaps that's a good move to make.

With some doctors having a monopoly, I think finding others might be a good consideration.

But I'm so sorry to learn about your mother's distressing situation. Please let us know how she is after your visit this evening.
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Issy, I'm sorry that your mom is in such distress. One thing about doctors and privileges? All hospitals in my area have hospitalised these days. Even if your dr. has priveleges, you only see the hospitalist.
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We have spoken about changing doctors.......we will see where we go from here. I was so shocked to learn about primary doctors not being able to admit a patient! I felt like we had to tell our story a hundred times to get any response!

The psychiatrist was wonderful. He said she has some residual frontal damage from a stroke she had 5 years ago which made her susceptible to depression. The depression intensified and created the fibromayalgia symptoms she was having which resulted in the prescription of Lyrica.....since fibro wasn't the issue, the depression continued to worsen until she wasn't sleeping. Sleep deprivation + depression + residual stroke damage equated to "pseudo-dementia". He told us that if we wouldn't have gotten her in when we did, we probably would have lost her. Scary stuff!

Anyway had a wonderful visit last night. She was more herself, cheerful, and clearer of thought. Huge relief. She will be there for a week or so and then be able to come home. Psychiatrist is working on a drug plan for her and is confident she will be fine. She has to do a lot of work as she is in the psych ward but I think its been good for her. She has therapy, group sessions, coping sessions and the regime is very structured. She is doing well. He said no sign of dementia or Alzheimers and she will respond to treatment quickly.

So now I find myself with 4 days all to myself as my husband and son are going camping. I was going to go, but I need to stay close in case something happens with Mom. I'm exhausted!
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I have been visiting Mom each evening. Visiting hours are very strict right now. While her demeanor is improved and she's more cheerful, she is still exhibiting concerning issues. She tells me they are taking blood several times a day, wake her up at midnight to give her lunch, saw the walls and move the rooms around in the middle of the night and that she has a roommate. None of these things are true. The doctor is doing his best to adjust medications but it looks like I may have to place her in dementia care. I don't even know how to feel. I'm sad and grieving someone who is still alive.
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Thank-you for the updates.

I am sorry things are hard for your Mom. Thank goodness you were able to get her the right medical care. I hope they find the right medication mix and that she keeps improving!
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I'm glad to read this update, too. Thanks!
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{{{Hugs}}} Issybeau
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if there is any excuse to call her behavior an emergency, take her to the ER for a psych eval and possible hold.
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Get that doctor that has referred your mom two months away to a psychiatrist for PSYCHOSIS to prescribe her a tranquilizer. These docs have no heart. Two months is a long time.

OR get her into Geri Psych unit in a hospital sooner by a dramatic visit to the ER. Is she a danger to herself or others? Say yes.
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Mom was admitted on the 23rd. Since then her condition has deteriorated considerably. Her stories no longer make sense, she thinks she's in Canada, her memories are all jumbled together and she no longer thinks about changing her clothes or taking a shower.

It almost makes me sick to my stomach to visit and talk to her. I just almost panic and want to run from this person that I don't recognize!

We are still in limbo due to the holiday weekend. I'm pretty sure I will have to place her somewhere but it will be good to get her out of the psych ward........
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Issy, have they done a urine culture to find out what organism caused the UTI, and if she's on the proper med for it?
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They have. Now just waiting for the doctor to check her today. He's been gone over the holiday weekend.
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